ABSTRACT
We report successful palliative treatment of an Aspergillus fumigatus orbital mass in a patient with acquired immunodeficiency syndrome by direct injection of amphotericin B into the abscess cavity. This case presents intraorbital injection of amphotericin B as an alternative to surgical debridement of Aspergillus orbital infection. In patients who are unable or unwilling to undergo more aggressive treatment, this procedure appears to limit morbidity while still providing effective palliative therapy.
Subject(s)
AIDS-Related Opportunistic Infections/drug therapy , Abscess/drug therapy , Amphotericin B/therapeutic use , Aspergillosis/drug therapy , Eye Infections, Fungal/drug therapy , Orbital Diseases/drug therapy , Palliative Care , Adult , Humans , Injections , Male , Orbital Diseases/microbiologyABSTRACT
We reviewed the records of patients with ulcerative keratitis associated with contact lens wear admitted to The Ohio State University Hospitals from January 1, 1983 through December 31, 1987. Of 127 cases of infectious ulcerative keratitis, 25 (19%) were associated with the use of contact lenses. Of these 25, 21 cases (84%) were associated with the use of soft lenses (40% aphakic, 40% cosmetic). Seventy-six percent (19 of 25) were culture-positive; Pseudomonas was the most common isolate (12 of 19, 63% of culture-positive cases). When compared with daily wear soft contact lenses, cosmetic and aphakic extended wear contact lens related ulcers were associated with a delay in definitive diagnosis and a worse prognosis. Patching and steroid use were associated with more severe ulcers. Gram stain findings were of value only when gram-negative rods were noted. The findings emphasize the need for patients to understand: 1) the risks of extended wear; 2) the necessity of removing the lenses at the first sign of irritation; and 3) the importance of having prompt, intensive care readily available.
Subject(s)
Contact Lenses/adverse effects , Corneal Ulcer/etiology , Eye Infections, Bacterial/etiology , Pseudomonas Infections/etiology , Adult , Aged , Contact Lenses, Extended-Wear/adverse effects , Contact Lenses, Hydrophilic/adverse effects , Corneal Ulcer/diagnosis , Corneal Ulcer/epidemiology , Eye Infections, Bacterial/epidemiology , Humans , Ohio , Prognosis , Pseudomonas/isolation & purification , Pseudomonas Infections/epidemiology , Risk Factors , Time FactorsABSTRACT
Five groups (n = 4) of congenitally athymic female nude mice bearing subcutaneous implants of CX-1 and/or SW-1116 tumor in the hind limbs received iodine-125 radio-labeled monoclonal antibodies (MoAbs) B72.3 (two groups), 17-1A (two groups), and cocktail (one group) (iodogen method, 50 microCi/10 micrograms/mouse). Daily probe counts were made in duplicate with a hand-held detector over each tumor site and the front leg (background) for 21 days. Animals were sacrificed and appropriate well counts were obtained. All the single MoAb preparations localized well in both tumor cell lines. Uptake of monoclonal antibody 17-1A was similar in the two tumor cell lines, with counts initially high and slowly decreasing over the 21-day period. Tumor/background ratios continued to increase over time, indicating that both tumor lines have similar antigenic expression for the monoclonal antibody 17-1A. This was not the case for monoclonal antibody B72.3, which showed a preferential uptake by the CX-1 tumor, with higher initial counts and prolonged binding of the antibody, giving rise to higher tumor/background ratios. The mixture of monoclonal antibodies B72.3 and 17-1A markedly improved the uptake by the CX-1 tumor cell line but not that by the SW-1116 cell line, where the effect was negative when compared to the uptake of the single MoAb preparations. The use of a monoclonal antibody mixture can enhance targeting of some tumor sites. Due to the heterogeneity of tumor cell lines, even within the same animal, different mixtures of monoclonal antibodies are needed to increase the targeting of tumor.
Subject(s)
Antibodies, Monoclonal , Gamma Rays , Neoplasms, Experimental/diagnostic imaging , Radiation, Ionizing , Adenocarcinoma/diagnostic imaging , Animals , Female , Humans , Mice , Mice, Nude , Neoplasm Transplantation , Radiography , Tumor Cells, CulturedABSTRACT
The biodistribution and kinetics of 7 monoclonal antibodies (MAb) with known reactivity against CX-1 tumor were examined over 21 days using a hand-held gamma-detecting probe (Neoprobe system). Twenty-eight immuno-deprived (athymic) nude mice implanted with human colon adenocarcinoma CX-1 xenografts were injected intraperitoneally with 50 microCi of 125I-labeled antibodies (4 mice/antibody). Of the 7 monoclonal antibodies, 4 were anti-CEA (MA, MB, MC, and MD), 2 were anti-TAG 72 (B72.3 NCI and B72.3 fermented) and one was anti-colorectal cancer (17-1A). Daily probe counts were recorded in duplicate over the tumor site and the contralateral nontumor site (background), and tumor-to-background (Tu/Bkg) ratios were calculated. Animals were sacrificed on day 21, and blood, heart, liver, spleen, lungs, kidneys, intestine, muscle, and the tumor were removed for gamma well counting. All antibodies identified the tumor as early as 24 h postinjection and specific tumor localization improved over time. Patterns of prolonged tumor binding varied considerably from one antibody to another, although all but one (MB) showed continuously increasing Tu/Bkg ratios. These data indicate progressive clearance of the antibodies from the background tissue and a persistence of labeled MAb activity in tumor resulting in improved tumor localization with increasing postinjection time.
