Distribution of intrapleural and intravenous Corynebacterium parvum in humans; 99mTc-, and 131I-labeled bacteria.

The distribution of Corynebacterium parvum labeled with 131iodine or 99mtechnetium was studied in 17 patients with bronchogenic carcinoma. The labeled bacteria were given intravenously or intrapleurally and monitored by whole-body gamma tracking and samples of blood and urine. Even though the rate of physical decay is quite different for 131iodine and 99mtechnetium, the tracking time of labeled bacteria was limited to 24 h after injection for both radioactive isotopes. Technetium labeling was preferred because of greater imaging resolution and less radiation dose to the patient. Following intravenous administration, labeled C. parvum was found predominantly in the liver and spleen, and in a lesser amount in the lung. Radioactivity was confined to the pleural cavity after intrapleural injection. These results suggest the combined intravenous and intrapleural route of adjuvant immunosupportive agents such as C. parvum for operable lung cancer patients.

Demonstration of splenic functions following splenectomy and autologous spleen implantation.

Autologous splenic tissue was implanted in 14 patients undergoing splenectomy for traumatic rupture or peroperatively arising lesion of the spleen. To demonstrate function of the implanted splenic tissue, spleen scintigraphy using 99mTc-labelled heat-damaged autologous erythrocytes, and percentage measurement of vacuolated erythrocytes in peripheral blood were performed one and three months after the splenectomy. The spleen scans were positive in eight patients after one month and in 12 patients after three months, demonstrating splenic phagocytic function. The numbers of vacuolated erythrocytes also indicated some restoration of the pitting function due to the implanted splenic tissue. No alterations were seen in serum immunoglobulins, but a moderate thrombocytosis still persisted after three months. The clinical significance of implantation of autologous splenic tissue is discussed.

Constant perfusion provocation in idiopathic hydronephrosis.

Twenty-two hydronephrotic units in 20 patients underwent preoperative pressure flow study in combination with electromyographic study of pelvic and ureteric peristalsis. Ten units had a continuous pressure rise during perfusion, whereas the rest had a stabilization of the intrapelvic pressure below 20 cm. of water. The high pressure group was identical with the low pressure group concerning degree of hydronephrosis judged by intravenous urography and function judged by the two-minute uptake of isotope on the renogram. The major difference was the presence of aberrant vessels which were present in 7 of 10 high pressure units and absent in 8 of 12 low pressure units. Long-term records prior to surgery were obtainable in only 1 patient who had spontaneous progression of hydronephrosis during a ten-year period. This unit had a low pressure response to perfusion. The investigation seems to indicate that pressure flow studies might reveal external obstruction, an obstruction which might not be fundamental to the course of the disease. More studies are needed before consequence are to be taken from urodynamic studies of the upper urinary tract.