Detection of acute inflammation with In-Labeled nonspecific polyclonal IgG

The detection of focal sites of inflammation is an integral part of the clinical evaluation of the febrile patient. When anatomically distinct abscesses are present, lesion detection can be accomplished by standard radiographic techniques, particularly in patients with normal anatomy. At the phlegmon stage, however, and in patients who have undergone surgery, these techniques are considerably less effective. While radionuclide methods, such as Gallium-67 (67Ga)-citrate and Indium-111 (111In)-labeled WBCs have been relatively successful for the detection of early inflammation, neither approach is ideal. In the course of studies addressing the use of specific organism-directed antibodies for imaging experimental infections in animals, we observed that nonspecific polyclonal immunoglobulin G (IgG) localized as well as specific antibodies. Preliminary experiments suggested that the Fc portion of IgG is necessary for effective inflammation localization. Since polyclonal IgG in gram quantities has been safely used for therapy in patients with immune deficiency states, we decided to test whether milligram quantities of radiolabeled IgG could image focal sites of inflammation in humans. Thus far, we have studied a series of 84 patients with suspected lesions in the abdomen, pelvis, vascular grafts, lungs, or bones/joints. In 48 of 52 patients with focal lesions detected by surgery, computed tomography (CT), magnetic resonance imaging (MRI), or ultrasound (US), the IgG scan correctly localized the site, while 31 patients without focal inflammation had no abnormal focal localization of the radiopharmaceutical. Four patients had false negative scans and one patient had a false positive scan. For this small series, the overall sensitivity and specificity were 92% and 95%, respectively. In this report, we review our experience with this exciting new agent.     

Analysis of malignancy in human cells: malignant and transformed phenotypes are under separate genetic control.

Human cell hybrids derived from malignant HeLa and normal fibroblast parental cells expressed many of the transformed properties of the HeLa parent but their tumor-producing capability was suppressed. Hybrids derived from HeLa/HeLa fusions retained both their transformed and malignant phenotypes. Thus, an apparent separation of the control of the transformed versus malignant phenotype is indicated. Furthermore, several transformed properties--including lack of density-dependent inhibition of growth, lectin agglutination, lowered requirement for serum growth factors, and anchorage independence--are expressed coordinately in the nontumorigenic hybrids. This finding suggests that none of these properties by themselves, or in concert, endows a cell with tumorigenic potential.     

The application of a new method of limb blood flow measurement using a radioactive isotope and a gamma camera

To evaluate a new method for limb blood flow measurement using a radioactive isotope and a gamma camera, blood flow measurements have ben made on 108 patients with peripheral vascular disease. Thirty-six patients had ischaemic rest pain, of whom two had previously undergone unilateral amputation. Five had bilateral symptoms, giving 29 asymptomatic limbs and 41 limbs with critical ischaemia. In 72 patients with intermittent claudication a series of exercise tests were attempted, in 33 these were unsatisfactory; 13 patients had a greater than 20% variability in the maximum walking distance between four tests and in 20 walking distance was limited by factors other than claudication. In these 33 patients the limb blood flow to the symptomatic leg was 3.95 (1.36-11.08) ml/100 ml of tissue/minute. This is not significantly different from the limb blood flow to the symptomatic leg of the 39 patients who satisfactorily completed four exercise tests, 3.75 (1.08-8.25) ml/100 ml of tissue/minute. In these 39 patients the mean pain-free walking distance was 40 metres and the mean maximum walking distance was 63 metres. The limb blood flow to the 41 symptomatic limbs of 36 patients with rest pain was 1.90 (0.90-4.49) ml/100 ml of tissue/minute, which is significantly less than that obtained in claudicants. There was a wide range of blood flow values found in the asymptomatic limbs of all the patients and in many cases the flow was markedly reduced from normal. This method of limb blood flow measurement is accurate and reproducible and may be recommended for assessment of peripheral vascular disease.     

Indirect fluorescence test for the detection of anti-gonoccocal antibodies.

(1) An indirect fluorescence test for the detection of anti-gonococcal antibody is described. (2) Positive results at a serum dilution of 1 in 16 or above were obtained with sera from 20 per cent. of males and 61 per cent. of females with bacteriologically proven gonorrhoea. 3-8 per cent. of presumed false positive results were given by sera from patients presumed not to have gonorrhoea. (3) In different groups of sera, tests for IgM anti-gonococcal antibody were positive in 32 per cent. of those from males but in only 43 per cent. of those from females with positive cultures.     

The problems and the values of objective nursing observations in psychiatric nursing care

This paper describes a drug trial which illustrates the problems involved in objective nursing recordings to assess response to a specific treatment. It also highlights some difficulties in recording results. The paper briefly describes the history and diagnosis of a patient and the choice of treatment. The method of formulation of a checklist and the difficulties in completing a study are discussed. The results of the study and their value in planning future work are outlined. Conclusions are drawn about the feasibility of carrying out a controlled drug trial with a patient on a ward but the most important aspects are the ability of nurses to perform objective assessments and the value of this approach when assessing a patient and his response to treatment.     

Ontogenesis of beta-adrenergic binding sites in kitten visual cortex and the effects of visual deprivation

We have determined maximum binding capacities for beta-adrenergic binding sites in developing cat visual cortex. These increase quickly from birth to 4 weeks, after which time a slower increase reaches maximal levels at 12 weeks. Dark-rearing and monocular eyelid suture have no influence on this developmental profile.