Evidence for capillary leakage during chemotherapy in man

The influence of intensive chemotherapy with high dose VP 16-213, cyclophosphamide and autologous bone marrow transplantation on transcapillary escape rate of albumin was evaluated. Transcapillary escape rate and plasma volume were measured with 131I-labelled albumin. Measurements were performed 1 day before (T0), 1 week after (T1) and 2 weeks after (T2) start of chemotherapy. Before therapy TER (n = 7, means = 7.1% h-1) was already raised in patients compared to controls (n = 5, means = 3.8% h-1, P less than 0.025). No difference was found for transcapillary escape rate on T1 (n = 9, means = 7.6% h-1) compared to T0. There was an increase of transcapillary escape rate from T0 to T2 (n = 8, means = 9.5% h-1, P less than 0.05). Plasma volume did not change during therapy. Serum albumin concentrations were reduced before chemotherapy (means = 38 g 1(-1] compared to controls (means = 44 g l(-1]. After 1 (means = 34 g 1(-1] and 2 weeks (means = 31 g 1(-1] these concentrations decreased further. The same was found for intravascular mass of albumin related to body weight. The intravascular mass of albumin/bodyweight and the transcapillary escape rate are related in the patients (r = -0.477, P less than 0.01) and the patients plus controls (r = -0.585, P less than 0.001). This means the higher the transcapillary escape rate the lower the intravascular mass of albumin. No correlation between transcapillary escape rate and presence of fever was found. It can be concluded that intensive chemotherapy leads to further increase of an already elevated transcapillary escape rate for albumin.

Gold-195m, an ultra-short-lived generator-produced radionuclide: clinical application in sequential first pass ventriculography

Gold 195m (Au-195m) has a half-life of 30.5 sec and can be produced at the bedside from the parent mercury-195m (T 1/2 = 41.6 hr). The generator produced sterile pyrogen-free Au-195m with mercury breakthrough of 0.75 +/- 0.09 (s.e.m.) muCi per mCi of Au-195m. Approximately 20 to 25 mCi of Au-195m was produced per elution from a generator containing 155 mCi of Hg-195m. We compared first-pass resting Tc-99m angiograms with Au-195m angiograms in 28 patients. The correlation coefficient between the two studies was 0.92 over an ejection-fraction range from 0.22 to 0.83. In addition, we tested the reproducibility of Au-195m first-pass angiograms by performing two studies 3 min apart. In 25 patients with ejection fractions ranging from 0.20 to 0.78, the correlation coefficient between such pairs was 0.93. The nuclide is reliably and reproducibly produced, and its short half-life allows the performance of background-free sequential first-transit studies with unusually low radiation exposure to the patient.