Immunoscintigraphy with a technetium 99m-labeled monoclonal antibody in patients with melanoma

In 24 patients with malignant melanoma the clinical feasibility of immunoscintigraphy (ISC) with a Tc99m-labeled F(ab)2 fragment of an anti-melanoma monoclonal antibody was evaluated. This antibody (225.28S) recognizes a human high molecular weight melanoma associated antigen with restricted tissue distribution, which is expressed on melanoma cells in about 90%. The results of ISC were related with the clinical stage of the patients and the level of invasion of the primary tumor (Clark level). Results of ISC indicate the possibility that patients with the highest Clark level have a higher incidence of false negative scintigrams than those with lower levels of invasion of the primary tumor. In 3 out of 5 patients with Clark level 5 false negative scintigrams were found, whereas in 14 patients with lower Clark levels ISC was true positive, however, the number of metastases was underestimated. 14 of 18 patients with clinical stage II-IIIb had positive scans visualizing 27 of 59 metastases. Thus overall sensitivity was 77% and regional sensitivity 46%. Scintigraphically lesions in lymph-nodes, liver and skin were frequently detected, whereas ISC was less sensitive for lung, bone and brain metastases. No false positive findings were observed by ISC (specificity 100%). Relating the sensitivity and specificity of ISC to the prevalance of disease post-test likelihoods for a normal and an abnormal test result were calculated. Post-test likelihood for the disease with an abnormal scintigraphic finding is 100%. However, with a disease prevalance of 75%, according to our patients, the predicitive value of a normal test result is 60%, thus the post-test likelihood for the disease remains rather high (40%).(ABSTRACT TRUNCATED AT 250 WORDS)     

Diagnosis and therapy of eating disorders

Even though there is no convincing evidence that eating disorders in general are on the rise, there has been an enormous increase in "treated" cases of patients with eating disorders. This review will cover important aspects of diagnosis and treatment of eating disorders. Psychotherapeutical and pharmacological treatment strategies in anorexia and bulimia nervosa will be discussed. For both eating disorders, psychotherapy is the treatment of choice. Drugs with a serotonergic function, e.g. serotonin-reuptake-inhibitors (SSRI), have demonstrated significant results in the treatment of bulimia nervosa and eating disorders with comorbid depression. In clinical practice "treatment packages" are offered because of the complexity of the disorders. The paper also deals with medical complications of eating disorders, motivational interviewing in anorexia nervosa and treatment with self-help manuals in bulimia nervosa.     

Herpesviral vectors and their application in oncolytic therapy,vaccination, and gene transfer

Herpesviruses are enveloped DNA viruses that infect vertebrate cells. Their high potential cloning capacity and the lifelong persistence of their genomes in various host cells make them attractive platforms for vector-based therapy. In this review, we would like to highlight recent advances of three major areas of herpesvirus vector development and application: (i) oncolytic therapy, (ii) recombinant vaccines, and (iii) large capacity gene transfer vehicles.     

Bayesian approach to estimating reproductive inhibition potency in aquatic toxicity testing

Effectively and accurately assessing the toxicity of chemicals and their impact on the environment continues to be an important concern in ecotoxicology. Single experiments conducted by a particular laboratory commonly serve as the basis of toxicity risk assessment. These laboratories often have a long history of conducting experiments using particular protocols. In the present study, a Bayesian analysis for estimating potency based on a single experiment was formulated, which then served as the basis for incorporating the experimental information from historical controls. A Bayesian hierarchical model was developed to estimate the relative inhibition concentrations (RIp) of a toxicant and flexible ways of using historical control information were suggested. The methods were illustrated using a data set produced by the test for reproduction in Ceriodaphnia dubia in which the number of young produced over three broods was recorded. In addition, simulation studies were included to compare the Bayesian methods with previously proposed estimators of potency. The Bayesian methods gave more precise RIp estimates with smaller variation and nominal coverage probability offsetting a small negative bias in the point estimate. Incorporating historical control information in the Bayesian hierarchical model effectively uses the useful information from past similar experiments when estimating the RIp, and results in potency estimates that are more precise compared to frequentist methods.     

Magnitude and causes of blindness and low vision in Anambra State of Nigeria (Results of 1992 point prevalence survey)

A survey to determine the prevalence and causes of blindness in Anambra State of Nigeria was conducted. The aim was to provide baseline data for the planning, implementation and evaluation of both the state's and the National Programme for Prevention of Blindness.A multistage cluster random sampling technique was used. The World Health Organization/Prevention of Blindness (WHO/PBL) Eye Examination Record Form was used. The WHOs definitions of blindness and low vision were adopted for the analysis.The prevalence of blindness in the state is estimated to be 0.33%±0.27%. Visual acuity of from 3/60 to less than 6/60 has a prevalence of 0.41%±0.30% while visual acuity of from 6/60 to less than 6/18 has a prevalence of 0.67%±0.39.There are equal numbers of blind males as females, although the prevalence among males is 0.44%±0.26% while among females it is 0.24%±0.15%. Most of the blind are above 50 y of age with prevalence of blindness in this age group being 2.62%±1.31% (3.27%±2.1% for males and 2.02%±1.58% for females).Cataract caused most of the blindness (70.59%), followed by glaucoma (17.65%). Macular degeneration is becoming important (5.88%) while obvious infective causes are rare. Errors of refraction are important public eye health care problems.Methods of tackling the cataract problem (both backlog and incident), and other eye health needs within the primary eye/health care are recommended. The need to extend refraction services to the rural areas is emphasized.     

An illustration of dangers of ignoring survival differences in carcinogenic data

This paper illustrates the effects of survival differences on the routine analysis of 2-year animal carcinogenesis experiments using quantal response. Not adjusting for decreased survival in the higher dosed groups results in a decrease in the actual significance level for the quantal response trend test, and a corresponding decrease in sensitivity for detecting a true treatment effect. Similar results hold for estimation of carcinogenic risk. Tables of the range of survival differences found in recent National Toxicology Program carcinogenesis studies are presented.     

Serum factors stimulate the motility of human spermatozoa

Motile human sperm were collected from a Percoll gradient and the effects on sperm motility of human serum, various serum fractions, follicular fluid and seminal plasma were assessed. In culture medium alone (RPMI-1640) sperm motility was lost after about 5 h. The addition of male blood serum both enhanced sperm motility and prolonged viability very significantly. Albumin, seminal plasma and follicular fluid all stimulated sperm motility but to a much lesser extent than did blood serum. No difference was noted between male serum or female serum which had been collected during the follicular or luteal phases of hormone-stimulated cycles and which contained high levels of oestradiol. Serum fractions obtained by separation on Sephacryl S-300 column were tested for their ability to enhance sperm motility. The most pronounced effect, much superior to that achieved by the albumin fraction, was obtained by a fraction with a molecular weight of around 200 kD. In conclusion, certain factors in human serum, which are different from albumin, strongly support sperm motility. The high serum concentrations of oestradiol resulting from hormone stimulation for in-vitro fertilization do not invalidate the use of serum from the same patient during sperm preparation, or in the medium used for ovum insemination and culture.     

Extremity bone tumors: evaluation by P-31 MR spectroscopy

High-resolution P-31 MR spectra were obtained in four patients with bone tumors of their distal extremities. In one case the tumor, a Ewing sarcoma of the tibia, was investigated during clinical remission after radiation therapy and chemotherapy. The other three cases - one low-grade chondrosarcoma of the tibial head, one malignant fibrous histiocytoma of the tibia, and one chondroblastoma of the medial femoral condyle - showed clinically active tumor growth, with corresponding increased metabolism as demonstrated by bone scintigraphy. The spectra of the three active tumors indicated a comparably high adenosine triphosphate content, similar to previously published spectra from animal tumors or human tumors implanted into animals. There were also high resonances of inorganic phosphate and low resonances of phosphocreatine; there were definite peaks in the phosphodiester and phosphomonoester regions, indicating the existence of these metabolites in the tumors. Slight but definite changes in the metabolite content were observed in one tumor after chemotherapy. The spectra of the unaffected leg did not show any well-resolved P-31 signals, which is typical for healthy bone. These are the first P-31 MR spectra of human bone tumors measured in patients to our knowledge.