Elderly alcoholics in a general medicine practice.
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Biomedical subjects
Publications and source records attributed to M Lichtenstein.
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This report describes the use of 131I-labeled monoclonal antibodies in two experimental models for tumor immunotherapy. In vitro treatment of the radiation-induced murine thymoma ITT-1-75NS with radiolabeled anti-Ly-2.1 significantly impaired subsequent tumor growth in vivo. However, in vivo treatment of this tumor, which previously had been injected into C57BL/6 mice, was unsuccessful. By contrast, in vitro treatment of a human colorectal tumor cell line (COLO 205) with 131I-labeled 250-30.6--a monoclonal antibody directed against a secretory component of normal and malignant gastrointestinal epithelium--completely inhibited subsequent tumor growth in BALB/c nude (nu/nu) mice. Furthermore, in vivo treatment of preexisting human colorectal tumor xenografts significantly impaired progressive tumor growth. Although some tumor inhibition was also produced by unlabeled 250-30.6 antibody, this response was considerably amplified by treatment with [131I]-labeled 250-30.6 (P less than .05), suggesting that in vivo treatment of human tumors with the use of 131I-labeled monoclonal antibodies may be clinically beneficial. The antithyroid drug propylthiouracil was used to reduce dehalogenation of the radiolabeled immunoglobulins in an attempt to improve their therapeutic efficacy.
A recurrent unilateral pleural effusion developed without obvious cause in two patients with cirrhosis of the liver. By the demonstration of the rapid passage of a radiolabelled colloid from abdomen to thorax, these effusions were proved to be secondary to clinically undetectable peritoneal effusions. A diaphragmatic tear, which had occurred during a previous splenectomy and which was apparent only at autopsy, was the cause of peritoneopleural communication in one patient. Previous surgery could also have been responsible for the pleural effusion in the other patient.
A radiolabelled monoclonal antibody was injected intravenously into two patients with disseminated carcinoma of the colon and serial scintigrams were then obtained on three consecutive days. In addition to the "specific" antibody image, blood pool and conventional liver scans were also obtained. After computer-based subtraction discrete hepatic metastases could be demonstrated in both patients, while in the second patient, the primary colonic tumour was also visualised for the first time. The study demonstrates the specific localisation of primary and secondary carcinoma of the colon with a radiolabelled monoclonal anti-tumour antibody and offers an improved method of specifically detecting tumours in man.
Thirty-two patients with fractures of the limbs were studied 15-30 min following 99mtechnetium sulphur colloid injection. In 17 of the 19 patients where osteomyelitis was superimposed on the various fractures, significant uptake of sulphur colloid was noted at the fracture sites. The sensitivity for the test was 89.5%. In 12 of the 13 cases where osteomyelitis was absent, the sulphur colloid scan was negative giving a specificity of 92.3%. Hence a technetium sulphur colloid scan has shown to be a successful method for detecting osteomyelitis complicating a limb fracture.
For the evaluation of the clinical usefulness of monoclonal antibodies as diagnostic or therapeutic reagents, tumor localization must be clearly demonstrated in an experimental model. In this report, nude mice carrying two human tumor xenografts--a colon carcinoma (Colo 205) and a melanoma (Colo 239)--were given ip injections of radiolabeled monoclonal antibodies. Monoclonal antibody 250-30.6, which reacted specifically with the colon carcinoma but not with the melanoma, was labeled with 125I, while a second monoclonal antibody of similar immunoglobulin subclass, but unreactive with either cell type, was labeled with 131I. Both antibodies were injected simultaneously, and either the mice were scanned with a gamma camera or their tissues were removed and the localization of radiolabeled antibody was calculated with the use of localization index (LI)--the ratio of the tissue to blood distribution for each isotope. The studies showed that specific localization had occurred, there being a colon tumor LI of 6 at 2 days. Tumors of 150-300 mg (mean diameter, 6 mm) and with an LI as low as 1.5 could be successfully imaged after computer-assisted background subtraction. This study demonstrated that relatively small human tumor xenografts in the nude mouse can be specifically detected with the use of paired monoclonal antibodies, each labeled with a different isotope.
This study investigated the hypothesis that individuals with androgynous personalities would be more competent sexually than individuals with sex-typed personalities. Scores on the Bem Sex-Role Inventory were compared for a patient group and a control group. The data revealed a higher percentage of androgynous subjects in the control group than in the patient group. Even when only one spouse was androgynous, the chances of sexual competence within the couple increased. In addition, there was more sex typing among the longer married patient couples and more stereotyped femininity in both men and women in the patient group. The results were taken to support the view that the androgynous person's flexibility and adaptability is conducive to a satisfactory sexual relationship. Some cultural differences between Israeli and American samples were noted. Findings contradicted the cultural stereotypes of the macho Israeli male and the nonfeminine Israeli woman.
Diuretic renography using radioidine sodium hippurate and a frusemide stimulus was used to differentiate between obstructive and nonobstructive dilatation of the urinary tract. Information was recorded by a gamma camera on line to a computer. Sixty-seven uretero-renal units (URU) were studied in 33 patients with an average age of 91/2 years. The diuretic renogram correctly indicated obstructions in 18 URU but gave false positive results in another five. Of these five, four had severely impaired function. The renogram indicated nonobstruction in 49 URU, and gave false negative results in another two; of these two one patient had a duplex kidney with a poorly functioning ureteric segment and the other patient had gross reflux and megaureters. The diuretic renogram is useful in the investigation of equivocal upper urinary tract obstruction but may be unreliable in situations of inadequate renal function.
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The vascular reactivity of forearm arterioles was measured in 16 control subjects (C) and 30 insulin-dependent diabetic (IDDM) subjects, 16 of whom were shown to have microvascular and/or neuropathic complications (DC) including 8 with autonomic neuropathy (DCa) and 14 were shown to be free of complications (DNC). Forearm blood flow was measured by strain gauge plethysmography basally, following a cold pressor stress and following a period of arterial occlusion (reactive hyperaemia). The tests were repeated 24 h later following aspirin treatment. Both C and DNC showed a significant reduction in blood flow in the cold pressor test (C 0.64 +/- 0.12, DNC 0.89 +/- 0.22 ml/100 ml forearm tissue/min reduction in flow P < 0.005), while DC showed no significant response. Reactive hyperaemia was significantly greater in C than in DNC or DC (8.37 +/- 1.14, 5.51 +/- 1.27 and 4.95 +/- 0.75 ml/100 ml tissue/min, respectively, P < 0.02). In the DC group, DCa had significantly less response than those without autonomic neuropathy. Aspirin treatment restored the response of DNC but not DC to normal, suggesting that the abnormality in the former group may have been due to overproduction of a vasoconstrictive cyclooxygenase product (such as thromboxane A2). It is concluded that the abnormalities of vasomotor responses in diabetic subjects are complex and are apparently dependent on autonomic neuropathy, humoral and perhaps structural changes.