Radiolabelled monoclonal antibodies in oncology. III. Radioimmunotherapy

The requirements, problems and progress of radioimmunotherapy in the management of certain malignancies are described. The future prospects using a two- or three-stage approach are promising.     

Value of a random single Doppler study of the umbilical artery for predicting perinatal outcome

A prospective blinded study was performed on 191 high-risk patients with pregnancies ranging from 25 to 42 weeks gestation to investigate the value of a single Doppler analysis of the umbilical artery blood flow waveform (systolic-to-diastolic ratio, S/D) for predicting poor perinatal outcome. This was defined as the presence of heavy meconium, delivery of a growth-retarded infant, an umbilical cord arterial pH less than 7.2, or a 5-minute Apgar score less than 7. The interval between Doppler examination and delivery ranged from 12 hours to 15 weeks. No clinical data were available to the examiner performing the Doppler study. Moreover, the Doppler measurements were unknown to the attending physicians. The sensitivity, specificity, and positive and negative predictive values of the Doppler study in predicting outcome were 30.4%, 92.9%, 36.8%, and 92.6%, respectively, with an adverse outcome prevalence of 12%. These results indicate that a single random S/D ratio from the umbilical artery is not an adequate screening test for the risk of perinatal complications.     

Common dental conditions in patients receiving restorative dentistry

Conditions that affect the dentition and the materials utilized to treat these conditions are often unfamiliar to the physician. Dental caries and missing teeth are processes routinely treated in dental practice. Recent improvements in dental materials and techniques permit the dentist to restore the dentition to allow for corrected form, function, esthetics, and patient comfort. This paper describes some of the common conditions that affect the dentition, and the modalities routinely used to treat them.     

Sero- and subtypes of group B meningococci causing invasive infections in Finland in 1976-87

Neisseria meningitidis group B (MenB) strains isolated from 1976 to 1987 in Finland in 339 patients with invasive infection were sero/subtyped by whole cell enzyme immunoassay using monoclonal antibodies to class 1 and 2/3 outer membrane proteins. 66.7% of the strains could be serotyped (class 2/3) and 70.2% subtyped (class 1). No single phenotype was clearly predominant. The most common serotypes were 4 (18.6%) and 14 (17.4%) and the most common subtypes P1.16 (20.1%) and P1.2 (12.1%). The Norwegian phenotype B:15:P1.16 was seen only rarely (a total of 18 strains). Strains from Northern Finland did not differ from those from Southern Finland: no single phenotype caused the slight increase seen in the incidence of MenB infections in the end of 1970s in the North.     

The oral liquid form of vinburnine: biopharmaceutics

Biopharmaceutic comparison is achieved between commercialized capsules of vinburnine and drops dosage form intended for geriatric pharmacotherapy. Drug bioavailability of vinburnine seems saved, if not significantly increased by the new formulation, in spite of the very important, and well known interindividual variations of vincamine drug products. Only the absorption rate seems statistically increased by drops.     

The effect of tartrate on bone cell acid phosphatase activity: a quantitative cytochemical study

Tartrate-resistant acid phosphatase activity (TRAPase) is widely used as a cytochemical marker to distinguish osteoclasts from macrophages and other related cell types. The degree of tartrate resistance, however, may depend on which reaction methods, tissues, or species are used. To investigate this further, we have measured the amount of cytochemical reaction product by microdensitometry. We compared osteoclast acid phosphatase (APase) activity in fresh frozen sections of neonatal rat calvaria using two different reaction methods; one is commonly employed for qualitative histochemistry and includes alpha naphthyl phosphate as substrate, simultaneous coupling to the chromagen Fast Garnet, and a 30-minute reaction time (method A). The other may be used to measure enzyme reaction rates in cells in situ and employs conditions suitable for initial velocity kinetics, namely naphthol-ASBI phosphate as substrate, post coupling to Fast Garnet, and a 2-minute reaction time. Although enzyme reaction rates differed greatly between the two methods, significant inhibition of APase activity by tartrate was observed in calvarial osteoclasts (69% and 59% with methods A and B, respectively), osteoblasts, and spleen macrophages. Using method B, mouse calvarial osteoclasts had similar APase activity to that seen in the rat. Tartrate produced little inhibition in these mouse cells, in contrast to the observations made with rat tissue, but murine spleen macrophages were significantly tartrate sensitive (40% inhibition with tartrate). On this basis, conclusions regarding the cell specificity of TRAPase should be treated cautiously.     

Assessment of echographic regression criteria in ruthenium-irradiated melanoma

Steady flattening of the tumor, increasing reflectivity and decreasing vascularity are echographic signs of successful irradiation treatment. The specific example of an irradiated choroidal melanoma shows that the absence of echographic changes by no means excludes tumor destruction. Because of a dense vitreous body hemorrhage, the melanoma could only be evaluated echographically. Since the echogram lacked evidence of regression, the tumor was locally resected 5 months later. Histology, however, revealed an amorphous mass of dead tissue pervaded by intact vessels. Apparently a successfully irradiated melanoma may generate an echo typical of vital melanoma tissue. The authors therefore draw the conclusion that only a steady tumor growth, as substantiated by an echogram, may be considered an unambiguous sign of tumor vitality.     

Uveal melanoma radiation. 125I brachytherapy versus helium ion irradiation

The optimum radiation therapy for uveal melanoma is uncertain. Both helium ion irradiation and 125I brachytherapy have been used to treat this neoplasm. This investigation analyzed the control and complication rates of uveal melanomas treated with helium ions of 125I plaques. In both a retrospective and a prospective dynamically balanced study, the control rates appeared to be similar. There were more posterior segment complications after 125I plaques and more anterior segment complications, including neovascular glaucoma, after helium ion irradiation. The follow-up period is too short to draw definitive conclusions on the radiation complications. Overall, approximately 89% of eyes were retained and less than 4% of treated eyes were removed because of failure to control the tumor.     

Ciliochoroidal effusions after neodymium:YAG posterior capsulotomy: association with pre-existing glaucoma and uveitis

Two patients with a history of glaucoma and a propensity for uveitis developed ciliochoroidal effusions following Nd:YAG laser posterior capsulotomy. Both patients experienced a waxing and waning course with eventual resolution of symptoms after a steroid regimen. The ciliochoroidal effusions were presumed to be secondary to uveitis induced by the YAG laser surgery. The role of glaucoma, previous surgeries, and an open posterior capsule is uncertain but may have predisposed these patients to ciliochoroidal detachment. We advise caution in performing YAG posterior capsulotomy in patients with glaucoma and a known propensity for uveitis.