[Biokinetics of tumor-affinity yttrium preparations--2]

After demonstrating that the application form 87Y-NTA-EDTMP-Ca is superior to the so far used citrate form of yttrium especially regarding the tumour/liver and tumour/bone ratios, the relationships between the concentrations of the components in the 87Y-NTA-EDTMP-Ca mixture and the 87Y biokinetics were investigated in tumour-bearing mice. The increase of the EDTMP and Ca2+ concentrations by several orders of magnitude caused no significant changes of tumour radioactivity but a clear radioactivity decrease in the liver, spleen and bone, respectively. The increase of the NTA concentration led also to a radioactivity decrease in all organs and tissues investigated. A significant radioactivity reduction in the tumour could be observed only after administration of rather high NTA amounts. Considerations of the tumour/background ratios depending on different compositions of the injection mixture showed the possibility of optimizing radionuclide biodistribution.

Blood biochemical profiles in induced aflatoxicosis of cockerels

1. Experimental intoxication induced in cockerels with varying doses of aflatoxin fed at the rate of 2.5 micrograms, 5.0 micrograms, and 10.0 micrograms per g of food resulted in appreciable changes in blood biochemical profiles. 2. At all doses the aflatoxin caused decreases in serum total proteins, albumin: globulin ratio, serum total cholesterol, serum calcium and phosphorus and increase in serum globulins, alanine amino transferase (ALT) and aspartate amino transferase (AST) concentrations. 3. No changes in serum bilirubin were observed. 4. Possible mechanisms for such blood biochemical changes are discussed and related to liver cellular damage caused by the aflatoxin toxicity.

[Biokinetics of tumor-affinity yttrium preparations--Part 1]

Differences of yttrium biokinetics after application to male tumor-bearing mice of 87Y-citrate were studied in comparison to a 87Y-NTA-EDTMP-Ca mixture after variation of both the manner of application (intraperitoneal vs. intratumoral) and the tumor type (mamma carcinoma vs. melanoma). The application of 87Y as NTA-EDTMP-Ca preparation led--in comparison to the citrate form applied so far--to a similar radionuclide tumor accumulation and distinctly lower extratumoral radioactivities in liver, spleen and skeleton with clearly more favorable tumor/background ratios. Melanomas showed a significantly higher radioactivity accumulation (factor 2-3) after injection of 87Y-NTA-EDTMP-Ca than mamma carcinomas. Intratumoral application led to high initial radioactivities in the tumors. Radioactivity concentrations which are comparable with those after intraperitoneal application were achieved within 4 h after intratumoral application. The application of the EDTMP-containing mixture promises in comparison to the traditional citrate form higher radiation doses in the tumor related to the whole-body radiation exposure. The consequences for a possible tumor therapy will be further investigated.

An activity gel assay for the detection of DNA helicases and nucleases from cell-free extracts

An activity gel assay was developed for the detection of DNA helicases in crude extracts. The assay was based on the ability of DNA helicases to unwind radioactive fragments from single-stranded M13 circles that were immobilized in an SDS polyacrylamide gel. The displaced radioactive strands were detected by blotting them to a filter and visualizing the resulting bands by autoradiography. Experiments with purified proteins demonstrated that DNA helicases, endonucleases and exonucleases could produce activity bands. A one-dimensional gel assay was sufficiently sensitive to allow detection of DNA helicase I, DNA helicase II, DNA helicase IV, the RecQ helicase as well as 3 unidentified putative DNA helicases in crude extracts of Escherichia coli. Exonuclease and endonuclease activities from crude extracts could be distinguished from DNA helicase activities by their ATP-independence and from each other by their band morphologies.

[Long term biokinetics of 169Yb following injection as citrate, hydroxyethylethylenediaminetetraacetate and nitrilotriacetate]

169Yb complexes with known biokinetics in tumour-bearing mice up to 48 h p.i. were injected into healthy mice to study the radionuclide biodistribution in various organs and tissues for 672 h after injection, in order to obtain reliable biokinetic data in an animal model, not affected by tumour-growth, as a basis for the calculation of biological half-life and dose distribution. The results demonstrated the existence of at least two components with different biological half-lives in the organs and tissues investigated. The effective half-lives of these components decreased with increasing stability of the complexes administered. The effective half-life of the fast component was a few hours and that of the slow one between about 200 and 800 h.

[The effect of ethylenediaminetetramethylenephosphonate on the biodistribution of tumor-seeking radionuclides]

It is well known that after application of radioactive complexes for tumour diagnosis or therapy, such as 67Ga-citrate or radiolanthanide complexes (167Tm- or 169Yb-nitrilotriacetate, -citrate, -alpha-hydroxyisobutyrate, 90Y-citrate, etc.) activity is accumulated not only in the tumour but also in other organs, above all liver and bone. This is the main obstacle to their medical use. Recently published results encouraged us to use ethylenediaminetetramethylene phosphonate (EDTMP) for the reduction of extratumoural liver activity. The results show that even small amounts of EDTMP (1-2 mg/kg BW) reduce the activity deposition in the liver by about one order of magnitude. EDTMP provoked elimination of activity from tumour, skeleton and other tissues but not to the same extent as from the liver. Tumor/liver activity ratios > 5 are achievable in this manner.

[The effect of bone-seeking metal salts on the biodistribution of tumor-seeking heavy metal complexes]

This work attempted to overcome the problem of unwanted bone radioactivity after injection of tumour-affine heavy-metal compounds (prototype 169Yb-citrate) by pre-application of stable yttrium- and calcium-compounds into tumour-bearing mice in doses of 1 mg metal/kg body weight. The pre-application of stable yttrium and calcium resulted in a smaller bone radioactivity. The most favourable results were achieved by injecting the metal salts simultaneously at or within 5 h before the 169Yb-citrate. On the other hand a strong radioactivity increase in the RES (liver and spleen) by a factor of 2 to 4 was observed after yttrium-preapplication.

Diagnostic significance of T I < T III and TV1 > TV6 signs in ischaemic heart disease

One hundred seventy patients with ischaemic heart disease (IHD) and 141 healthy controls were evaluated to assess the diagnostic significance of T I < T III and TV1 > TV6 as compared to widening of QRS-T angle. Number of cases with abnormal widening of QRS-T angle was significantly higher (P < .001) in frontal and horizontal planes in the IHD group. T I < T III sign has 61.2% sensitivity, 74.5% specificity and 25.5% false positivity in diagnosis of IHD. Along with abnormal QRS-T angle widening it gave a specificity of 95.5% but a false positivity of 35% and a low sensitivity index (35.3%). TV1 > TV6 sign has sensitivity, specificity and false positivity of 72.9% 84.4% and 15.6% respectively. Combining it with abnormally wide QRS-T angle did not materially improve these indices. Combining T I < T III and TV1 > TV6 signs gives a sensitivity of 49.4%, specificity of 95% and false positivity of 5% in IHD. This is a good diagnostic index and can be assessed at a quick glance without cumbersome estimation of QRS-T angle.

[The effect of Ca-diethylenetriamine pentaacetate on the bio-behavior of tumor-affine metal complexes]

The complexon CaDTPA was injected into tumour-bearing mice in concentrations of 0.05, 0.1, 0.3, and 0.6 mole/l (pH:6) 30 min after the 169Yb-injection. 100 microliters of a 0.3 M CaDTPA solution were injected at different time points (simultaneously, 2, 5, 10, 20, 30, 40 and 50 min, 1, 1.25, 1.5, 2.5 and 10 h) after 169Yb-citrate injection. The animals were killed 24 h after radionuclide administration. A strong radioactivity decrease was observable 24 h p.i. not only in blood, liver, spleen, muscle and bone but also in the tumour if CaDTPA was administered within the first 2 h after ytterbium injection. Thereafter no change in radioactivity could be achieved by DTPA. A time phase in which the Yb could be eliminated from the tissues by means of DTPA (time intervals < 2 h) was distinguishable from a time phase in which it was not attainable for DTPA (time intervals > 5 h). This indicates that the incorporation of Yb into the cells is completed after 5 h and that the metals are intracellularly bound, probably to the lysosomes. Improvements of the scintigraphic tumour detection cannot be expected from the use of complexons.

Capillary zone electrophoresis in pharmaceutical analysis

The paper presents a brief characterization of capillary zone electrophoresis, a modern analytical separation method with high expediency for practical applications, especially in pharmaceutical analysis. Basic theoretical considerations are presented and discussed to explain the effects of the operational parameters upon the separation efficiency and resolution of species. Descriptions of simple instrumentation and of the analytical procedure itself are given. Experimental examples are given of the separation of mixtures of pharmaceutically important compounds and of the effects of operational parameters, especially pH of BGE and voltage applied. Lastly, the practical application of CZE for analysis of isoxsuprine in commercial preparations is shown.

Dermatitis artefacta

Dermatitis artefacta is an uncommonly encountered condition. This paper presents a case report of two such rare patients. The symptomatology and history of fourteen and sixteen year old males with dermatitis artefacta are described. Possible psychophysiological aetiology of the cases is discussed.

Complete intraventricular dissociation. Electrocardiographic manifestation of a rare intracardiac complete dissociation

Complete Intraventricular Dissociation manifesting as dual ventricular rhythm was observed on surface electrocardiography in two middle-aged males with acute myocardial infarction. The first patient had a dominant accelerated (AV) junctional rhythm, and there was a sudden emergence of an additional independent slow and regular idioventricular escape rhythm. These ventricular complexes were bizarre and markedly widened, waveform with prolonged undulating electric potentials. In the second case, the emergence of a dominant idioventricular rhythm was coexistent with an additional independent escape rhythm with monophasic wider agonal ventricular complexes. Terminal tracings recorded later were essentially the same, except that an ill sustained ventricular fibrillation had replaced the ectopic agonal beats, and there was an enhanced automaticity in the dominant ventricular part. The sites of ectopic ventricular rhythms were thought to be in the ischaemic damaged ventricular myocardium, with a surrounding zone of conduction block.

Uptake of 67Ga-6-mercaptopurines in Morris hepatoma-3924 A

67Ga-chloro-6-mercaptopurine and 67Ga-citrato-6-mercaptopurine complexes have been prepared and their distribution in Morris-hepatoma-3924 A-bearing rats studied. The tumour affinity of the gallium-67 compounds varies in the order: 67Ga-chloro-6-mercaptopurine greater than 67Ga-citrato-6-mercaptopurine greater than 67Ga-citrate greater than 67Ga-chloride.

Effect of aluminium impurities in the generator-produced pertechnetate-99m ion on thyroid scintigrams

Cases of reduced uptake of pertechnetate-99m ion in the thyroid gland due to the presence, in the injected solution, of aluminum species at concentrations higher than 4 microgram/cm3 are reported. This inconvenience can be avoided either by injecting chromatographically pure pertechnetate-99m ion or by allowing the eluate of high aluminium content to stand for about 4 h.

Treatment of pathological fractures of long bones excluding those due to breast cancer

Seventy-two pathological fractures associated with tumors other than carcinoma of the breast in the long bones of the extremities of sixty patients were treated over a five-year period at Roswell Park Memorial Institute. Pain was relieved in 91 per cent of the patients treated by internal fixation, in 59 per cent of those treated by irradiation, and in 45 per cent of those treated by other means. Among patients with lower-extremity fractures, 61 per cent of those treated by internal fixation became ambulatory, whereas only 23 per cent of those treated by other methods were able to walk. Internal fixation of these pathological fractures appeared to be the best treatment.

Primary neoplasms of the duodenum

The records of 12 patients with primary malignant neoplasms of the duodenum, excluding ampullary lesions, have been studied. There were eight adenocarcinomas and four leiomyosarcomas. The second portion of the duodenum was the most common site for these neoplasms. Common symptoms were epigastric pain; obstructive symptoms, such as nausea and vomiting; obstructive jaundice, and hematemesis. Hematemesis is the most common symptom in leiomyosarcoma of the duodenum. The mean duration of symptoms was six months for leiomyosarcoma and 3.2 months for adenocarcinoma. In five patients, excision of the tumor was carried out more frequently for those in the distal portion of the duodenum. More radical procedures, such as pancreaticoduodenectomy, are the treatment of choice in neoplasms of the second portion of the duodenum. A bypass procedure is done for palliation of intestinal obstruction. Three patients with leiomyosarcomas that were resected had a mean survival time of 51 months. On the other hand, patients with adenocarcinomas that were resected had a mean survival time of nine months, while patients with unresectable tumors had a mean survival time of 2.3 months.

Extended therapy of stage D carcinoma of the prostate with oral estramustine phosphate

We treated 50 patients with stage D carcinoma of the prostate with 15 mg. per kg. per day oral estramustine phosphate for 3 to 24 months. We are able to evaluate 44 patients. Objective remissions were induced in 8 of the 44 patients (19 per cent) and subjective remission occurred in all objective responders and in 7 additional patients for a subjective response of 15 of 44 (36 per cent). No hematologic or renal toxicity was encountered. Transient nausea occurred early in half of the patients and was dose limiting in 3 patients. One case of hepatic toxicity was seen. Oral estramustine phosphate is well tolerated and long-term therapy is feasible.

Splenectomy or radiation and splenectomy for hypersplenism in lymphosarcoma

This is a retrospective study of 14 patients with lymphosarcoma with hypersplenism. Eight patients received radiation to the spleen followed by splenectomy for recurrence of hypersplenism. Six patients underwent primary splenectomy for hypersplenism. Radiation decreases the size of the spleen but recurrence of hypersplenism is seen in an average of 8 mo. Splenectomy in these cases improves the hematological picture. Average postsplenectomy survival is 27.6 mo. Splenectomy alone in hypersplenism also improves the hematological picture. Postsplenectomy survival in this group is 13 mo. One case of primary lymphosarcoma of the spleen is reported.

Comparative evaluation of serum acid phosphatase, urinary cholesterol, and androgens in diagnosis of prostatic cancer

Serum acid phosphatase activity, urinary total cholesterol, and ratio of deoxy to oxy urinary 17-ketosteroids were measured in a group of 42 patients with prostatic carcinoma and in a group of 14 age-matched normal healthy individuals. Our purpose was to evaluate whether or not the simultaneous determinations of these tests would increase the rate of detection obtained by the single assay alone. The results of single assay revealed for the following detection rate: 67 per cent (28 of 42 patients) for serum acid phosphatase, 62 per cent for urinary total cholesterol, and 22 per cent for ratio of 17-ketosteroids. A significant increase of detection rate was observed when simultaneous determinations of two assays were performed; 86 per cent for serum acid phosphatase activity and total urinary cholesterol; 74 per cent for serum acid phosphatase and ratio of 17-ketosteroids; and 74 per cent for total urinary cholesterol and ratio of 17-ketosteroids. A detection rate of 88 per cent (37 of 42 patients) was obtained as all three assays were analyzed, though it was not significantly different from a ratio of 86 per cent for simultaneous assays of acid phosphatase and total cholesterol. It was concluded that simultaneous determinations of serum acid phosphatase activity, urinary total cholesterol, and androgens are of values in diagnosis for patients with prostatic neoplasia.

Heparin and chemotherapy in the management of inoperable lung carcinoma

Twenty-eight patients with inoperable or metastatic carcinoma of the lung who failed to respond to conventional chemotherapy and/or radiotherapy were entered in this study. All of them received repeated courses of multiple chemotherapy (cyclophosphamide, 5-fluorouracil, 6-thioguanine, methotrexate, and vincristine) with or without concurrent intravenous heparin anticoagulation. No tumor regression was noted in any of the 14 patients who received the multiple chemotherapy only. On the contrary, tumor progression was seen in all of them, and subsequently 12 died of their disease. The other 14 patients were anticoagulated with heparin, then received the same multiple chemotherapeutics while anticoagulated. Over 50% tumor regression was noted clinically and radiologically, and occasionally demonstrated histologically in 7 of them. Two patients in this group are alive and well for 1 1/2 years. No increase in toxicity or metastases was noted. The 2 patients who had progression of their disease while on the multiple chemotherapy program alone showed tumor regression when they received the same chemotherapy after heparinization.

Oral estramustine phosphate (NSC-89199) in the treatment of advanced (stage D) carcinoma of the prostate

Thirty-two patients with stage D carcinoma of the prostate were treated with oral estramustine phosphate at a dose of 15 mg/kg/day from 3 to 15 months. Objective remissions, reduction of greater than 50 percent of measurable lesions such as soft tissue masses, lymph nodes, and prostatic masses, were seen in seven of 32 patients (22 percent response rate). Subjective response, ie, relief of pain, weight gain, sense of well being, snd improved performance status, occurred in all objective responders and in seven other patients with stable disease (15 of 32 patients = 47 percent). No hematologic, hepatic, or renal toxic effects were observed. Transient nausea occurred early in one half of the patients and nausea and vomiting was dose limiting in only two patients. Oral estramustine phosphate is well tolerated and worthy of further clinical use.