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Biomedical subjects

S Packer

Publications and source records attributed to S Packer.

At least 55 records · Page 3Linked to original sources

A symptom based approach to the diagnosis of schizophrenia.

This study reviews the attempts of Carpenter et al to develop valid diagnostic criteria of schizophrenia by means of a flexible 12 point system of signs and symptoms based on the IPSS. The authors applied the 12-point system to 67 inpatients and obtained different levels of certainty in identifying proportions of schizophrenic and non-schizophrenic patients: 80% of clinically diagnosed schizophrenic patients obtained 5 or more points. Kappa statistics revealed a 0.59 proportion of agreement in excess to chance between clinical and experimental diagnosis of schizophrenia, indicating the clinical usefulness of the 12 point system.

Adolescent

Chlorpromazine distribution in hamsters and mice bearing transplantable melanoma.

Chlorpromazine (CPZ) distribution was measured in tissues of Syrian golden hamsters bearing Greene melanoma and in BALB/c mice bearing Harding-Passey melanoma. Distribution was evaluated as a function of time (0.5 to 14 days) and as a function of single and multiple doses (up to five) of from 5 to 50 mg CPZ per kg body weight. Routes of administration (i.p., i.v., p.o.) were compared. The physiological behavior of CPZ is of interest as it is used extensively as a tranquilizing drug (Thorazine). Further, since CPZ binds to the pigment melanin, the possibility exists of using CPZ to transport diagnostic or therapeutic agents to melanoma. It was found that, at 2 days postinjection, tumor/tissue concentration ratios exceeded 10 for metabolizing organs, such as liver and 100 for "back-ground" tissues, such as blood and muscle. Absolute concentrations of CPZ in tumor exceeding 100 microgram CPZ per g tumor were obtained with both single and multiple doses. This selective high concentration in tumor would make CPZ an ideal vehicle for the transport of boron to tumor for use in neutron capture therapy via the 10B(n, alpha)7Li reaction.

Animals

Melanin content of hamster tissues, human tissues, and various melanomas.

Melanin content (percentage by weight) was determined in both pigmented and nonpigmented tissues of Syrian golden hamsters bearing Greene melanoma. Melanin content was also measured in various other melanoma models (B-16 in C57 mice, Harding-Passey in BALB/c mice, and KHDD in C3H mice) and in nine human melanomas, as well as in selected normal tissues. The purpose was to evaluate the possible efficacy of chlorpromazine, which is known to bind to melanin, as a vehicle for boron transport in neutron capture therapy. Successful therapy would depend upon selective uptake and absolute concentration of borated compounds in tumors; these parameters will in turn depend upon melanin concentration in melanomas and nonpigmented "background" tissues. Hamster whole eyes, hamster melanomas, and other well-pigmented animal melanomas were found to contain 0.3 to 0.8% melanin by weight, whereas human melanomas varied from 0.1 to 0.9% (average, 0.35%). Other tissues, with the exception of skin, were lower in content by a factor of greater than or equal to 30. Melanin pigment was extracted from tissues, and the melanin content was determined spectrophotometrically. Measurements were found to be sensitive to the presence of other proteins. Previous procedures for isolating and quantifying melanin often neglected the importance of removing proteins and other interfering nonmelanic substances.

Animals

Irradiation of choroidal melanoma with iodine 125 ophthalmic plaque.

Radioactive iodine 125 is a low-energy gamma isotope with physical characteristics suitable for irradiation of intraocular tumors. Metal ophthalmic applicators have been designed to shield vital ocular structures while allowing irradiation of the tumor. We compared the radiation effects of iodine 125 and cobalt 60. The Greene melanoma was transplanted into the suprachoroidal space of rabbits. The tumor then grew as an intraocular mass, was irradiated, and was followed up for two months before enucleation. Histopathologic examination defined the extent of the radiation damage to the tumor and other ocular structures from the iodine 125 and from the cobalt 60. The eye irradiated with iodine 125 suffered minimal radiation damage, whereas the tumor was sterilized. The eye irradiated with cobalt 60 showed substantial radiation damage, and the melanoma was incompletely treated. Our results support the use of iodine 125 in treating intraocular tumors. More research is needed as to optimum total dose and dose rate.

Animals

Radiotherapy of choroidal melanoma with iodine-125.

The low-energy radioactive source iodine-125 is ideal for the irradiation of an intraocular tumor tumor such as a choroidal melanoma. The energy (28 kev) of iodine-125 should be sufficient to allow sterilization of tumors as high as 10 mm. However, shielding of 18-kev photons can be achieved with thin metal (eg, gold) plaques. Thse eye plaques can be individually designed for each eye tumor, depending on its size, shape, and location. This paper deals with the basic considerations and preliminary observations that have lead us to the adoption of iodine-125 as the sole source for the radiation treatment of all intraocular tumors.

Choroid Neoplasms

Digital infrared fundus reflectance.

An infrared sensor was inserted at the film plane of a fundus camera. The signal was visualized on an oscilloscope. In this manner we measured infrared reflectance from the surface of the fundus. The purpose was to characterize choroidal malignant melanomas more reliably than is done with infrared color translation photography. Control lesions were choroidal nevi, metastatic tumors, and disciform macular degenerations. Correlations were made with radioactive phosphorus (32P) uptake, fluorescein angiography, and histopathologic findings. Several cases are presented, one in which this new method of infrared detection was the first diagnostic test to detect the spread of a choroidal melanoma. The simplicity of this technique and its increased accuracy justify the needed further refinements.

Adult

Radiotherapy of choroidal melanoma with iodine 125.

Although specific data on patients will be useful only after a 5- to 10-year follow up, radiotherapy of choroidal malignant melanoma with 125iodine has several advantages over the other radioactive sources that are presently being used. The low gamma energy of 125iodine allows for construction of metal eye plaques that can attenuate the radiation preferentially so that the tumor is treated while the rest of the eye receives minimal irradiation. This ability to direct the radiation is not possible with high energy sources such as 60cobalt. The ability to control the dose rate as well as the total dose is yet another advantage. Exact positioning of the 125iodine seeds in a plaque allows for an even distribution of the radiation throughout the tumor. Six patients have been treated. We are enthusiastic, but consider this an experimental procedure until our follow-up is complete.

Aged

Radioactive phosphorus uptake test. An in vitro analysis of choroidal melanoma and ocular tissues.

The concentration of radioactive phosphorus in uveal melanoma and normal parts of the eye was determined in vitro in 14 eyes. The eyes were enucleated after a positive 32P uptake test. Portions of the melanoma as well as normal choroid, retina, sclera, lens, and vitreous were analyzed. The 32P uptake test had been performed at various intervals after intravenous administration of 32P from 24 to 556 hr. The in vitro uptake of 32P was compared to cell type, tumor volume, time of testing, percent uptake measured clinically, and specific activity. The only positive correlation was between percent uptake measured clinically and 32P concentration (dpm/gm). A higher concentration of phosphorus in melanoma resulted when carrier-free 32P was used. A negative correlation existed between number of hours from injection to clinical measurement of percent uptake, although melanoma to normal choroid ratios did not change from 24 to 72 hr. No correlation was found between uptake and tumor volume. The sample was small; however, we saw no correlation between 32P uptake and degree of malignancy.

Aged

Treatment of minimal brain dysfunction in a young adult.

A discussion of the clinical picture and treatment of minimal brain dysfunction in post adolescence is presented. Small amounts of methylphenidate appear to have a salutary effect on symptoms such as irritability, moodiness, restlessness and poor concentration .

Adolescent

The effect of zinc on insulin metabolism.

Experiments were designed to study the effect of Zn on in vivo and in vitro insulin metabolism. The in vivo experiments involved pretreating mice with either Zn or Na, followed by ip [125I]iodoinsulin injection. Pretreatment of mice with Zn resulted in an accelerated and increased magnitude of binding of [125I]iodoinsulin to the liver compared to mice pretreated with Na. Results are submitted which support the probability that the changes in the amounts of intact and degraded insulin in circulation with time are related to the binding and degradation of insulin in the liver rather than in the kidney. In vivo ip injected insulin was demonstrated to preferentially bind to the plasma membrane of the liver. Liver plasma membranes isolated from mice pretreated with Zn bound more [125I]iodoinsulin than plasma membranes of Na-pretreated mice. In vitro experiments employing isolated liver plasma membranes demonstrated that added Zn increased the binding and inhibited the degradation of insulin. Evidence is presented that supports the concept that two receptors exist, one at which degradation of [125I]iodoinsulin occurs and another at which degradation does not occur.

Animals

The ultrasound guided 32P test.

The accurate and early diagnosis of intraocular malignant melanoma in eyes with opaque media remains a diagnostic problem. Ultrasonography and the radioactive phosphorus (32P) uptake test have been used separately as modalities for diagnosis of choroidal melanoma. However, their combined use has received limited attention. This report presents our experience in 5 cases with the combined use of a contact B-scan ultrasound unit and a posterior eye probe. In all cases we were able to accurately perform the 32P uptake test with simultaneously ultrasound visualization of the tumor and the probe.

Aged

Metal isotopes used as radioactive indicators of ocular melanoma.

We studied radioactive metal compounds to determine their localization in malignant Greene melanoma in the eye of the Syrian golden hamsters. Scintigraphy of an ocular melanoma was achieved with several radioactive metals: radioactive indium(111In)-bleomycin, radioactive gallium (67Ga)-citrate, and radioactive lead (203Pb)-tris. The 111In-bleomycin had the highest tumor uptake (5.45% dose/g), but not the highest tumor-to-background ratios. The 67Ga-citrate had a maximum tumor uptake of 4.87% dose/g at 48 hours. The 111In-chloride had a melanoma uptake of 2.26% dose/g, while with 203Pbtris the uptake was 1.61% dose/g. These uptake ratios compare favorably with that of radioactive phosphorus (32P)-2.21% dose/g. Noninvasive localization of malignant melanoma in the eye was accomplished with metal isotopes. Detailed analysis of in vitro uptake date by tumor and background tissues revealed the optimum time for scanning and precluded unnecessary trials.

Animals

Radiation therapy of choroidal melanoma.

During the past 8 years, 32 patients with melanoma of the choroid have been treated with cobalt-60 ophthalmic applicators. Excluding three patients lost to follow-up, 24 patients who have now been observed for at least 3 years after treatment form the subject of this study. Each application but two delivered 8,500 to 10,000 rads to the tumour apex. A second application was performed in large tumours showing a poor response to the initial plaque treatment. The factors affecting results include age of the patient, tumour size, total dose delivered, and dose rate. Three out of seventeen patients with tumour diameters greater than 12 mm died of their disease with pulmonary and/or liver metastasis. Three eyes required enucleation and no residual tumour was found in two specimens. Three patients, average age 76 years, died from causes other than melanoma. An 83 per cent relative survival, excluding the three patients lost to follow-up, compares favourably with enucleation. The low incidence of metastasis after radiotherapy suggests augmentation and/or continuation of the host's immune response. Low energy radiation using Iodine-125, with its unusual protective characteristics is ideal for treatment of choroidal melanoma.

Aged

Urinary outputs of oxalate, calcium, and magnesium in children with intestinal disorders. Potential cause of renal calculi.

24-hour urinary outputs of oxalate, calcium, and magnesium have been determined in a total of 62 children aged 3 months to 17 years who fell into the following groups: (i) 16 normal controls, (ii) 3 with primary hyperoxaluria, (iii) 9 with small and/or large intestinal resections, (iv) 9 with untreated coeliac disease, (v) 5 with pancreatic dysfunction, and (vi) a miscellaneous group of 20 children with a variety of intestinal disorders. Taken as a whole, 58% of patients with intestinal disorders had hyperoxaluria, and of these 7% had urinary outputs of oxalate which fell within the range seen in primary hyperoxaluria. The proportion of children with hyperoxaluria in the different diagnostic groups was as follows: intestinal resections (78%), coeliac disease (67%), pancreatic dysfunction (80%), and miscellaneous (45%). 35% of the patients with hyperoxaluria had hypercalciuria, whereas magnesium excretion was normal in all subjects studied. In 2 patients treatment of the underlying condition was accompanied by a return of oxalate excretion to normal. These results indicate that hyperoxaluria and hypercalciuria are common in children with a variety of intestinal disorders, and that such children may be at risk of developing renal calculi without early diagnosis and treatment.

Adolescent

Cellular infiltrate of the jejunum after re-introduction of dietary gluten in children with treated coeliac disease.

Jejunal lamina propria plasma cells and eosinophils and intraepithelial lymphocytes were raised in coeliac children on gluten-containing diets, but only intraepithelial lymphocytes were increased in patients on gluten-free diets. In contrast, lamina propria lymphocytes were reduced in children with coeliad disease on gluten-containing diets but were normal in paitents on gluten-free diets. In children with coeliac disease who were studied serially, lamina propria plasma cells and eosinophils and intraepithelial lymphocytes increased, and lamina propria lymphocytes decreased, within three months of the reintroduction of gluten to the diet. These observations are essentially similar to those made in the adult form of the disease and suggest that more than one type of immunological reaction is involved in the pathogenesis of the jejunal lesion.

Adolescent