A pilot study of 131I monoclonal antibodies in the therapy of leptomeningeal tumors

A pilot study was performed to investigate the toxicity and therapeutic effect of radiolabeled antibody administered intrathecally in patients with leptomeningeal tumors. Five patients who failed conventional therapy received between 11 mCi and 40 mCi of radiolabeled antibody. The choice of antibody varied depending on the immunophenotype of the tumor. Therapy was well tolerated generally, with minimal acute toxicity. Four of five patients achieved an objective response to treatment that has been sustained for a period varying from 7 months to 2 years. No clinical signs of chronic toxicity have been observed in patients 1 and 2 years after therapy.

Neoplastic meningitis from a pineal tumour treated by antibody-guided irradiation via the intrathecal route

A monoclonal antibody (UJ181.4) was labelled with 131I and given intrathecally to a patient who was critically ill with neoplastic meningitis due to a disseminated pineoblastoma. The target antigen had first been demonstrated on tumour cells by immunocytological testing of cerebrospinal fluid (CSF). As a preparation for therapy, a test dose of 131I-UJ181.4 antibody was given simultaneously with a control antibody labelled with 125I. Good evidence of in vivo immunolocalization was obtained by external gamma counting and by analysis of the radiolabels on centrifuged CSF cells. Specificity ratios of between 10:1 and 20:1 were obtained by these methods. A single relatively small therapeutic dose of 131-I (870 MBq) given by the intrathecal route, resulted in a marked clinical improvement and sustained remission for 22 months.

Chordomas--ultrastructure and immunohistochemistry: a report based on the examination of six cases

Six chordomas (three classic and three chondroid) were examined ultrastructurally and with a panel of monoclonal antibodies. The three classic tumours showed the presence of desmosomes and intermediate filaments on electron microscopy, findings which gave a direct positive correlation when the tumours were stained with monoclonal antibodies against low molecular weight cytokeratin proteins. These results suggest that chordomas are essentially epithelial neoplasms and underline the fact that monoclonal antibodies to cytokeratins cannot be used in the differential diagnosis of classic chordoma vs carcinoma. Furthermore, the epithelial characteristics are lost as the tumour undergoes chondroid differentiation.

Radioimmunolocalization of human brain tumours: biodistribution of radiolabelled monoclonal antibody UJ13A

Monoclonal antibody UJ13A, radiolabelled with 131I, was intravenously administered to patients with primary brain tumours. The antigen recognised by UJ13A is present on most neuroectodermally derived tissue. The ratio of uptake in tumour to normal brain, assessed by scintigraphy, improved with time. Maximal tumour uptake occurred between 4 and 48 h. Dynamic and static scintigrams indicated some early sequestration of radiolabelled antibody by the liver. Tumours were surgically resected in seven patients at various intervals after antibody administration showing tissue to blood ratios increasing with time in all parts of the lesion (viable and necrotic tumour, cyst fluid), and in normal brain. The highest tissue to blood ratio in viable tumour was 5.1 at 16 days after injection. In tissues resected 2-3 days after injection there was relatively greater uptake in the viable tumour compared to necrotic tumour and cyst fluid. In contrast, tissues resected later (6-16 days) showed greater uptake in ischaemic tissue than viable tumour, suggesting diffusion was an important factor influencing tumour uptake. The amount of radioactivity per gram of tumour tissue was less than 0.005% of the injected dose. Future studies are needed using different antibodies, antibody fragments and additional methods of optimising delivery.

Effect of testosterone oenanthate on spermatogenesis and serum testosterone concentrations in adult mice

Administration of 80 or 160 micrograms testosterone oenanthate s.c. three times per week for 8 or 12 weeks reduced testis weight and increased seminal vesicle weight in mice. Radioimmunoassay indicated that treatment increased serum testosterone concentrations. Treatment with testosterone oenanthate decreased the number of step 16 and step 7 spermatids, pachytene spermatocytes and type A spermatogonia, and particularly reduced the proportion of step 7 spermatids which matured to form step 16 spermatids.

Effects of cisplatin on the mouse testis

This study reports the effects of cisplatin, an anti-cancer agent, on testicular function in mice. A single dose of 8 mg cisplatin/kg body weight administered to MF1 mice by an ip injection reduced the number of resting primary spermatocytes only. These cells decreased by 69% 3 days after treatment, 76% 4 days after treatment, 95% 5 days after treatment and 89% 6 days after treatment. Sperm motility was reduced by an average of 36% and the rate of testicular DNA synthesis by 36%. A body weight loss of 10% was also recorded. Cisplatin did not affect the rate of protein synthesis by the testis; nor was there a change in testicular protein, RNA and DNA contents. The weights of the testis, seminal vesicle and epididymis were also not affected by treatment. No significant change was noted in epididymal sperm number or in the proportion of abnormal sperm. Since cisplatin did not affect stem cell spermatogonia, there appears to be no danger of permanent sterility. The effect on spermatogenesis is probably transient and reversible after withdrawal of the drug.

Emotional difficulties in diabetes mellitus

Sixty children and adolescents with diabetes aged between 9 and 18 years were investigated for emotional difficulties in association with their diabetic control. Seventeen (28%) had appreciable emotional or behavioural difficulties according to parental report, and seven (12%) considered themselves 'possibly depressed'. These latter patients had a mean glycosylated haemoglobin concentration below 10%, poorer self esteem, and a greater external locus of control. Three were considered not to have pronounced emotional difficulties according to parental report.

An investigation into the effects of ketoconazole on testicular function in Wistar rats

Ketoconazole was administered orally to sexually mature Wistar rats and testicular function assessed. A single oral dose of 24 mg ketoconazole/kg body weight lowered plasma testosterone and DHT levels by 83 and 50%, respectively within 2 h, without altering gonadotrophin levels. Treatment for up to 7 days decreased epididymal sperm number and motility and increased the proportion of abnormal sperm. The sperm appeared to be most affected 3 days after a single dose of ketoconazole and recovery had taken place by the seventh day. Daily treatment for up to 90 days also decreased sperm number and motility and increased the proportion of abnormal sperm, but did not affect testicular germ cells. No significant change was noted in the weights of the testis, epididymis, seminal vesicle and prostate; nor was there a change in testicular DNA, RNA and protein contents. Although fertility appeared to be impaired by long-term treatment, some of the treated rats mated successfully.

Renal function in diabetes mellitus

Glomerular filtration rate, day and night-time albumin excretion, and blood pressure were estimated in 83 children with diabetes mellitus and compared with measures of glycaemic control, age, and duration of disease. Careful attention was paid to definition of normal values in age matched controls. The glomerular filtration rate was greater than normal, and correlated with duration of disease, but not with albumin excretion or blood pressure. Daytime albumin excretion correlated with duration of disease and glycosylated haemoglobin, but not with age, glomerular filtration rate, or blood pressure. Night-time albumin excretion was significantly raised and correlated with duration of disease, glycosylated haemoglobin, mean blood sugar concentration, and M value but not with age, glomerular filtration rate, or blood pressure. Diastolic blood pressure was significantly raised but was not correlated with any other measured variable. We have confirmed abnormalities of renal function in a children's diabetic clinic. The measurement of overnight albumin excretion rates may provide a sensitive early indicator of renal damage.

Continuous subcutaneous insulin infusion in diabetes mellitus. A year's prospective trial

Thirteen children aged between 8 and 16 years were entered into a 12 month prospective trial comparing continuous subcutaneous insulin infusion with intensified conventional treatment. Two of seven children on insulin infusion withdrew after eight and nine weeks, and three of six children on conventional treatment withdrew after four to eight weeks. Withdrawals in both groups were related to dissatisfaction with the techniques. The group on insulin infusion treatment achieved a mean plasma glucose of 9.8 mmol/l (176.4 mg/100 ml), a median M value of 50 mmol/l (900 mg/100 ml) and a mean glycosylated haemoglobin of 9.1% during the year. This represents a significant improvement compared with the previous values, and also when compared with the conventional treatment group whose trial values of a mean plasma glucose of 15.5 mmol/l (279 mg/100 ml), median M value of 167 mmol/l (3006 mg/100 ml), and glycosylated haemoglobin of 10.4% were not significantly different from those before the trial. Two children on insulin infusion developed subcutaneous abscesses in the early months. There was an increased incidence of diabetic ketoacidosis in this group, but no difference in the incidence of serious hypoglycaemia between the two groups. The children reported improved well-being when using insulin infusion and continued with the technique after the trial finished. Insulin infusion offers an acceptable means of improving glycaemic control for some diabetic children.

Urinary albumin excretion in school children

Concentrations of albumin were measured by an enzyme linked immunoassay in 24 hour urine collections (divided into day and night-time samples) from 183 boys and 191 girls aged 4 to 16 years. The 24 hour albumin excretion rate and day and night-time albumin excretion rates all increased with age in both girls and boys. Albumin excretion during the day exceeded that at night in both girls and boys. Albumin excretion rates were higher in girls than boys during the day but there was no significant difference at night-time. The urinary albumin creatinine ratio showed no change with age, but was greater in girls than boys during the day and at night, and was also greater during the day than at night in both sexes. Graphs of normal values of albumin excretion rates and albumin creatinine ratios are provided.

The estimation of serum guanosine deaminase activity in liver disease

An assay for the estimation of guanosine deaminase is described. The method employs guanosine as substrate and after incubation of serum and substrate at 22 degrees C for 18 h the ammonia liberated is estimated using the Berthelot reaction. Absorbance is measured as 625 nm and the catalytic activity read from a standard curve obtained using ammonia standards. The method provides reproducible measurements of serum guanosine deaminase. The results obtained using 'normal' sera have been used to calculate the 'normal range' for the enzyme in serum. Preliminary results suggest that guanosine deaminase is increased in hepatitis and in patients with liver metastases but normal in all other liver diseases including cirrhosis and obstructive jaundice.

Stimulation of transport of alpha-aminoisobutyric acid into the testes of immature mice in vivo by follicle-stimulating hormone

Groups of immature mice were injected sc with radiocarbon-labelled alpha-aminoisobutyric acid (AIB) after being given a single sc injection of hFSH or of 0.9% saline. As an index of the transport of AIB, the specific activity of isotope was measured in homogenates of testis and of liver. FSH treatment caused statistically significant increases in the specific activity of isotope in the testes and in the ratio of testicular to liver specific activity. The effect was greatest in 9-day-old mice injected with FSH 16 h before removal of the testes. Uptake of labelled AIB was not stimulated after administration of hCG or testosterone. Doses of cycloheximide sufficient to reduce the rate of protein synthesis by over 99% did not impair testicular uptake of labelled AIB or the influence of FSH on AIB uptake. These results suggest that FSH stimulates amino acid transport into cells of the immature testis and that this action is independent of the stimulatory effect of FSH on testicular protein synthesis.

Newborn transport in South Australia, 1978-80: experience of the Queen Victoria Hospital, Adelaide

389 infants were transported to the Queen Victoria Hospital, Adelaide between 1978 and 1980. Twenty-three percent (99) of the infants were ventilated, and 49% (189) received intravenous or intra-arterial therapy. Fifty-six percent (217) of the infants required transport because of prematurity; 11% (46) because of perinatal asphyxia in babies weighing more than 2,500 g. Only one baby died during transport, while 14% of the babies died subsequently. A core temperature of less than 36 degrees C in either hospital is important; a cold baby is 3.5 times more likely to die (X2=25.46, P less than 0.001). The transport of babies over distances greater than 300 kilometres is peculiar to Australia. Significantly more of these babies were cold than those retrieved from hospitals near Adelaide (X2=4.7, P less than 0.05), and significantly more died. Difficulty in transferring mothers in preterm labour may be another reason these babies did relatively badly. Better education and facilities will be important if we are to improve their survival chances.

Gamma ray inactivation of some animal viruses

Twenty samples of animal viruses comprising 14 different viruses in 12 families were subjected to varying doses of gamma irradiation from a 60Co source in a Gamma Cell 220 (Atomic Energy of Canada Limited) to determine lethal dose levels. The dose responses appeared linear throughout inactivation. The D10 values, that is the dose necessary to reduce infectivity by one log10, ranged from less than 0.20 Megarads to approximately 0.55 Megarads. There was not a complete inverse correlation between the target size (virion core) and the D10 value.

Potential of 5-thio-D-glucose as an agent for controlling male fertility

This paper reviews experimental work bearing on the feasibility of using the analog of glucose, 5-thio-D-glucose, to control human male fertility. The initial experiments in mice indicated that suitable oral doses of thioglucose caused reversible infertility unaccompanied by loss of libido or evidence of extratesticular toxicity. Subsequent work in mice and rats showed that treatment of 7 or 8 weeks appeared to cause irreversible sterility in many of the animals. In both species the smallest doses causing infertility also caused transient hyperglycemia. In rats a large dose of thioglucose was found to raise the concentration of nonesterified fatty acids in the blood and repeated smaller doses increased the excretion of catecholamines. These reports, suggesting that it can cause sterility and has extratesticular effects on metabolism, do not augur well for the acceptibility of thioglucose as a suitable chemical with which to control fertility in the human male.

Timing and localization of the stimulatory effect of follicle-stimulating hormone on uridine incorporation in the mouse testis in vivo

Human pituitary FSH increased the incorporation of [5-(3)H]uridine into RNA in vivo in the testes of intact 9-day-old mice and of hypophysectomized adults. In both groups the effect was greatest 8 h after administration of 5--7.5 i.u. FSH. Autoradiographs were prepared from the testes of hypophysectomized adult mice given subcutaneous injections of FSH or of 0.9% saline 6 h, and [5-(3)H]uridine 1.5 h, before death. Treatment with FSH caused statistically significant increases in the density of silver grains over the nuclei of Sertoli cells, type A and intermediate spermatogonia, and preleptotene and mid-pachytene primary spermatocytes. It was concluded that FSH has a generalized stimulatory action on RNA synthesis in the nuclei of Sertoli cells and those types of germinal cell which synthesize RNA most actively.

Autoradiographic study of lysine and arginine incorporation stimulated by follicle-stimulating hormone in the mouse testis in vivo

Hypophysectomized adult mice were given injections of highly purified FSH 12 h before killing, and of tritiated lysine or arginine 2 h before killing. Autoradiographs were prepared from paraffin wax sections of testes. Treatment with FSH increased the density of silver grains over the nuclei of the Sertoli cells and of all types of germinal cell except the early spermatids. The stimulatory effect of GSH on incorporation of both lysine and arginine was most marked in the nuclei of preleptotene primary spermatocytes. The ratio of arginine to lysine incorporation was greater in spermatids undergoing nuclear elongation than in other types of cell.

Carotid sinus hypersensitivity in patients presenting with syncope

In 23 patients (ages 44 to 81) presenting with syncope, vertigo, or transient amnesia, carotid sinus massage produced a significant bradycardia in association with symptoms. The 10 most severely symptomatic patients were studied electrophysiologically, including measurement of intracardiac conduction times and corrected sinus node recovery times, as well as with carotid sinus massage before and after atropine. The only detectable abnormality in five of this group was asystole produced by carotid sinus massage; the other five had, in addition, evidence of either sinuatrial disease or an intracardiac conduction defect. Cardiac pacing in these 10 patients completely abolished their symptoms. In a control group of 52 asymptomatic patients (ages 36 to 87), an abnormal response to carotid sinus massage was uncommon (2%).

Serum deoxycytidylate deaminase activity after myocardial infarction

The activity of serum deoxycytidylate deaminase, not hitherto reported to increase after myocardial infarction, has been investigated and the results have been related to other cardiac enzymes, including the MB fraction of creatine phosphokinase. Deoxycytidylate deaminase was found to increase to maximum activity on the third day after infarction. It may therefore be added to the list of 'cardiac enzymes.