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Biomedical subjects

L Berná

Publications and source records attributed to L Berná.

34 records · Page 2Linked to original sources

Radioimmunolocalization of colorectal carcinoma. A correlation among RIL results, surgical findings, serum tumor marker levels and the presence of CEA and CA 19.9 in tumor tissue: the experience of the Hospital de la Santa Creu i Sant Pau.

We report a prospective study in two groups of colorectal cancer patients carried out by radio-immunolocalization (RIL) with F(ab') fragments of monoclonal antibodies against CEA and CA 19.9 labeled with 131-I. Twenty-two patients were studied before radical surgery and 12 patients after initial surgery, when progressive increase in CEA was registered. Scintigraphic images obtained in vivo in RIL studies were compared with scintigraphic images of the corresponding surgical specimens. Results were compared with known serum marker levels and with the presence and localization of markers in the excised specimens. RIL images correctly identified 13 of 23 (52%) primary tumors, with only one false positive image. Scintigraphy of surgical specimens correlated with RIL findings in 14 of 19 cases (74%). Four specimens which showed antibody uptake had not been visualized preoperatively in the RIL study. Two of them were retrovesical and were obscured by residual activity in the bladder. Nine of 13 (64%) patients with at least one elevated tumor marker were imaged. Staining pattern or intensity of antigen staining in the specimens did not correlate with RIL findings. Recurrent disease was confirmed by laparotomy or other exploration in 10 of the 12 patients with progressive CEA elevation during follow-up. Spontaneous normalization of CEA levels was observed in the remaining 2 patients. RIL studies were positive in 7 of the 10 patients with confirmed recurrent disease. Of the 3 false negative patients 2 had liver metastases and one developed clinical lung, bone and adrenal metastases 11 months later. No false positive studies were observed in this group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗

Bone marrow regeneration after hormonal therapy in patients with bone metastases from prostate carcinoma.

Two patients with prostate carcinoma and bone metastases were treated with hormonal therapy. Radioimmune imaging of bone marrow performed with 99mTc-labeled antigranulocyte antibody BW 250/183 before treatment demonstrated absence of granulopoietic bone marrow in extensive regions of the central and proximal peripheral skeleton, indicating diffuse bone marrow invasion. Bone marrow scans performed after treatment demonstrated presence of granulopoietic bone marrow in these regions, indicating bone marrow regeneration. This finding was consistent with favorable response to treatment.

Aged↗

Transient alterations in cardiac performance after a six-hour race.

Ten long distance runners were enrolled in a 6-hour competitive race. Immediately after the race technetium-99m-albumin gated blood pool scans were performed and indium-111 antimyosin was injected. Forty-eight hours later antimyosin scans were obtained and control gated blood pool scans were performed. Left ventricular ejection fraction was higher after the race (65 +/- 5 vs 60 +/- 7%, p less than 0.01) due to a decrease in end-systolic counts. Right ventricular ejection fraction was lower after the race (42 +/- 7 vs 54 +/- 12%, p = 0.03) due to an increase in both end-diastolic and end-systolic counts. A longer systolic period was observed after the race (53 +/- 5% of the RR interval vs 39 +/- 3%, p = 0.005). No significant differences were observed in peak filling or peak emptying rates after the race. An increase in pulmonary blood volume (116% of control) was observed after the race. Antimyosin scans were normal in 7 athletes and minimal antimyosin myocardial uptake was seen in 3. Transient alterations in biventricular performance present after the race correspond to function adaptation to strenuous exercise and are not due to irreversible myocyte damage.

Adult↗

Radioimmune imaging of bone marrow in patients with suspected bone metastases from primary breast cancer.

Radioimmune imaging of bone marrow was performed by technetium-99m- (99mTc) labeled antigranulocyte monoclonal antibody BW 250/183 (AGMoAb) scans in 32 patients with suspected bone metastases from primary breast cancer. AGMoAb scans showed bone marrow defects in 25/32 (78%) patients; bone invasion was subsequently confirmed in 23 (72%) patients. Conventional bone scans performed within the same week detected bone metastases in 17/32 (53%) patients (p less than 0.001). AGMoAb scans detected more sites indicating metastatic disease than bone scans in 12 of these 17 patients (71%). All patients with bone metastases in the axial skeleton had bone marrow defects at least at the sites of bone metastases. Of 15 patients with normal, or indicative of, benign disease bone scans, 8 patients (53%) presented with bone marrow defects in the AGMoAb scans. Bone invasion was confirmed in six of them. AGMoAb bone marrow scans provide a method for the early detection of bone metastatic invasion in patients with breast cancer and suspected bone metastases.

Antibodies, Monoclonal↗

Indium-111-antimyosin scintigraphy after doxorubicin therapy in patients with advanced breast cancer.

Indium-111-antimyosin (111In-antimyosin) scans were performed in 20 women with advanced breast cancer after 10 cycles of chemotherapy consisting of cyclophosphamide, 5-fluorouracil and doxorubicin (total cumulative dose of doxorubicin of 500 mg/m2). Antimyosin uptake in the myocardium was quantified by means of a heart-to-lung ratio (HLR). Antimyosin uptake in the myocardium was observed in 17/20 (85%) patients, and HLR after chemotherapy was 1.86 +/- 0.25. Left ventricular ejection fraction (EF) was determined before and after chemotherapy. Patients with decreased EF (8/20, 40%) presented with more intense antimyosin uptake (HLR of 2.11 +/- 0.10 versus 1.70 +/- 0.16 (p = 0.01]. HLR values correlated with EF values after chemotherapy (r = -0.47, p less than 0.05). Positive antimyosin studies after chemotherapy including doxorubicin, indicate the presence of myocardial damage in these patients. Antimyosin studies are a sensitive method to detect myocyte damage in patients after doxorubicin therapy.

Adult↗

[Circumferential profiles versus visual analysis in studies of myocardial perfusion during exertion using thallium-201].

Two methods of analysis for perfusion myocardial studies with thallium are compared: the conventional visual analysis, and a quantitative method which shows results as circumferential profiles. Three hundred and ninety myocardial segments in 65 patients were studied. Visual analysis showed abnormalities in 44/65 (68%) patients, the quantitative method did it in 53/65 (81%). When localization and/or extension discrepancy between the two methods was found, angiography was always concordant with circumferential profiles findings. Total agreement between the two methods was present in 20/65 (31%) patients. The quantitative method is more sensitive than the visual analysis. It is also more precise in defining localization and extension of thallium defects.

Coronary Angiography↗

Indium-111 antimyosin scintigraphy to assess myocardial damage in patients with suspected myocarditis and cardiac rejection.

Indium-111 antimyosin scans were used to assess myocardial damage in patients with suspected myocarditis and cardiac transplant rejection. The calculation of a myocardium to lung ratio (AM index) to quantify antimyosin uptake was performed. AM index in normal subjects (n = 8) at 48 hr postinjection was 1.46 +/- 0.04. In patients with suspected myocarditis (16 studies in 13 patients), AM index was 2.0 +/- 0.5 (p less than 0.001); suggesting a considerable incidence of ongoing cell damage in this group, despite the small proportion of positive right ventricular endomyocardial biopsy (RVbx) (4/13). In patients studied after cardiac transplantation (37 studies in 17 patients), AM indexes correlated with RVbx. In patients with RVbx proven rejection (n = 14), AM index was 1.87 +/- 0.19 (p less than 0.001). In patients with RVbx showing infiltrates but not myocyte damage (n = 13), AM index was 1.80 +/- 0.27 (p = 0.02). In patients with normal RVbx (n = 10), AM index was 1.56 +/- 0.17 (p = NS versus controls; p = 0.001 versus those with positive RVbx). Calculated AM indexes correlated with graded visual analysis of the scans (r = 0.823; p = 0.001). Antimyosin scans are an appropriate method to assess myocardial damage in patients with suspected myocarditis and cardiac rejection.

Adult↗

Myocardial iodine-labeled metaiodobenzylguanidine 123 uptake relates to age.

BACKGROUND: 123I-labeled metaiodobenzylguanidine (123I-MIBG) is used increasingly to assess cardiac adrenergic neuron function. Few studies have reported data on myocardial MIBG uptake in relation to age, with contradictory results. This study reports the results of myocardial MIBG studies in untreated patients with cancer to assess the influence of age on myocardial MIBG uptake. METHODS AND RESULTS: Thirty-nine patients with cancer enrolled in a study to assess the effect of doxorubicin administration on adrenergic neuron function underwent baseline studies with 123I-MIBG before chemotherapy. None of the patients had a history of neuropathy, previous cardiac disease, or previous chemotherapy or mediastinal radiotherapy. Myocardial MIBG uptake was quantified by a heart/mediastinal ratio (HMR) 4 hours after intravenous administration of 5 mCi 123I-MIBG. The mean age of patients was 38 years, ranging from 16 to 75 years. Ten patients were below 20 years, 13 patients were between 20 and 40 years, six patients were between 40 and 60 years, and 10 patients were greater than 60 years of age. Myocardial 123I-MIBG uptake was observed in all patients, with a mean HMR of 1.85 +/- 0.29 (range 1.31 to 2.62). HMR correlated with age (r = -0.6264; p < 0.001). A decrease in 123I-MIBG uptake with aging was observed. The mean HMR of patients of less than 20 years was 2.07, of patients between 20 and 40 years 1.89, of patients between 40 and 60 years 1.83, and of patients greater than 60 years 1.56. The best separation was observed comparing patients who were greater than 60 years (mean HMR 1.56 +/- 0.16; range 1.31 to 1.78) with patients who were less than 60 years of age (mean HMR 1.95 +/- 0.24; range 1.56 to 2.62; p = 0.003). CONCLUSIONS: Myocardial 123I-MIBG uptake relates to age. A decrease in myocardial MIBG uptake is observed with aging, especially in those patients over 60 years of age. The influence of age on myocardial MIBG uptake has to be taken into account when studies are designed to assess cardiac adrenergic neuron function with 123I-MIBG.

3-Iodobenzylguanidine↗

Noninvasive localization of human atherosclerotic lesions with indium 111-labeled monoclonal Z2D3 antibody specific for proliferating smooth muscle cells.

BACKGROUND: Targeting exclusive antigens in atherosclerotic plaques with antibodies may provide a noninvasive means to detect rapidly proliferative atherosclerotic lesions. 111In-labeled negative charge-modified Z2D3 F(ab')2 (Z2D3) specific for an antigen expressed exclusively by proliferating smooth muscle cells has been shown to accumulate in rabbit atherosclerotic plaques. METHODS: The safety, biodistribution, accumulation, and elimination of Z2D3 were assessed in 11 patients who were candidates for carotid endarterectomy. The presence of atheromas in these patients was confirmed by angiography and Doppler ultrasound. Z2D3 (250 microg) labeled with 5 mCi of 111In was administered by slow intravenous injection. Planar and single photon emission computed tomography (SPECT) images were obtained 4, 24, 48, and 72 hours later. Carotid endarterectomy was performed and the surgical specimens were imaged, weighed, gamma-counted, and analyzed by immunostaining. RESULTS: Uptake of Z2D3 at the site of the carotid plaques was observed in the planar and SPECT views at 4 hours in all subjects. In addition, antibody uptake was noted in the contralateral vessel in 5 subjects. SPECT images identified the atherosclerotic plaques with focal uptake. The antibody uptake corresponded with the angiographic location of the disease. Immunohistochemical studies of the endarterectomy specimens confirmed the localization of Z2D3 into the plaque areas containing smooth muscle cells. Adverse drug reactions were not observed. CONCLUSION: This study demonstrates the feasibility of targeting atherosclerotic lesions with negative charge-modified antibody. It also proposes the possibility of selective identification of various components of atherosclerotic plaque, which may contribute to determining strategies of intervention in future.

Aged↗

[Biventricular functional adaptation during a prolonged race. An analysis of global and regional ventricular function].

To determine the effects of a six-hour competitive race on left and right ventricular performance, 99mTc gated blood pool scans were performed to 6 long distance runners before the race (rest), each hour during the race and one hour after concluding the exercise (recovery). Heart rate increased during the race, peaking at 4th hour of competition (55 +/- 3 to 110 +/- 9 lpm; p = 0.001). Evolution of right ventricular ejection fraction showed a similar behavior with the evolution of left ventricular ejection fraction during the competition (r = 0.39; p = 0.006). Blood volume in the lungs increased at the end of the race (index 1.13 +/- 0.14) normalizing at recovery (index 1.03 +/- 0.03). Left and right ventricular peak filling rate had an inverse correlation with pulmonary blood volume (r = -0.31; p = 0.041 and r = -0.47; p = 0.001 respectively). Both left and right ventricular ejection fraction had an inverse correlation with pulmonary blood volume (r = -0.38; p = 0.006 and r = -0.34; p = 0.01 respectively). The anteroseptal regional ejection fraction showed an inverse correlation with end-systolic and end-diastolic volume (r = -0.32; p = 0.03 and r = -0.4; p less than 0.01 respectively). The posterolateral region showed a parallel evolution with the global ejection fraction for both left and right ventricles (r = 0.57; p less than 0.0001 and r = 0.38; p = 0.009 respectively). In conclusion, a transient biventricular functional adaptation during a prolonged race is related to pulmonary blood volume redistribution and to a higher preload for both ventricles and a greater afterload for the right ventricle. The posterolateral and inferoapical regions show a similar behavior as both left and right ventricular ejection fraction, response that does not occur with the anteroseptal regional ejection fraction.

Adaptation, Physiological↗