Biomedical subjects
Publications and source records attributed to G Lundell.
Eight patients with persistent pain due to disseminated bone metastases from mammary carcinoma were given about 370 MBq (10 mCi) of 32P-pyrophosphate on 10 occasions. All but one of the patients experienced alleviation of pain lasting 1 to 4 months. The side effects, which derived mainly from haematopoetic tissue, prevent the routine use of this compound.
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Between 1952 and 1965, 10,133 patients received an average of 60 mu Cl of 131I for diagnostic examinations of the thyroid gland. The examinations were mainly done on adults, and only 5% of the patients were younger than 20 years at the time of examination. Of the patients, 9 appeared in the Swedish Cancer Registry between 1958 and 1977 with a diagnosis of malignant tumor of the thyroid gland more than 5 years after the administration of 131I. Inasmuch as the expected number of malignant thyroid tumors computed from Swedish cancer incidence figures was 8.3, there was no elevation of the incidence of malignant thyroid tumors in these patients receiving diagnostic doses of 131I. The patients were examined because of a suspected thyroid dysfunction and therefore represented a selected group. The investigation is being continued to analyze further parameters that could have a bearing on these results.
The size of the thyroid glands was analyzed for 10% of the patients in a selected group that had been exposed to diagnostic doses of 131I. The mean thyroid gland weight +/- SD was 50 +/- 33 g for patients 20 or more years of age and 10 +/- 5 g for patients less than 20 years of age. With the present follow-up, diagnostic doses of 131I appeared not to be associated with an increased risk for later development of malignant thyroid tumors. Possible reasons for the difference between the observed number of such tumors and the number expected (47-124) on the basis of risk estimates of the United Nations Scientific Committee on the Effects of Atomic Radiation are discussed.
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Peripheral lymphoid cells from euthyroid and hyperthyroid subjects were tested for proliferative responses to human thyroglobulin in vitro using [3H] thymidine incorporation as assay. Non-fractionated lymphoid cells from both groups displayed weak stimulation. Using a rosette technique for separating sub-populations of lymphoid cells it was concluded that T-cells constituted the responding cells. The results indicate that both hyperthyroid and euthyroid subjects possess clones of T-cells which are reactive against human thyroglobulin.
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The value of 75Se-selenite scintigraphy in clinical staging was investigated in 45 patients with Hodgkin's disease and in 28 patients with non-Hodgkin's lymphoma. Of these, 9 patients had recurrence of previously treated lymphomas. The scintigraphic results were compared with clinical, cytologic, histologic and radiographic findings in different anatomic regions. 75Se-selenite scintigraphy resulted in 6 to 20 per cent false negative findings, 15 to 43 per cent false positive and 12 to 20 per cent equivocal evaluations, the accuracy being least in the abdominal region. The relatively high rediation dose delivered by 75Se-selenite, furthermore, makes it less attractive for use in the primary diagnosis of malignant lymphomas.
The DNA-synthesis of human lymphoid cells as estimated by the measurement of thymidine incorporation in vitro was investigated in healthy controls and in patients with various thyroid disorders before and after therapy. Hyperthyroid patients treated with 131I and surgery (euthyroid at initial blood sampling before surgery), patients with atoxic nodular goitre treated by surgery and healthy untreated control individuals comprised the material. The synthesis of DNA in lymphocytes was higher in hyperthyroid patients in comparison with euthyroid individuals, and decreased subsequent to 131I therapy in the hyperthyroid patients. No decrease was recorded in the other groups of patients. No evidence suggesting a change in the lymphocyte reactivity to thyroglobulin was found in any of the patient groups.
Thymus-derived and non-thymus-derived peripheral blood lymphocytes were examined by means of E- and EAC-rosette tests. The frequency of these lymphocyte populations was the same in hyperthyroid and euthyroid individuals. It was also demonstrated that PHA responsiveness of lymphocytes from hyperthyroid patients was equal to that of lymphocytes from euthyroid controls and did not change after treatment with 131I.
A comparison of three compounds for bone scanning has been carried out in 9 patients with metastatic mammary carcinoma for evaluating their effectiveness. The best results were obtained with 99Tcm diphosphonate. For the other two compounds tested, 99Tcm polyphosphate and 99Tcm pyrophosphate, no difference could be demonstrated.
The different types of circulating leucocytes were examined in 54 patients before and 2 to 4 months after 131I therapy for hyperthyroidism. An absolute and differential percentage increase in the number of juvenile segmented neutrophils, eosinophilic and basophilic granulocytes was demonstrated in the patients free from signs of hyperthyroidism after therapy. This increase was statistically significant. No changes occurred in the 11 patients remaining hyperthyroid.
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The impact of D- and L-forms of triiodothyronine and thyroxine on DNA-synthesis of human lymphoid cells was tested in vitro. The incorporation of 14C-thymidine into DNA was increased by addition of large quantities of both types of hormone in either racemic form.
A new 99Tcm-labelled compound, 99Tcm-Solcocitran, has been introduced for detection of bone and brain malignancy. It is claimed to be specific for neoplastic tissue. In the present material, however, 99Tcm-Solcocitran was less sensitive in indicating metastatic bone lesions in patients than was 99Tcm-Diphosphonate or conventional radiography. Both 99Tcm compounds accumulated in fractures in dogs. 99Tcm-Solcocitran seems to offer no advantage over existing techniques in the detection of bone malignancy.
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