Kinetics, quantitative analysis and radioimmunolocalization using indium-111-HMFG1 monoclonal antibody in patients with breast cancer.

HMFG1 tumour associated monoclonal antibody IgG1 and F(ab')2 fragments were radiolabelled with indium-111 and used to study patients with breast cancer. In vitro and in vivo stability of the radiolabelled antibodies was shown to be satisfactory. Thirty patients with primary breast cancer underwent tumour resection and quantitative evaluation of the radioactivity in the tumour and normal tissues following administration of specific and non-specific antibodies. The mean tumour uptake of HMFG1 F(ab')2 fragments at 24 h was significantly higher (P less than 0.05) than the intact IgG but at 48 h there was no difference. The mean tumour uptake with the specific antibody was higher than the non-specific antibody of the same subclass (P less than 0.05). Lymph node metastases showed higher antibody uptake than the corresponding primary tumours (P less than 0.05). Fifteen patients with primary or metastatic breast cancer were investigated by external body scintigraphy using HMFG1 F(ab')2 fragments. Successful localisation was observed in approximately 50% of the primary and metastatic lesions with no false positive results. All the patients had observable concentration of 111In in the liver (20% of the injected dose), the kidneys and the spleen. Following i.v. administration, F(ab')2 fragments cleared from the blood more rapidly than the intact IgG. We conclude that HMFG1 F(ab')2 fragments can localise specifically and faster than intact IgG in breast cancer but the sensitivity of the radioimmunoscintigraphy is relatively low. This method needs further improvement before becoming clinically useful for detecting and staging breast cancer

Transthoracic induction of a hiatal hernia in domestic swine

Background: With the common performance of laparoscopic Nissen fundoplication for gastroesophageal reflux disease, there is renewed interest in the pathophysiology and potential histologic consequences of hiatal hernias. However, in vivo model exists that both reliably reproduces the hiatal hernia and is amenable to subsequent laparoscopic repair. Methods: A transthoracic approach was used to induce a hiatal hernia surgically in female James pigs (50-160 kg; n = 5). Results: Hiatal hernias were successfully induced in all pigs and verified with barium swallow, endoscopy, and/or laparoscopy. Laparoscopic reduction and Nissen fundoplication were subsequently completed on each animal on postoperative day 30. One postoperative death occurred on postoperative day 4 after thoracotomy. Conclusions: We describe the induction of a hiatal hernia via a transthoracic approach in domestic swine. The hiatal hernia is amenable to subsequent laparoscopic repair, enabling surgeons to acquire the technical skills required to correct this defect in the laboratory. To our knowledge, this is the first report of a reproducible model of a transthoracically induced hiatal hernia that allows subsequent laparoscopic repair. We suggest that in addition to refinement of surgical skills, our model may provide new information to researchers regarding the potential indications for antireflux procedures, as well as the natural history and appropriate management of hiatal hernias

Transthoracic induction of a hiatal hernia in domestic swine

Background: With the common performance of laparoscopic Nissen fundoplication for gastroesophageal reflux disease, there is renewed interest in the pathophysiology and potential histologic consequences of hiatal hernias. However, in vivo model exists that both reliably reproduces the hiatal hernia and is amenable to subsequent laparoscopic repair. Methods: A transthoracic approach was used to induce a hiatal hernia surgically in female James pigs (50-160 kg; n = 5). Results: Hiatal hernias were successfully induced in all pigs and verified with barium swallow, endoscopy, and/or laparoscopy. Laparoscopic reduction and Nissen fundoplication were subsequently completed on each animal on postoperative day 30. One postoperative death occurred on postoperative day 4 after thoracotomy. Conclusions: We describe the induction of a hiatal hernia via a transthoracic approach in domestic swine. The hiatal hernia is amenable to subsequent laparoscopic repair, enabling surgeons to acquire the technical skills required to correct this defect in the laboratory. To our knowledge, this is the first report of a reproducible model of a transthoracically induced hiatal hernia that allows subsequent laparoscopic repair. We suggest that in addition to refinement of surgical skills, our model may provide new information to researchers regarding the potential indications for antireflux procedures, as well as the natural history and appropriate management of hiatal hernias