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Biomedical subjects

H A Fritsche

Publications and source records attributed to H A Fritsche.

72 records · Page 4Linked to original sources
PubMed1984

Diagnostic and prognostic values of carcinoembryonic antigen in medullary carcinoma of the thyroid.

This study was conducted to compare the diagnostic and prognostic values of calcitonin (CT) and carcinoembryonic antigen (CEA) measurements in patients with medullary carcinoma of the thyroid (MCT). Plasma CEA, basal CT (BCT), and peak CT (PCT) levels after pentagastrin stimulation were determined in 15 patients with occult familial MCT before treatment. CEA was elevated in 11 patients (73%), BCT in 8 patients (53%), and PCT in all patients. The prognostic values of serial CEA and BCT determinations were studied in 24 other MCT patients followed for a period of 1.5-8 yr. These patients were divided into 2 groups; group I consisted of 11 patients with normal serial CEA levels, and group II consisted of 13 patients with persistently elevated CEA levels. In group I, 2 patients (18%) developed metastases compared with 10 patients (77%) in group II (P less than 0.001). Elevated BCT levels were found in all patients with metastases as well as in 63% of patients with no evidence of disease. When CEA time curves were studied, three patterns could be identified: 1) a steep slope with rapidly rising CEA levels in patients with rapidly progressive disease, 2) a flat slope in patients with no metastasis or nonprogressive disease, and 3) an intermediate type of slope in patients with slowly progressive disease. Slope analysis of BCT time curves was not done because of marked fluctuations in BCT levels. PCT after pentagastrin stimulation remains the best diagnostic marker for MCT. However, CEA may be a better prognostic indicator, as it discriminated more efficiently between patients with and without metastasis. Slope analysis of CEA time curve and calculation of the doubling time are recommended, as they correlated well with the course of the disease.

Adolescent↗
PubMed1984

Pharmacokinetic study of partially pure gamma-interferon in cancer patients.

A pharmacokinetic study was performed with partially pure immune (gamma) interferon (IFN-gamma) in patients with metastatic cancer. Nine patients were given IFN-gamma by the i.m. route in doses ranging from 1.5 X 10(5) to 9.6 X 10(6) antiviral units. There was no detectable antiviral activity in patients' serum, and only minimal side effects were observed. Fifteen patients were given IFN-gamma by i.v. bolus infusion in doses ranging from 1.5 X 10(5) to 54 X 10(6) units. Serum clearance of antiviral activity was described by a monoexponential disappearance curve. The serum half-life was dose dependent (3 min at the lower doses and 34 min at the highest doses). There were few consistent biological effects observed in the patients. Based on these pharmacokinetic data, eight patients were treated by a 6-hr continuous infusion consisting of 3 X 10(6) units by i.v. bolus followed by 4 X 10(6) units/hr for 6 hr. This regimen resulted in consistent serum levels of IFN-gamma ranging from 40 to 60 units over the 6-hr period. Marked granulocytopenia occurred within 24 hr and was sustained during the 10-day infusion period. There was marked increase in serum beta 2-microglobulin. We conclude that, in order to induce consistent serum antiviral activity, partially pure IFN-gamma, because of its rapid serum disappearance curve, must be administered by continuous i.v. infusion.

Drug Evaluation↗
PubMed1983

Serial plasma carcinoembryonic antigen measurements during treatment of metastatic breast cancer.

Serial plasma carcinoembryonic antigen (CEA) levels were measured in 167 patients with metastatic breast cancer treated with fluorouracil, doxorubicin hydrochloride, and cyclophosphamide (FAC). In 84 patients, the pretreatment CEA value was abnormal. Response rates and remission duration were similar in patients with normal and abnormal pretreatment levels. Carcinoembryonic antigen concentrations decreased in 94% of patients who responded to FAC therapy. The duration of response was 22 months for patients in whom the CEA levels normalized v nine months in those in whom it decreased but never returned to normal. Increasing CEA levels correlated with progressive disease in 87% of patients and preceded clinical evidence of progression in 77%. Serial CEA measurements can monitor response to chemotherapy, provide useful prognostic information of response duration, and detect progressive disease early.

Adult↗
PubMed1982

Serum lactate dehydrogenase isoenzyme 1 in patients with advanced testicular cancer.

Abnormal levels of serum lactic dehydrogenase-1 (LD-1) activity have been observed in 81% (34/42) of patients with stage III germ cell malignancy of the testis. The criteria for evaluation the electrophoretic isoenzyme patterns of these patients were, as follows: For criterion 1 elevations the LD-1 value in absolute units was greater than 52.0 U/I with the LD-1/Total LD ratio greater than 37.2%. Criterion 2 elevations had absolute values of LD-1 less than 52.0 U/I, but the LD-1/Total LD ratio was greater than 37.2%. For criterion 3 elevations of LD-1, the absolute value was greater than 52 U/I and the LD-1/Total LD ratio was less than 37.2% activity with the LD-5/LD-1 ratio less than 0.5; or when the LD-5/LD-1 ratio was greater than 0.5 but the LD-1 is equal to or greater than the LD-2. The frequency of LD-1 elevation correlated well with the extent of the disease (stage II-B-1 and 2, 50%; stage III-B-3, 86%; stage III-B-4, 91%; stage III-B-5, 93%). LD-1 elevation occurred in groups I, II, IV and V histopathologic cell types (Dixon and Moore Classification) and there did not appear to be any correlation between the histologic cell type and the frequency of elevation of LD-1. Interpretation of LD-1 activity only on the basis of its relative ratio to the total LD value (criterion 1 and 2) identified a total of 28 patients (67%). A criterion 3 elevation was demonstrated in 6 (14%) additional patients. All patients with persistent elevations or recurrent elevations of LD-1 have shown progressive or recurrent disease and patients with no clinical evidence of disease have demonstrated normal LD-1 values. In those patients with elevated LD-1 activity, serial measurements of serum. LD-1 isoenzyme reflect the response of the patient to therapy.

Choriocarcinoma↗
PubMed1982

A micro-assay for estrogen receptor in breast tumor with use of 125I-labeled estradiol.

The concentration of estrogen receptor protein in breast-tumor tissue is generally expressed in units of femtomoles of estradiol bound by the receptor per milligram of cytosol protein. The sensitivity of the estrogen receptor radioligand assay is therefore related to the specific activity of the steroid label used for the binding assay, the amount of the receptor protein in the volume of cytosol used, and the protein concentration in the cytosol. In this paper, we discuss factors affecting the sensitivity of the estrogen receptor assay and present various approaches for optimizing the assay. We also describe a procedure that involves a radioiodinated estradiol of high specific activity, a micro-technique for preparing tumor cytosol, and a micro-assay procedure with which the estrogen receptor protein can be measured in as little as 50 mg (wet weight) of tissue.

Breast Neoplasms↗
PubMed1980

CSF carcinoembryonic antigen in meningeal carcinomatosis from breast cancer.

Levels of CSF carcinoembryonic antigen (CEA) were determined in 23 patients with breast cancer and meningeal carcinomatosis. Levels greater than 1.5 ng/mL were observed in 16 patients; seven patients had undetectable levels. The meningeal disease of seven patients with elevated CSF CEA levels completely responded to treatment, and their CSF CEA levels concurrently decreased. Two patients whose meningeal disease responded poorly to treatment had persistently elevated levels of CSF CEA. In two other patients, a rising CSF CEA level was detected before there was any other evidence of meningeal relapse. Serial measurement of CSF CEA may play an important role in the clinical management of meningeal carcinomatosis in patients with breast cancer.

Breast Neoplasms↗
PubMed1980

A direct competitive binding radioimmunoassay for carcinoembryonic antigen.

We have incorporated commercially available CEA standard and antiserum into the triple isotope double antibody radioimmunoassay and we have evaluated this assay for the routine determination of CEA. The competitive protein binding (CPB) assay for CEA can be performed directly on serum or plasma without perchloric acid extraction. The assay sensitivity was 0.98 ng/ml, and the day-to-day precision as defined by the coefficient of variation was 12.5% and 13.3% for mean values of 7.6 and 23.9 ng CEA/ml, respectively. The normal range (X +/- 2 S.D.) for CEA determined with the direct CPB method was 3.2--6.2 ng CEA/ml for non-smokers. The upper limit of normal for smokers was 10.0 ng/ml. A method comparison study (Roche perchloric acid extraction vs. direct CPB) showed excellent agreement between the methods for plasma samples containing less than 20.0 ng CEA/ml. The least square analysis parameters were: N = 116, slope = 1.01, y-intercept = 3.5 ng/ml, Sy/x -2.05 ng/ml, and the correlation coefficient was 0.79. Recovery and dilution studies showed no demonstrable non-specific interference due to serum proteins in the direct CPB assay. The clinical significance of the direct CPB assay for CEA was assessed by correlating serial CEA values with the clinical status of patients with breast and colorectal cancer. Increasing CEA values correlated with progressive or recurrent neoplastic disease, and decreasing CEA values correlated with response of the patient to therapy. No false positive direct CPB values for CEA were observed in the clinical study or in the method comparison study. Our laboratory and clinical evaluation demonstrate that the direct CPB method is an accurate and reliable method for the quantitation of CEA. In addition, the method permits high volume analysis and eliminates the hazards to safety that are associated with perchloric acid.

Binding, Competitive↗
PubMed1980

Carcinoembryonic antigen levels in malignant pleural fluids obtained from patients with mammary cancer.

The clinical usefulness of the carcinoembryonic antigen test for defining the malignant origin of pleural fluids obtained from patients who have mammary cancer was evaluated. Of 57 malignant pleural fluids obtained from 51 patients who had mammary cancer, 31 (54.4%) demonstrated a significantly elevated carcinoembryonic antigen content: the ratio of pleural fluid to serum carcinoembryonic antigen values ranged from .24 to 3.55; whereas for 14 of 23 patients who had normal levels of both serum and pleural fluid carcinoembryonic antigen, the ratio ranged from 0.25 to 2.30. This study indicates that the pleural fluid carcinoembryonic antigen value may be significantly elevated in only 50-60% of mammary cancer patients having documented malignant pleural fluids, and that the pleural fluid to serum carcinoembryonic antigen ratio is of no value in defining the malignant origin of pleural fluids obtained from these patients.

Breast Neoplasms↗
PubMed1977

Tyrosinase activity in the sera of patients with malignant melanoma: method and specificity.

Serum tyrosinase activity has been measured by adapting the [3]tyrosine assay for tyrosinase and significant elevations of serum tyrosinase activity were found in patients with malignant melanoma. In contrast to findings in a study which utilized [14C]tyrosine, augmented levels of tyrosinase activity were not observed in sera from patients with other malignancies, including subjects with carcinoma of the breast. The results of the examinations for soluble tyrosinase activity in human malignant melanoma tissue-cultured lines were all positive, whereas human cell lines from carcinoma of the breast, carcinoma of the colon and sarcoma uniformly showed no activity. The method employed for detecting tyrosinase activity holds promise as a specific diagnostic test and may be valuable for monitoring the response to clinical treatment of patients with malignant melanoma.

Breast Neoplasms↗
PubMed1975

Enzymatic endpoint analysis of glucose with the hexokinase method and the Union Carbide fast centrifugal analyzer.

1. We describe an enzymatic endpoint method for glucose using the hexokinase reaction and the Union Carbide fast centrifugal analyzer. The new method permits the direct spectrophotometric measurement of serum blanks, and eliminates the need for separate blank determinations or computer-assisted calculation of the sample blank absorbance values. 2. The direct automatic blanking is accomplished by measuring the absorbance of the test solution 2 seconds after the reactants have been mixed. Our studies show that no appreciable conversion of glucose occurs during this time interval. 3. The results of the new method agree well with the results from the conventional hexokinase assay. In addition, the method requires only 5 microliters of serum, and has a high sample throughput rate.

Autoanalysis↗
PubMed1975

The determination of serum immunoglobulins by automated nephelometric analysis.

We have evaluated the Technicon Automated Immunopreciptin System for the determination of immunoglobulins G, A and M in human serum. The new method is based on the nephelometric measurement of complexes formed during the antigen-antibody reaction. In this paper, we review the principles of nephelometry and describe its application to the measurement of antigen-antibody complexes. We have found the nephelometric method to be reliable for routine clinical use. The new method gives immunoglobulin test results which are highly reproducible, and agree well with the results determined by a radial immunodiffusion method.

Antigen-Antibody Complex↗
PubMedDate not supplied

Squamous cell carcinoma antigen in genitourinary tumors.

We have evaluated the serum levels of squamous cell carcinoma (SCC) antigen in patients with adenocarcinoma of the kidney, adenocarcinoma of the prostate, germ cell tumors of the testis, transitional cell carcinoma of the bladder, and SCC of the penis, urethra, and bladder. Serum SCC antigen levels were elevated in 5 of 11 patients (45%) with metastatic SCC of the penis, and in the 3 patients for whom serial determinations were made, the serum levels correlated correctly with the progression of disease or response to treatment. The antigen was elevated in 1 of 3 patients with SCC of the urethra, and 1 apparent false-positive value was observed in a patient with adenocarcinoma of the prostate. Otherwise, no SCC antigen elevations were noted among 10 patients with metastatic adenocarcinoma of the prostate, 8 with metastatic adenocarcinoma of the kidney, 11 with metastatic transitional cell carcinoma of the bladder, 8 with metastatic nonseminomatous germ cell tumors of the testis, and 2 patients with metastatic SCC of the bladder.

Antigens, Neoplasm↗
PubMedDate not supplied

Underestimation of monoclonal proteins by agarose serum protein electrophoresis.

The effect of serum dilution on monoclonal protein quantitation by serum protein electrophoresis (SPE) on the agarose gel Paragon system was investigated in 388 serum samples from 106 patients with Ig G monoclonal gammopathy. It was found that the pre-electrophoretic 1:5 serum dilution recommended by the manufacturer was adequate for some but not all sera, especially those with the highest M-protein concentrations. As a result of the inadequate dilution, 232 (60 percent) of the 388 samples had M-protein concentrations that were significantly underestimated and the corresponding albumin concentrations overestimated. By Paragon SPE, the mean albumin concentration in these 232 sera was 41.8 (SD 6.7) g/L. After further dilution of these sera, the mean albumin concentration was 36.7 (SD 6.8) g/L and was, in each case, always less than that in the corresponding 1:5 diluted serum. By the bromcresol green (BCG) dye-binding method, the albumin concentration was 34.9 (SD 4.3) g/L. Similarly, the M-protein concentration for 1:5 diluted sera was 51.9 (SD 12.9) g/L vs. 59.1 (SD 16.1) g/L for the further diluted sera, with the M-protein concentration in each further diluted sample always exceeding that in the corresponding 1:5 diluted serum. Underestimation of the M-protein concentration limits its clinical utilization in evaluating the patient's response to therapy and for early detection of disease progression. A recommendation was made of a 1:10 dilution of sera that contain total protein from 91 g/L to 114 g/L and a 1:20 dilution of sera in which the protein content is in the range of 115 g/L to 152 g/L to insure accurate estimation of protein fractions by Paragon SPE.

Antibodies, Monoclonal↗