Jogging in place. Evaluation of a simplified exercise test.

The purpose of this study was to evaluate jogging in place as an electrocardiographic exercise test. Jogging in place continuously recorded via an ordinary single-channel electrocardiograph was compared with the Bruce treadmill protocol with a three-channel monitor and recorder in 141 cases with a wide spectrum of chest complaints. Agreement for the presence or absence of electrocardiographic ischemia (ST-segment displacement greater than or equal to 1 mm at 80 ms from the J point, or U-wave inversion) for the two tests was observed in 91 percent of the cases (95 percent confidence intervals: 86 percent to 95.5 percent). One hundred of the previous cases with paired electrocardiographic exercise tests were compared with the presence of reversible defects on exercise myocardial thallium-201 scintigraphy. The electrocardiographic ischemia had a similar correct classification rate in both methods (83 percent with jogging in place and 85 percent with Bruce treadmill protocol; not significant) against the finding of scintigraphic ischemia. This was also true for 52 cases having selective coronary arteriography. The correct classification rate was 54 percent (28/52) with jogging in place and 48 percent (25/52) with Bruce treadmill protocol (not significant). Given the safety and the easy applicability, even in older persons, this simplified test can be recommended as a valid alternative to the established multistage exercise tests.

Immunoscintigraphy with 131I-labelled monoclonal antibodies HMFG2 and HMFG1 F(ab')2 versus abdominal CT scan in the detection of residual disease in ovarian cancer patients.

131I-labelled HMFG2 or HMFG1 F(ab')2 monoclonal antibody (MAb) was administered intraperitoneally to 15 patients with epithelial ovarian cancer who had completed chemotherapy and were in complete or good partial remission. Each patient received 2-3 mCi. Patients were scanned immediately after and until 7 days post-injection. In 3/15 patients the immunoscan failed because extensive adhesions from the previous surgery prevented MAb diffusion. Of the remaining 12 patients, 9 underwent second-look laparotomy (SL). Immunoscan was true positive in 8/9 (89%) patients and equivocal in 1/9 (11%), whereas the abdominal CT scan gave true positive results in 6/9 (67%) patients. In 8 out of 9 patients there was a good correlation between distribution of all sites of abnormal uptake and the surgical findings at SL. Of the 3 patients not undergoing SL, the immunoscan was positive in all, whereas clinical examination and abdominal CT scan were negative. All 3 patients relapsed after 3, 4 and 5 months. Thus the total true positivity of immunoscan reached 92%, CT scan remaining at 50%. Immunoscan with intraperitoneal administration of 131I-labelled MAbs can thus accurately detect the presence of residual disease in ovarian cancer patients and appears more sensitive than abdominal CT scan.

Immunoscintigraphy with 131I-labelled HMFG2 and HMFG1 F(ab')2 in the pre-operative detection of clinical and subclinical lymph node metastases in breast cancer patients.

Radiolabelled specific monoclonal antibodies (MAbs) HMFG2 and HMFG1 F(ab')2 and non-specific 11.4.1 and 4C4 F(ab')2 were injected into the webs between the 2nd and 3rd fingers of both hands in 31 patients with clinical diagnosis of breast cancer. We studied 10 patients with clinically obvious axillary lymph-node disease (group A) and 10 patients with clinically negative axilla (group B) using HMFG2, 5 patients with clinically negative axilla (group C) using HMFG1 F(ab')2 and 6 patients with clinically positive axilla (group D) using non-specific 11.4.1 and 4C4 F(ab')2 MAbs. In group A, 7 patients had true positive scans. There were also 3 false negative scans, due to problems related to proper iodination at the beginning of this study. In group B there were 4 true positive scans, 4 true negative, I false positive and I false negative. In group C there were 4 true negative scans. In one patient the radiolabelled antibody was arrested in the middle of the arm, because of lymphatic obstruction. In group D, there were 3 false negative scans with 11.4.1 antibody and 3 false negative scans with 4C4 F(ab')2 MAb. The results of immunoscintigraphy were in accordance with the histopathology and immunoperoxidase staining findings. These results indicate that this non-invasive approach can accurately detect metastatic involvement in the axillary lymph nodes and can be used for the diagnosis and staging of breast cancer.