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Biomedical subjects

S Mather

Publications and source records attributed to S Mather.

At least 19 recordsLinked to original sources

Women in the Persian Gulf War: health care implications for active duty troops and veterans.

The health of women who participated in Operations Desert Shield/Storm was evaluated to better understand the medical requirements of deployed military women and women veterans of the Persian Gulf War. Women's health care needs during the Persian Gulf War were reported to be very similar to those of men, with the exception of gynecologic problems, which generally were not serious and did not require hospitalization. However, insufficient data were obtained to identify specific health care needs among deployed women troops. During the 5 years since the end of the Persian Gulf War, no unique health problems have been identified among women veterans. Whether there will be any exceptional long-term health care requirements currently is unknown. Nevertheless, important medical problems of all women-reproductive issues, menopause, osteoporosis, joint disease, breast cancer, heart disease, and stroke-inevitably will be major considerations when caring for this population of war veterans.

Adult

Immediate and delayed contact hypersensitivity to verbena plants.

Plants from the Verbenaceae family may cause contact dermatitis of unknown nature. This report describes 2 cases of allergic reactions to the Verbena species. A teenage boy developed an anaphylactic allergic response following contact with the leaves of Verbena hybrida. Characterization of the patient's specific IgE response to Verbena hybrida, using Western blots and autoradiography, identified the specific 62000 Dalton allergen present in the verbena leaves to which the patient reacted. This is the first report of an IgE-mediated immediate contact hypersensitivity reaction to Verbena hybrida, a common perennial in South African gardens. The other case was a 23-year-old female gardener who developed immediate and delayed-type contact dermatitis from Verbena elegans 'Cleopatra' produced in a Danish nursery. Prick tests to plant material were considered positive and of an allergic nature.

Adolescent

Hepatic ultrasound findings in the glycogen storage diseases.

Hepatic ultrasonography was performed on 70 patients with the hepatic glycogen storage diseases (GSDs) to assess parenchymal echogenicity. 27 patients had GSD-I, 24 had GSD-III and 19 had GSDs-VI/IX; ages varied from 0.6 to 35.7 years (median 11.7). 31 (44%) had normal or mild parenchymal changes, and 41% (11/27) of those with GSD-I, 25% (6/24) with GSD-III and 11% (2/19) with GSDs-VI/IX had marked changes. No relationships were found between the ultrasonographic appearances and other indices of metabolic control, including plasma triglycerides, total cholesterol or height standard deviation score. Seven adult patients (21-29 years) were found to have hepatic tumours: six with GSD-I and one with GSD-III. Those with GSD-I and tumours tended to have the more severe hepatic parenchymal changes. We conclude that ultrasonography may be useful in identifying patients with GSD-I at risk of hepatic tumour formation.

Adenoma

IgE specific immune responses to an African grass (Kikuyu, Pennisetum clandestinum)

Kikuyu grass (Pennisetum clandestinum) is widely used as a grazing pasture in Africa and, although it is extensively cultivated as a lawn for sports fields and domestic gardens, its allergenicity has never been studied in vitro. Using an extract of Kikuyu grass pollen, polyacrylamide gel electrophoresis, Western blotting and a monoclonal anti-human IgE antibody, the specific IgE binding, in the serum of 160 allergic and non-allergic patients in the Cape Town area, to a Kikuyu grass extract was studied. IgE in the sera of 43/104 known grass-allergic individuals bound to Kikuyu grass on the Western blots. In addition, 4/28 'non-allergic' control subjects were found to have Kikuyu grass-specific IgE. Five different profiles of specific IgE reactivity to Kikuyu grass antigens were observed. In 29/43 patients, IgE bound to two dominant 48 and 70 kD allergens in the Kikuyu extract. Although a degree of cross-reactivity with Bermuda grass (Cynodon dactylis) was found in immunoabsorption studies, the 48 and 70 kD allergens appear to be unique to Kikuyu grass. Exposure of heparinized blood from Kikuyu grass-positive patients to the Kikuyu extract stimulated the release of histamine from their basophils in vitro. Kikuyu grass pollen is thus identified as an important aero-allergen in South Africa.

Allergens

Pseudotumoral cystitis in children: a review of the ultrasound features in four cases.

Pseudotumoral cystitis is an uncommon inflammatory condition which may masquerade as a bladder tumour in children. There are a variety of clinical presentations such as haematuria, dysuria, infection and obstruction. Reported causative factors include infection (bacterial, fungal and parasitic) and allergy. Ultrasound is an excellent imaging modality for demonstrating this intravesical lesion although the spectrum of features is poorly described in the literature. We report our recent experience of four patients with pseudotumoral cystitis and describe the clinical features and ultrasound appearance of this condition in children.

Child

A scintigraphic comparison of iodine-123-metaiodobenzylguanidine and an iodine-labeled somatostatin analog (Tyr-3-octreotide) in metastatic carcinoid tumors.

A number of neoplasms are known to express somatostatin receptors, and the use of somatostatin receptor imaging in their localization has recently been described. We compared an 123I-labeled somatostatin analog Tyr-3-octreotide (TOCT) and 123I-labeled metaiodobenzylguanidine (MIBG) scintigraphy in seven patients with histologically proven metastatic carcinoid tumors. The optimum time for identifying tumor uptake on scanning after [123I]MIBG was 24-48 hr, and after 123I-TOCT 10-30 min postinjection. Both radiopharmaceuticals showed a varying spectrum of tracer uptake ([123I]MIBG showed no uptake in one patient; minimal in two; moderate in two; and intense in two; 123I-TOCT showed no uptake in two patients; minimal uptake in one; moderate uptake in two; and intense uptake in two). In two patients, 123I-TOCT identified metastatic lesions not seen by [123I]MIBG scintigraphy. These preliminary results suggest that [123I]MIBG and 123I-TOCT are useful and complementary imaging techniques for detecting metastatic carcinoid tumors.

3-Iodobenzylguanidine

A PAC study of the binding of 111In to a monoclonal antibody via the macrocyclic molecule 1,4,7-triazacyclononanetriacetic acid.

Time integral and time differential PAC measurements have been made from samples of 111In bound to the functionalized 9N3 macrocycle, and 111In bound to the monoclonal antibody AUA1 via the macrocycle, over the temperature range 80-350 K. Values obtained for the integrated perturbation coefficient G22 (infinity) clearly illustrate the effects which the antibody has on the angular correlation of the gamma-rays emitted by the 111In decay. Measurements of the quadrupole frequency in the 111In-9N3-AUA1 samples show a transition temperature between 250 and 275 K which was not detected in the 111In-9N3. An arrhenius plot of the temperature dependence of the correlation time for the 111In-9N3 yielded a value of 0.10 +/- 0.01 eV for the activation energy associated with molecular re-orientation, whilst a Debye plot indicated an effective volume of (10 +/- 1) x 10(-27) m3 for the same sample. Extrapolation of the Debye plot suggests a high relaxation constant which may be attributed to internal vibrational modes in the macrocycle. Comparisons are made with similar work on the plasma protein transferrin.

Antibodies, Monoclonal

Therapeutic considerations in the use of intraperitoneal radiolabelled monoclonal antibodies in ovarian carcinoma.

Eleven patients with ovarian cancer have been treated with a radiolabelled monoclonal antibody directed against human milk fat globule membrane (HMFG2). All patients had Stage III disease and had previously undergone debulking surgery followed by chemotherapy. Although 16 patients have been referred, 5 could not be treated. This paper discusses the criteria for patient selection and treatment, and describes the technical difficulties of this form of therapy and the complications sustained following the intraperitoneal instillation of up to 150 mCi iodine-131 labelled HMFG2. Significant complications included two ileo-cutaneous fistulae and peritonitis in one patient which prevented treatment from being given.

Adult

von Recklinghausen's disease of nerves: a modern day social response.

We describe a patient with von Recklinghausen's Disease of Nerves whose appearance provoked an emotive reaction in the close community of an RN ship akin to that reported in the case of Sir Frederick Treves' "Elephant Man". The RN divisional system provided a valuable contribution to the resolution of the problems created.

Adult

Clinical experience with 99mTc-MAG3, mercaptoacetyltriglycine, and a comparison with 99mTc-DTPA.

The preparation, application and clinical usage of 99mTc-mercaptoacetyltriglycine, MAG3, a tubular secreted compound, is described in the first 225 patients in a phase III study. Image quality, relative renal function, and renal transit times were compared with a 4 fold greater administered activity of 99mTc-DTPA in 11 patients. Correlation coefficients of 0.94 for relative function, 0.83 for parenchymal transit time index and 0.82 for whole kidney transit time index were found. Frusemide responses were similar. 99mTc-MAG3 is an efficacious radiopharmaceutical for routine renal radionuclide studies, giving excellent image quality in patients with hypertension, poor renal function, obstructive nephropathy or a renal transplant.

Adolescent

The treatment of intraperitoneal malignant disease with monoclonal antibody guided 131I radiotherapy.

Seven patients with small volume ovarian carcinoma, remaining after conventional therapy with surgery and a platinum containing chemotherapy regimen, were treated with intraperitoneal monoclonal antibody guided radiotherapy. 100 mCi131I conjugated to 10 mg of monoclonal antibody were injected i.p. in 2,000 ml peritoneal dialysis fluid. Patients were evaluated 3 months later; 3 had clinical progressive disease while third look laparotomy demonstrated progressive disease in 3 of the remaining 4 patients. The seventh patient did not have a third look laparotomy and is currently inevaluable for response. Five patients with recurrent malignant ascites not controlled by diuretics or repeated paracentesis were similarly treated with 75-170 mCi131I conjugated to 10 mg monoclonal antibody. In three patients the ascites was controlled for a mean of 4 months. One patient died too early to assess the control of his ascites but tumour cells disappeared from the ascitic fluid after therapy. In the patient whose ascites were not controlled, a subpopulation of antigen-negative tumour cells was demonstrated. This study was unable to demonstrate a therapeutic benefit for i.p. injected monoclonal antibody guided radiotherapy for solid intraperitoneal tumour but suggests that it may be capable of controlling the accumulation of antigen positive malignant ascites.

Adult

Tumour-associated monoclonal antibodies for the diagnosis and assessment of ovarian cancer.

A tumour-associated radiolabelled monoclonal antibody (HMFG 2) was used to investigate 51 patients who were referred with a pelvic mass and suspected ovarian cancer or recurrent disease. The day before operation the 123I-labelled antibody was injected and the patients then underwent radioimmunoscintigraphy immediately and again 4 and 22 h after the injection. An exploratory laparotomy with appropriate surgery was then performed and the tumours were staged. Tumours were positively imaged 3 min-22 h after injection in all the patients with ovarian cancer, with a mean 0.6% of the injected antibody taken up by the tumour. The presence of HMFG antigen on the tumour was confirmed by immunoperoxidase staining of the surgically-removed tissues. Of the 51 patients, 39 proved to have ovarian cancer. The accuracy of diagnosis and detection of primary and metastatic malignant disease was 95% when correlating pre-operative radioimmune scan findings and laparotomy findings. The procedure is minimally invasive, apparently without side-effects and offers information for tumour detection as an adjunct or alternative to existing methods.

Antibodies, Monoclonal

A prospective study of 123I-labeled monoclonal antibody imaging in ovarian cancer.

Thirty patients presenting with a pelvic mass were entered into a prospective study on the use of radioimmunoscintigraphy with the 123I-labeled monoclonal antibody HMFG2. The imaging data was obtained without knowledge of the clinical data and compared with subsequent surgical findings. A false-positive diagnosis of ovarian cancer was made in five of ten patients subsequently shown not to have ovarian cancer; thus the technique cannot be used as a screening test. A true-positive diagnosis was made in 19 out of 20 patients shown subsequently to have ovarian cancer. In 18 of these patients the distribution of uptake closely fitted the surgical findings. Methods of improving these results are described. In conclusion, radioimmunoscintigraphy is of no use in determining whether a pelvic mass is due to ovarian cancer, but has benefit in the evaluation of chemotherapy and may, in the future, prevent the need for second-look operations in some circumstances.

Antibodies, Monoclonal