Local microwave hyperthermia in the treatment of carcinoma of the prostate

The clinical electromagnetic hyperthermia system has been in use at the Kaplan Hospital since 1980, for treating patients with hyperthermia combined with radio- or chemotherapy. For prostatic tumors, hyperthermia at 43 degrees C is achieved in the prostatic mass using microwaves of 2.45 GHz, with simultaneous cooling of the rectal mucosa and the rectal wall. Thirty-two patients with carcinoma of the prostate have been treated: 4 with heat alone, 20 with hyperthermia combined with radiotherapy, and 8 with hyperthermia combined with hormonal therapy. Follow-up was carried out up to 34 months. Objective local tumor regression was achieved in 3 out of 4 patients treated by heat alone, but the patients relapsed after 6 months. All the 20 patients treated with combined hyperthermia and radiotherapy responded to treatment. Patients treated with combined hyperthermia and hormone therapy responded locally to treatment but died of their metastatic disease, or of unrelated diseases with a follow-up period up to 31 months. Hyperthermia did not increase morbidity beyond that expected for radiation therapy.

Generation of primary murine CTL specific for allogeneic and xenogeneic MHC determinants upon stimulation with murine L cells transfected with class I genes

This communication describes in vitro culture conditions that permit the use of MHC gene-transfected L cells as stimulators of primary CTL responses. The use of L cells as stimulators usually results in the generation of "nonspecific" anti-L cell cytotoxicity too great to permit visualization of antigen-specific CTL responses. This study demonstrates that the generation of such anti-L cell cytotoxicity can be abrogated by strategies that prevent the in vitro activation of self-Ia-restricted TH cells. These maneuvers allowed the use of L cell transfectants as stimulators of allospecific and xenospecific CTL precursors in primary in vitro mixed lymphocyte reaction cultures.

Generation of primary murine CTL specific for allogeneic and xenogeneic MHC determinants upon stimulation with murine L cells transfected with class I genes

This communication describes in vitro culture conditions that permit the use of MHC gene-transfected L cells as stimulators of primary CTL responses. The use of L cells as stimulators usually results in the generation of "nonspecific" anti-L cell cytotoxicity too great to permit visualization of antigen-specific CTL responses. This study demonstrates that the generation of such anti-L cell cytotoxicity can be abrogated by strategies that prevent the in vitro activation of self-Ia-restricted TH cells. These maneuvers allowed the use of L cell transfectants as stimulators of allospecific and xenospecific CTL precursors in primary in vitro mixed lymphocyte reaction cultures.

Localized deep microwave hyperthermia in the treatment of poor operative risk patients with benign prostatic hyperplasia

Non-invasive localized deep microwave hyperthermia was applied as an alternative treatment to surgery in 29 patients with contraindications for prostatectomy. Patients were treated twice weekly, on Mondays and Thursdays, for 1 hour, without sedation on an outpatient basis. All patients tolerated treatment well without secondary effects. The results indicate that localized deep microwave hyperthermia applied by this method is safe and effective in the treatment of benign prostatic hyperplasia.

Assignment of the porcine major histocompatibility complex to chromosome 7 by in situ hybridization

The major histocompatibility complex (SLA) of the domestic pig (Sus scrofa) was regionally mapped to 7p12----q12 by in situ hybridization with an SLA class I-specific recombinant DNA probe. This localization contradicts linkage data suggesting a possible assignment of the SLA locus to porcine chromosome 15.

Liver-spleen studies with the rotating gamma camera. II: Utility of tomography

A prospective comparison of conventional scintigrams and single-photon emission computed tomography (SPECT) studies of the liver and spleen was carried out. Care was taken to insure high-quality, artifact-free studies. Two hundred patients were imaged by both methods. A definitive diagnosis of normal was established in 86 cases, abnormal in 107 cases, and seven cases were indeterminate. All studies were read by two observers and graded as to degree and type of abnormality seen. ROC curves were constructed and errors of interpretation studied to identify problems. One observer showed no difference in performance between the two methods. The other showed a small improvement with SPECT. Image artifacts apparently contributed to errors of interpretation in 24 of 54 cases using SPECT. SPECT appears comparable with conventional scintigraphy and may improve specificity. Improvements are needed in SPECT imaging equipment and image display capability to realize fully the potential of SPECT.

Liver-spleen studies with the rotating gamma camera. I: Utility of the rotating display

The clinical utility of a computer-generated dynamic cine display (rotating display) of the unprocessed projection images of the liver and spleen obtained with rotating gamma-camera tomography was prospectively compared with that of the standard multi-view static scintigram display. Two hundred cases were independently and blindly analyzed by three observers. Each study was coded from 1-5, indicating the certainty of normality or abnormality present. When abnormality was noted, the study was assessed for the presence of metastatic disease, inhomogeneous uptake, hepatosplenomegaly, and colloid distribution shift. ROC analysis was then performed on the initial coding for certainty of abnormality, and the causes for discrepancies were evaluated from the assessment of the type of abnormality present. No significant interdisplay differences could be demonstrated. In the small percentage of cases where interdisplay disagreement occurred, this was usually accompanied by marked interobserver variation and was most commonly due to differing assessment of organ size. It is concluded that the static and rotating display formats can be used interchangeably in the evaluation of technetium-99m-labeled sulfur colloid liver studies.

Influence of hypocholesterolemic drugs on aortic cholesterol esterase in rabbits

We have studied the influence of three hypocholesterolemic drugs (Fenofibrate, Pirinixil and Probucol) on aortic cholesterol esterase (E.C.3.1.1.13) activity in cholesterol-fed rabbits. After three weeks, cholesterol-fed controls exhibited a 28% increase in cholesteryl ester synthetase activity (S) and a 13% decrease in cholesteryl ester hydrolase activity (H) giving a 47% increase in S/H ratio. None of the drugs influenced cholesterol-induced synthetase activity, but fenofibrate treatment increased hydrolase activity resulting in a fall in the S/H ratio to the level observed in rabbits fed corn oil but no cholesterol. The other two hypocholesterolemic agents did not affect the aortic S/H ratio.

Evidence that schistosome MHC antigens are not synthesized by the parasite but are acquired from the host as intact glycoproteins

Schistosoma mansoni schistosomula recovered from the lungs of mice have previously been shown to express serologically detectable products of the major histocompatibility complex (MHC). To determine whether these determinants are products of the schistosome genome, DNA from cercariae and adult worms of the parasite was probed with a 32P-cDNA clone encoding a human class I MHC antigen. Although this probe hybridized to mouse DNA, no hybridization was observed with DNA isolated from schistosomes, indicating that there are no DNA sequences homologous to class I MHC antigens in the parasite genome. The class I MHC antigens found on schistosomes were characterized in a further series of experiments. Two monoclonal antibodies known to recognize spatially distinct determinants of H-2Kk both bound to lung-stage schistosomula recovered from mice expressing this haplotype, suggesting that a significant portion of the H-2K molecule is present at the larval surface. Furthermore, both antibodies precipitated from lysates of 125I-lactoperoxidase-labeled lung-stage schistosomula, a molecule of approximately 45,000 daltons similar in mobility to H-2Kk precipitated from 125I-labeled mouse spleen cells. These results support the hypothesis that the class I MHC antigens expressed on S. mansoni are not synthesized by the parasite but are acquired from the host as intact glycoproteins.

Ultraviolet light, cataracts, and spectacle wear

Two groups of patients older than 60 years were examined for degree of development of nuclear sclerotic cataracts. The first group of patients had worn glass spectacles for a majority of their lives, while the patients in the second group had never worn spectacles or had worn only reading glasses. Subjects in the group with spectacles showed significantly less development of sclerotic nuclear lens changes. These findings may be due to the screening effect by spectacle glass of light in the ultraviolet range and suggest that uv light may be one of the risk factors in the development of nuclear sclerotic cataracts.

Evidence that schistosome MHC antigens are not synthesized by the parasite but are acquired from the host as intact glycoproteins

Schistosoma mansoni schistosomula recovered from the lungs of mice have previously been shown to express serologically detectable products of the major histocompatibility complex (MHC). To determine whether these determinants are products of the schistosome genome, DNA from cercariae and adult worms of the parasite was probed with a 32P-cDNA clone encoding a human class I MHC antigen. Although this probe hybridized to mouse DNA, no hybridization was observed with DNA isolated from schistosomes, indicating that there are no DNA sequences homologous to class I MHC antigens in the parasite genome. The class I MHC antigens found on schistosomes were characterized in a further series of experiments. Two monoclonal antibodies known to recognize spatially distinct determinants of H-2Kk both bound to lung-stage schistosomula recovered from mice expressing this haplotype, suggesting that a significant portion of the H-2K molecule is present at the larval surface. Furthermore, both antibodies precipitated from lysates of 125I-lactoperoxidase-labeled lung-stage schistosomula, a molecule of approximately 45,000 daltons similar in mobility to H-2Kk precipitated from 125I-labeled mouse spleen cells. These results support the hypothesis that the class I MHC antigens expressed on S. mansoni are not synthesized by the parasite but are acquired from the host as intact glycoproteins.

Angiographic nephrectomy using iodinated contrast agent

Diatrizoate meglumine and sodium (Renografin-76) was perfused in an obstructed renal artery in 13 dogs. Intense and prolonged accumulation of contrast agent ("contrast staining") was achieved in all animals. Repeat injection was frequently necessary to enhance staining. Renin output from the stained kidneys was lower than that from the opposite kidneys. Angiography at 14-18 weeks demonstrated a marked decrease in renal size in all dogs, with complete occlusion of the renal artery in two dogs. No collateral circulation was discerned. Grossly, all experimental kidneys were uniformly shrunken. Histologically, diffuse renal infarction was evident with coagulative necrosis. Contrast staining is an effective method for uniform destruction of renal tissue.

Ultrasonographic assessment of bladder tumors. I. Tumor detection

A total of 37 patients with 71 bladder tumors underwent ultrasonographic examination in an attempt to evaluate its accuracy in detection of bladder tumors. Accurate detection depended on the size and location of the neoplasm. Bladder tumors less than 0.5 cm. in diameter, regardless of location, as well as those of any size located in the bladder neck or dome areas were difficult to detect. On the other hand, diagnostic accuracy was 95 per cent for tumors more than 0.5 cm. in size and situated on the posterior or lateral walls of the bladder. Thus, ultrasound is an additional diagnostic tool for detection of bladder tumors and is indicated in those cases in which cystoscopy could not be done or was not conclusive.

Ultrasonographic assessment of bladder tumors. II. Clinical staging

Uniformity of the echo return from the bladder wall has been demonstrated in experimental and patient studies. An infiltrating bladder tumor disrupts this uniformity. The studies also showed a sharp bladder wall outline that was less echogenic, probably representing the perivesical fat. Thus, the ultrasonographic estimation of tumor staging as related to the depth of infiltration of the bladder wall. A staging accuracy of nearly 100 per cent was found for deep tumors of the bladder wall or those penetrating extravesical structures. On the other hand, many superficial tumors were overstaged, their staging accuracy being only slightly higher than 55 per cent. However, in view of its accuracy in staging infiltrating tumors, in addition to its other already known advantages, ultrasound seems to be the method of choice in preoperative staging of tumors. We believe that it should be included in the routine protocol and should follow diagnostic cystoscopy in all cases of tumors larger than 0.5 cm.

Hepaticocholecystostomy and cholecystojejunostomy for bile drainage. A palliative procedure

A new anastomotic technique was performed in a second-look operation for obstructive jaundice after an initial Rous-en-Y cholecystojejunostomy for an adenocarcinoma of the pancreas. This palliative bypass procedure consisted of the interposition of the gallbladder between the common hepatic duct and the jejunum to allow the free drainage of bile.