Gould A. Andrews

DISTRIBUTION OF COLLOIDAL RADIOACTIVE CHROMIC PHOSPHATE AFTER INTRACAVITARY ADMINISTRATION

Colloidal radioactive gold, Au198, has been used for several years in the palliative treatment of patients with recurrent pleural and abdominal effusions caused by malignant neoplasm. Its use has been reasonably well established and evaluated, but the results, although encouraging, leave much to be desired. The extent of the contribution of the gamma emission of the radioactive gold to the therapeutic result is not known, but this component of the radiation produces a total-body effect that is undesirable. An isotope which, like colloidal gold 198, remains largely in the region of the injected cavity, yet has only a beta emission, would have the advantage of producing less total-body irradiation. Since the need for protecting the operator against gamma radiation complicates the use of the gold, a beta emitter would also be easier to administer. P32 with an energetic beta emission of 1.72 mev, in the form of a colloid, chromic phosphate, should be useful for this purpose. The chromic phosphate can be made ...

INTRACAVITARY USE OF COLLOIDAL RADIOACTIVE GOLD

Among the radioisotopes which have therapeutic value is radioactive gold, AU198. It has a half-life of 2.8 days and decays with both beta and gamma emissions. One peculiar advantage of this element is that it can be prepared as a colloid which is chemically stable and relatively inert biologically. Dr. Paul Hahn, of Meharry Medical College, has introduced the use of this isotope for direct injection of tumors and intravenous administration (1, 2, 3). Its value as a means of irradiating body cavities for the control of fluid accumulation is the subject of the present discussion. This use for the isotope was first suggested by J. Muller (4), of Switzerland. During the last two years our group at the Oak Ridge Institute has been carrying on a program of experimental treatment with radioactive colloidal gold. The present discussion is based largely upon material which has already appeared in other publications (5–8). We have injected the isotope into pleural and peritoneal spaces of patients with effusions ca...

Pathologic changes in normal human thyroid tissue following large doses of I-131.

Abstract 1.1. The early histologic changes which occur in normal thyroid tissue after relatively large doses of I-131 are described on the basis of information obtained from ten patients. 2.2. Because of variations in size of the gland and differences in concentration and retention of the isotope, the radiation dose to the thyroid tissue is not closely correlated with the total dose administered. 3.3. Even when all of the factors known to influence tissue radiation dosage are considered, it is not possible to predict the biologic response on the basis of dosage. 4.4. The accomplishment of complete destruction of the thyroid by means of a single, safe dose of radioiodine is a rather uncertain procedure. In some cases large total doses have failed to cause complete necrosis of the gland.

Histopathologic Studies of the Liver Following Intravenous Colloidal 198Au Therapy

Histologic studies of liver tissue from 27 patients given up to 395 mCi (cumulative) of intravenous colloidal 198Au showed no definite radiation injury and no correlation between hepatic abnormalities and dose. Demonstration of aggregates of colloidal gold in the Kupffer cells was inconsistent, suggesting slow removal or dispersion. Although the liver ordinarily receives the highest radiation dose, the critical organ is the marrow. Results support the recent introduction of 198Au to supplement teletherapy for certain neoplasms diffusely infiltrating the liver. Apparently the beta distribution minimizes endothelial injury in large vessels, which has been shown to be the cause of radiation hepatitis.

Measurement of thyroid clearance of plasma iodide: The effect of expansion of the iodide space

Abstract A procedure for the measurement of thyroid clearance during the first hour after iodine-131 administration is described. The behavior of iodine-131 in the extrathyroid tissues of the neck is considered and the effect of changing distribution is taken into account in the calculation of uptake of iodine-131 by the thyroid. It is shown that the extrathyroid iodide space of distribution is approximately 11. at 2 min, 1·27 1. at 30 min, and 1·31 1. at 60 min after intravenous injection of iodine-131. About one third of this volume is intravascular and the rate of expansion of the iodide space of distribution is similar to the rate of expansion of the sodium ion space of distribution. Equations that make a correction for this changing “neck background” are derived and the calculation of thyroid plasma iodide clearance is illustrated.

A Study of Gallium721

During the years 1949–51, the staff of the Medical Division of ORINS spent a major portion of its effort on a study of the therapeutic use of gallium72. This report summarizes the problems which were encountered, the results obtained, the studies completed, and the resulting clinical judgments. Since gallium is still a relatively unknown element and its isotopes are only rarely used in biology, the studies began with problems in physics, proceeded through chemistry, biology, and pharmacology, and ended with an assessment of clinical results. The physical characteristics of the gallium isotopes were restudied. A method of standardization of activity was established for routine use. Methods were developed for tissue assay, and a number of new devices were set up to measure activity. Protection of personnel was a major problem. A device for remotely controlled injection of the active material was designed and built. A urine storage container was constructed, and a system of shielding certain patients was ins...

A Study of Gallium72

During the years 1949–51, the staff of the Medical Division of ORINS spent a major portion of its effort on a study of the therapeutic use of gallium72. This report summarizes the problems which were encountered, the results obtained, the studies completed, and the resulting clinical judgments. Since gallium is still a relatively unknown element and its isotopes are only rarely used in biology, the studies began with problems in physics, proceeded through chemistry, biology, and pharmacology, and ended with an assessment of clinical results. The physical characteristics of the gallium isotopes were restudied. A method of standardization of activity was established for routine use. Methods were developed for tissue assay, and a number of new devices were set up to measure activity. Protection of personnel was a major problem. A device for remotely controlled injection of the active material was designed and built. A urine storage container was constructed, and a system of shielding certain patients was ins...

Thrombocytopenic purpura complicating radioactive phosphorus treatment in a patient with polycythemia vera

Abstract A patient who had polycythemia vera was given radioactive phosphorus and developed severe thrombocytopenic purpura associated with prominent changes in the appearance of the megakaryocytes. It is suggested that radioactive phosphorus should be used with caution especially in patients who already have thrombocytopenia.