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PubMed1979

Intracavitary uses of colloids.

Pleural and peritoneal effusion secondary to primary malignancy is a significant problem in the management of the cancer patient. Respiratory embarrassment and discomfort associated with the formation and collection of fluid in the chest and abdomen are among the most distressing symptoms encountered as a result of malignant disease. The guidelines for treatment should be based on respiratory symptoms, and with the understanding that the procedure is palliative. Both surgical and medical forms of treatment have been used. These include thoracostomy-tube drainage alone or with the instillation of antimicrobial agents. Pleurectomy is effective but should be reserved for situations in which conservative approaches have failed. Antitumor agents, such as nitrogen mustard, are effective but toxic. The mode of action of antineoplastic agents is related to their ability to cause pleural sclerosis and obliterate the pleural space. Systemic chemotherapy and external beam radiation are rarely effective. The intracavitary application of radioactive colloids has been used since 1945. Colloidal radioactive gold Au 198 has been replaced by the pure beta emitter, colloidal chromic phosphate P 32. Instillation of a colloidal suspension of radioactive phosphorus represents a significant and effective palliative therapeutic modality for malignant effusion.

Adult↗
PubMed1978

[Results of the intraperitoneal application of radioactive gold in cases of ovarian cancer (author's transl)].

Radioactive gold was instilled once into the peritoneal cavity of 248 patients with ovarian carcinoma of varying stages. The criterium for the radioactive gold instillation was either for the post-operative treatment in stage 1A or for the treatment of ascites in more advanced stages. The treatment had no clear cut influence on the five year survival rate. The treatment with radioactive gold Au 198 was very effective in the treatment of ascites and had less side effects than other radioactive colloidal materials.

Ascites↗
PubMed1975

Liver blood flow and blood volume following chronic phenobarbitone administration.

Mlae rats were ra&ndomly divided into 2 groups one of which received 30 mg/kh phenobarbitone for 4 days i.p. and the other sodium chloride. Liver blood flow was measured 24 hr following the last injection of phenobarbitone or sodium chloride using the radioactive colloidal gold clearance technique. In addition, blood volume, liver weight and extraction of radioactive gold were estimated. Following 4 daily infections of phenobarbitone the body weight and the blood volume of both groups were not significantly different. The liver weight in the phenobarbitone treated groups was 27% higher than that found in the control group. Liver blood flow increased from 22.7 ml/min (92,8 ml/min/kg body weight) to 30.1 ml/min (123.7 ml/min/kg body weight). This increase of 33% was highly significant (p less than 0.005). In contrast, the extraction of radioactive gold was 11% lower in the phenobarbitone treated groups than in the controls. The earlier, semiquanititative finding of increased blood flow using a chronic implanted thermocouple could thus be quantified by the present study.

Animals↗
PubMed2001

Synoviorthesis with radioactive gold in haemophilia.

According to the experiences of the Malmö Haemophilia Centre, the best way to avoid recurrent joint bleedings and synovitis in haemophilic patients and to prevent progressive joint disease is prophylactic factor treatment. If prophylaxis is impracticable and also in patients with factor inhibitors, radioactive synoviorthesis seems to be a good treatment option if started early.

Adolescent↗
PubMed1988

Similarities in function between pancreatic tumor cells and macrophages and their inhibition by murine monoclonal antibodies.

Fine structural studies of human pancreatic adenocarcinomas have demonstrated their composition of one major secretory cell type, a mucin secreting cell. It was also demonstrated that pancreatic tumor cells have a high endocytotic activity via the regular endocytotic pathway with uptake via coated pits and vesicles. These findings indicate a striking similarity between pancreatic tumor cells and human mononuclear phagocytes. Therefore monocyte-related functions like endocytosis, lysosomal enzyme secretion and superoxide anion production were measured in various cell lines of human pancreatic adenocarcinomas in comparison to human mononuclear phagocytes. These functions were measured under basal conditions and after exposure to zymosan or immune complexes. All pancreatic tumor cells tested demonstrated increased endocytotic, secretory and oxidative burst activity to a similar extent as human mononuclear phagocytes after exposure to the stimuli (zymosan or immune complexes). In a further attempt murine monoclonal antibodies produced against pancreatic tumor cells were characterized in relation to their tissue specificity, the epitope recognized in in vitro and in vivo radiolocalization and their potential to mediate biological functions (e.g. antibody dependent cellular cytotoxicity or complement mediated cytolysis). Mouse monoclonal IgG1 antibodies which specifically bind to the majority of well differentiated adenocarcinomas of the human pancreas as well as to human mononuclear phagocytes have been shown to inhibit several cellular functions (lysosomal enzyme release, pinocytosis of colloidal gold 198Au, and chemiluminescence) of those cells. Incubation of 10 micrograms/ml of monoclonal IgG1 antibody with pancreatic tumor cell lines or human monocytes either simultaneous or followed by the stimulation with zymosan (50 micrograms/ml) or immune complexes (100 micrograms/ml) resulted in the inhibition of lysosomal enzyme release and uptake of colloidal radioactive gold of both human mononuclear phagocytes and pancreatic tumor cells responding to zymosan or immune complexes. In addition those monoclonal antibodies have been found to inhibit luminol-dependent chemiluminescence. Kinetic measurements of chemiluminescence showed a quick inhibition of this activity on both cell types within 1 to 3 minutes. Antibody F(ab')2 fragments behaved analogously to the whole antibodies, whereas monovalent Fab fragments were not able to inhibit any of the mentioned functions. When used alone the monoclonal antibodies were not cytotoxic and did not theirselves trigger release of acid hydrolases, did not alter pinocytosis and did not induce oxidative metabolism.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenocarcinoma↗
PubMed1989

Cerebral aneurysms following radiotherapy for medulloblastoma.

Three patients, two males and one female aged 21, 14, and 31 years, respectively, developed cerebral saccular aneurysms several years after undergoing radiotherapy for cerebellar medulloblastoma at 2, 5, and 14 years of age, respectively. Following surgery, all three received combined cobalt-60 irradiation and intrathecal colloidal radioactive gold (198Au) therapy, and died from rupture of the aneurysm 19, 9, and 17 years after the radiotherapy, respectively. Autopsy examination revealed no recurrence of the medulloblastoma, but widespread radiation-induced vasculopathy was found at the base of the brain and in the spinal cord, and saccular aneurysms arose from the posterior cerebral arteries at the basal cistern or choroidal fissure. The aneurysms differed from the ordinary saccular aneurysms of congenital type in their location and histological features. Their locations corresponded to the areas where intrathecally administered colloidal 198Au is likely to pool, and they originated directly from a segment of the artery rather than from a branching site as in congenital saccular aneurysms. It is, therefore, concluded that the aneurysms in these three patients were most likely radiation-induced.

Adolescent↗
PubMed1979

Screening for pancreatic disease: A comparison of grey-scale ultrasonography and isotope scanning.

The efficiency of ultrasound in the diagnosis of pancreatic disease was compared prospectively with that of selenomethionine isotope scanning in 46 patients presenting with abdominal pain or weight-loss or with jaundice. Of 14 patients who later proved to have pancreatic carcinoma, all had an abnormal isotope scan and 13 had an abnormal ultrasound scan. Of 10 patients with chronic pancreatitis, all had an abnormal isotope scan and 9 had an abnormal ultrasound scan. The small advantage of selenomethionine was, however, offset by a higher false-positive rate: of 22 patients who proved not to have pancreatic disease, 13 had abnormal isotope scans compared with only 3 with ultrasound. Review of earlier experience with the two techniques yielded similar results: in pancreatic carcinoma and chronic pancreatitis, isotope scanning gave slightly fewer false-negative results than ultrasound but many more false-positives. Because of its lower false-positive rate, because it avoids ionising radiation, and because it can usually distinguish carcinoma from pancreatitis, ultrasound is the procedure of choice for initial investigation of patients with suspected pancreatic disease.

Chronic Disease↗
PubMed1975

Mass isolation and culture of rat kupffer cells.

Collagenase perfusion of the liver followed by pronase treatment of the cell suspension thus obtained gave a quantitative recovery of viable nonparenchymal liver cells (NPC). From these NPC, Kupffer (K) cells can be purified by attachment to tissue culture dishes. Tail vein injection of carbon 1-2 h before liver perfusion permitted stepwise calculation as well as visualization of carbon-containing K cells. When these K cells have been put into tissue culture medium with serum and incubated overnight, they exhibit typical macrophage characteristics. Phase-contrast and transmission electron microscopy showed typical macrophage morphology and scanning electron microscopy revealed well-spread cells with cytoplasmic projections and ruffled membranes. Endocytosis studies using radioactive colloidal gold and inert latex particles also indicated that these cells are highly active in pinocytosis and phagocytosis. Further characterization of K cells is the identification of Fc receptor on their membranes. Studies on lysosomal enzymes showed that purified K cells possess higher specific activities in beta-glucuronidase, acid DNase, and cathepsin D than in purified parenchymal cells.

Animals↗
PubMed1977

A rational approach to the surgical management of melanoma.

Our experience with 294 regional lymph node dissections in 250 patients are reviewed. The relationship between the Clark's level of invasion and the thickness of the primary is related to regional lymph node metastases. Patients with Clark's Level III melanoma had a 29% incidence of regional lymph node metastases, Clark's Level IV had a 42% incidence of regional lymph node metastases and Clark's Level V a 58% incidence of regional lymph node metastases. Primary melanomas greater than 1.5 mm in thickness had a 38% incidence of positive regional lymph nodes. We therefore recommend a regional lymphadenectomy in patients with Clark's Levels III, IV and V and all melanomas that are greater than 1.5 mm in thickness. A new technique is described which is helpful in localizing the direction of ambiguous lymphatic drainage in patients with truncal melanoma. The use of radioactive colloidal gold scanning has been useful in predicting lymphatic shed in these ambiguous truncal melanomas. Certain technical aspects of inguinal lymph node dissection are emphasized in an attempt to reduce the morbidity of these dissections. It is emphasized that iliac-obturator lymph node dissections are not performed unless the inguinal lymph nodes are found to be involved by frozen section examination at the time of surgery.

Female↗
PubMed1979

Radiocolloids in the treatment of ovarian cancer.

Though radiocolloids have been used for over twenty years in the treatment of ovarian cancer, no comprehensive review of the literature exists. This review incorporates the historical development of radiocolloids, discusses the physical properties and physics of the two commonly used colloids, radioactive gold (Au-198) and radioactive phosphorus (P-32), discusses instillation and distribution of intraperitoneally administered P-32, and reviews result of treatment. The conclusions reached from this review are that Au-198 is a very different radiocolloid than P-32; that the dose of clinically used P-32 is determined from an empirically determined dose of Au-198; and that the dose of 100 mCi to 150 mCi of Au-198 yields significantly greater radiation than 10 mCi to 15 mCi of P-32. The complications associated with Au-198 are results of a possibly excessive dose, with a significant gamma component, delivered over a shorter period of time. It is clear that in greater than 99% of distintegrations each beta particle is associated with a gamma component. The review of the literature also shows that no propsective randomized well controlled study has indicated the effectiveness of P-32 over other treatment modalities. The clinical applicability of P-32 awaits prospective randomized trials and the ability to accurately determine dose and dose-distribution in-vivo.

Dose-Response Relationship, Radiation↗
PubMed1990

Effect of sulfur dioxide on pulmonary macrophage endocytosis at rest and during exercise.

Inhaled SO2 may cause damage by injuring upper airways. To what extent can SO2 also alter pulmonary macrophage function in the parenchyma and what is the impact of exercise? We studied the effect of SO2 on pulmonary macrophage endocytosis in resting and in exercising animals by measuring the rates of macrophage endocytosis in situ for 1 h of a test particle of insoluble radioactive colloidal gold (198Au), 1, 24, or 48 h after inhalation exposure to SO2. Resting hamsters exposed for 4 h to 50 ppm SO2 had no significant reduction in macrophage endocytosis compared with air-breathing control hamsters. However, if hamsters were exposed to the same concentration of SO2 while continuously running (40 min at 0.9 km/h), macrophage endocytosis was significantly reduced 1 h after exposure even though the exposure time was only one-sixth as long. Twenty-four hours later, the percentage of gold ingested by pulmonary macrophages remained significantly depressed. By 48 h, the rate had returned to control values. Exercise alone did not affect endocytosis. Hamsters exposed to 50 ppm SO2, with or without exercise, also showed significant reductions in the number of lavaged macrophages. This decrease was greatest and most persistent in the SO2 plus exercise group. These data indicate that even when animals are exposed to water-soluble gases, which are normally removed by the upper airways, exercise can potentiate damage to more peripheral components of the pulmonary defense system such as the macrophage.

Animals↗