ABSTRACT
The poor survival rate of patients with extrahepatic bile duct tumors is well documented. Over the course of 4 years, we treated a white woman with diabetes diagnosed with histologically proven adenocarcinoma of the common bile duct with six injections of dihematoporphyrin ether followed by seven photodynamic therapy treatments to the biliary duct. As of July 1989, the patient was still alive, was not jaundiced, and had a Karnofsky performance status of 70. No changes occurred in any blood chemistry value from the time of injection to the time of photodynamic therapy. Of the transient elevations of some blood chemistry values and the white blood cell count, which occurred within 24 to 48 hours after photodynamic therapy, only those of alanine aminotransferase, aspartate aminotransferase, and amylase were significant.
Subject(s)
Adenocarcinoma/drug therapy , Common Bile Duct Neoplasms/drug therapy , Hematoporphyrins/therapeutic use , Photochemotherapy , Cholangiography , Dihematoporphyrin Ether , Endoscopy, Digestive System , Female , Fiber Optic Technology , Hematoporphyrins/administration & dosage , Humans , Injections, Intralesional , Intubation , Middle AgedSubject(s)
Contracture/prevention & control , Mammary Glands, Animal/surgery , Povidone-Iodine/therapeutic use , Povidone/analogs & derivatives , Prostheses and Implants , Silicones , Surgical Wound Infection/prevention & control , Animals , Anti-Infective Agents/therapeutic use , In Vitro Techniques , Methods , Mice , Mice, Inbred Strains , Povidone-Iodine/administration & dosage , Staphylococcal Infections/prevention & control , Tensile StrengthABSTRACT
Subsequent to recent disclosures that low serum vitamin B12 results can appear normal using many of the current radioassay methods because of the presence of cobalamin (vitamin B12) analogues in human serum, a number of radioassay kits have become available with modified intrinsic factor preparations and claims of measuring "true" vitamin B12. While evaluating two of these kits, one with R protein activity blocked and the other with R protein removed, the possibility was discovered that normal results could appear low owing to high nonspecific binding encountered with one of the methodologies. The problem of nonspecific binding was apparently due to incomplete inactivation of serum endogenous binding proteins and inadequate separation of free and bound radioisotope. The results demonstrate that "lower" vitamin B12 values are not necessarily "truer" values, and therefore caution and critical evaluation should temper the haste to change to commercial radioassay procedures that claim to provide "true" vitamin B12 levels.
Subject(s)
Protein Binding , Radioligand Assay/methods , Reagent Kits, Diagnostic , Vitamin B 12/blood , Humans , Hydrogen-Ion Concentration , Intrinsic FactorABSTRACT
Prostatic acid phosphatase and alkaline phosphatase values in bone marrow were correlated with skeletal surveys and diagnoses during a six-month study. In cases of biopsy-proven adenocarcinoma of the prostate, bone marrow prostatic acid phosphatase was the most consistently abnormal value. Diagnoses other than prostatic cancer involving the bone marrow, e.g., myeloma and leukemias, were associated with elevated prostatic acid phosphatase and alkaline phosphatase values. In cases in which the bone marrow was not involved by metastasis, these values were normal. Bone marrow prostatic acid phosphatase assay was found to be a very good tool for detecting early osseous metastases from any site, including prostatic adenocarcinoma.
