William A. Reilly

Typhoid fever in fourteen children treated with chloramphenicol

Summary Nine children with typhoid have been cured with chloramphenicol in an initial dose of 50 mg. per kilogram followed by 125 to 250 mg. single doses every two to three hours until fever first disappeared, an average of about two to four days, and then every four to six hours during four to five days of normal temperature. Two relapses occurred which the drug quickly stopped. There were no drug reactions, disease complications, sequelae, or known carriers.

Thymectomy and ACTH in lymphatic leucemia

Summary 1. Four patients with lymphaticleucemia were thymectomized and later treated with ACTH. 2. Temporary clinical and hematologicalremissions occurred following both the thymectomy and ACTH therapy. 3. All four patients relapsed. PatientAll four patients relapsed. Patients2 and 4 have died. Patient 1 has relapsed and is being treated with transfusions. Patient 3 is in temporary remission following a second course of ACTH therapy. and 4 have died. Patient 1 has relapsed and is being treated with transfusions. Patient 3 is in temporary remission following a second course of ACTH therapy. 4. In our four cases thymectomyand ACTH were of temporary benefit in lymphatic leucemia. 5. If thymectomy is to be of any benefit, it should be performed early.

The value of the measurements of thyroid uptake andurinary excretion of I131 in assessing thyroid function of normal and congenitally hypothyroid children

Summary 1. I 131 in doses of 5 to 10 μc was used to measure quantitatively both iodine uptake in the thyroid gland and urinary excretion in twenty-five euthyroid children and in five congenitally hypothyroid children (cretins). 2. Over a 96-hour period the thyroid of the normal children took up between 8.7 and 29.8 per cent with the maximum between 24 and 96 hours. During 96 hours their urinary excretion ranged from 29.3 to 70.6 per cent; the maximal excretion occurred between 24 and 48 hours. 3. Repeated tests showed I 131 uptake in the cretins to be negligible. It was between 1 and 2 per cent and it was not appreciably influenced by thyroid therapy. The untreated cretins excreted 73.5 to 92.4 per cent of I 131 within 96 hours, while the same cretins when treated excreted between 35.8 and 84.5 per cent within the same length of time.

Increased uptake of iodine-131 by the thyroid gland after administration of hesperidine methyl chalcone.

Scott(1) has shown that the rats thyroid takes up 50 to 200% more radioiodine under the influence of hesperidine methyl chalcone (H.M.C.). It was therefore decided to try this drug in human beings in order to determine its effect upon thyroidal accumulation of radioiodine. This drug is known to suppress the output of I131 through the kidney; probably I131 stays in the body in circulation a long enough time to favor increased uptake by the gland. Method. Nineteen patients having the diagnoses shown in Table I were studied. All of these were considered to be euthyroid except K.E. and O.C. who were judged to be hyper-and hypothyroid respectively . Two periods of tests were done on each patient. These were the first or the patients control period before the administration of H.M.C. and the second or his testing period following the administration of H.M.C. At the start of the control period, 20 μc I131 was given orally. Thyroid gland uptake measurements were done at 24-hour intervals for 96 hours. After a rest period of three days, the same patients thyroid uptake was again measured for residual I131 then 1.0 g of H.M.C. mixture in water was ingested. After an hour lapse to allow for effective absorption of the drug the patient ingested 80 μc I131. At 24-hour intervals, for 96 hours, his thyroid gland uptake was measured and due correction for decay and effective half-life was made for the residual I131 uptake from the control period. The tracer dose of 80 μ I131 was large enough to be readily measurable in the presence of residual I131 and thus also to minimize statistical differences between the measurements of the two periods. Results. Studies on the nineteen patients summarized in Table I show that the oral administration of one gram of H.M.C. significantly increases the thyroidal accumulation of I131.

Effect of Butazolidin upon the Fate of I131 in the Rat

During the course of the evaluation of other drugs upon the thyroidal accumulation of iodine in patients, it was observed that a patient being given butazolidinR had a very low I131 thyroid uptake. In this study rats were used in order to measure more completely the effect of this drug upon iodine metabolism. Methods. Young albino rats were given butazolidineR by subcutaneous injection at dosage levels ranging from 8 to 200 mg/kg body weight. In some groups of animals this was followed immediately by a tracer dose of 5 μc of I131 intraperitoneally. No additional iodide was added in these studies; thus the administration of the I131 served only to label the iodide pool of the body. The total amount of iodide present in 5 μc of I131 is calculated to be less than 1 × 10-3 μg. As will be noted in Table I, the uptake of I13 by control animals varied as much as 100%. Although the experimental and control animals for each group are of the same lot and origin, both Sprague Dawley and Slonaker strains of rats were employed in the several experiments combined in Table I. In our hands, Sprague Dawley rats recently received from Wisconsin have much higher thyroid uptake of I131 than that observed in rats bred locally. We believe that this merely represents a smaller iodide pool in rats imported from the Midwest since this higher uptake is reduced to that seen in local rats after a period of several weeks in their new environment. These animals were sacrificed 20 hours following I131 administration. Other groups of rats were given the drug daily for periods of 10 to 16 days in which the last injection of the drug was followed by 5 μc of I131.

Citrovorum factor in leucemia: Two cases with autopsy findings*

Summary 1. The clinical and autopsy findings are reported in two cases of leucemia, one acute lymphatic and the other acute myelogenous leucemia. 2. The toxic effects of aminopterin and amethopterin were temporarily suppressed by the use of citrovorum. 3. In Case 1, in which hemorrhagic lesions developed in chicken pox, the citrovorum did not prevent the return of the toxic manifestations of aminopterin. The dosage may have been too small. 4. It is felt that the effects of the citrovorum factor were due to a general inhibition of the antifolic acid compounds.

Treatment of typhoid fever with terramycin

Summary 1. Six patients with clinical typhoidfever were treated with terramycin. 2. The terramycin was effective in four cases. 3. In two cases in which terramycinwas not effective, the dosage may have been too small. 4. No toxic effects were noted inany of our patients.

Rocky Mountain spotted fever treated with chloramphenicol and aureomycin.

Summary Six patients with rickettsial diseases with clinical findings and skin rashes typical of R. M. S. F. were successfully treated, four with Chloromycetin and two with aureomycin. One patient (Case 5) suffered a relapse, possibly due to too small a dose of the drug initally, but responded on reinstitution of aureomycin. The response to Chloromycetin in four patients and to aureomycin in one patient was in keeping with the findings of others.

Determination of Iodine-131 in Urine.∗

Summary A method for the determination of Iondine-131 in urine is described. A dipping counter mounted on a modified microscope base using a blackened test tube with a sample large enough to cover the sensitive area of the tube was used. Counting of gamma radiations is quite reproducible by this procedure.

Standardization of I131 solutions by direct comparison of gamma activities.

Summary A rapid and convenient method for the standardization of I131 solutions is described. A statistical evaluation of the method showed that the standard deviation of the mean for 10 samples was approximately 1%.