Late Effects of Thorium Dioxide in Man

Cassel, Chester

doi:10.1001/archinte.1951.03810070052007

Cited by 13 publications

(1 citation statement)

References 16 publications

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“…Jacobson and Rosenbaum (1938) and Cassel, Ruffin, Reeves and Stoddard (1951) also described cirrhotic changes in the livers of some of their patients who had received Thorotrast for diagnostic purposes from 5 to 17 years previously. It has alwavs to be remembered, of course, that some form of pre-existing liver damage may be the reason for the use of Thorotrast in the first place.…”

Section: Discussionmentioning

confidence: 99%

A Comparison Between the Late Effects of Thorotrast and a Non-Radioactive Zirconium Hydroxide Sol in Mice

Bensted¹,

Crookall²

1963

Br J Cancer

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IN a previous communication (Guimaraes and Lamerton, 1956) upon the late effects of Thorotrast administration in mice, it was suggested that the apparent carcinogenic effect of Thorotrast might be related in some way to its physical properties rather than to its purely radioactive properties. The object of the present investigation was to follow up this suggestion by employing a colloidal contrast medium which was similar to Thorotrast in its distribution and other properties but which was at the same time entirely non-radioactive, and to compare the resulting tissue damage and tumour incidence.The ideal product for this purpose would be derived from a non-radioactive thorium isotope, but since no such isotope is known, attention was turned to the other elements in Group IV A of the Periodic Table, and in particular to hafnium, the closest analogue of thorium. Our attempts to produce a concentrated hafnium oxide sol were only partially successful. Owing to the relative scarcity and cost of hafnium salts further work was carried out using zirconium salts since these are virtually identical from the point of view of their chemical properties.A concentrated zirconium oxide sol was prepared (hereafter called Zirconotrast) and this material was well tolerated when given to mice by intravenous injection. This contrasts with a report (Shapiro, 1955) that whereas soluble zirconium salts are relatively non-toxic, a colloidal zirconium oxide preparation consistently caused death from pulmonary infarction when given intravenously to rabbits and guinea-pigs. In view of this finding we thought it worth while to include details of our method of preparing Zirconotrast.The present article concerns the results of a comparative study of the effects resulting from intravenous injection of Thorotrast and Zirconotrast into small groups of mice which were observed radiologically over a period of time and finally killed 8-17 months later for histological studies. METHODS ZirconotrastThe preparative scheme conisists essentially of three parts. First, formation of a dilute zirconium oxide sol by hydrolysis at the boiling point of a solution of zirconyl chloride (Robinson and Ayres, 1933). Second, neutralisation of the acid sol without the formation of locally high pHs which cause gelling, and third, concentration of the sol after the addition of dextrin as a stabilising agent. Dextrin was chosen since this is used in the preparation of Thorotrast (Zellmann, 1933).Twenty g. of z rconium oxychloride (ZrOCl2 . 8 H20) are dissolved in about

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Section: Discussionmentioning

confidence: 99%

A Comparison Between the Late Effects of Thorotrast and a Non-Radioactive Zirconium Hydroxide Sol in Mice

Bensted¹,

Crookall²

1963

Br J Cancer

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Unusual Clinicopathological Syndromes with Kaposi's Visceral and Related Sarcomata

Perkins¹

1960

AMA Arch Intern Med

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A young woman was followed at Duke Hospital through the course of a rapidly fatal illness which was diagnosed at autopsy as visceral Kaposi's sarcoma. The patient is reported here because of the rarity of this neoplasm in women and because of the occurrence during life of an unusual physical finding. Two other cases are included in this report where similar neoplasms were found at autopsy: one had had thorium dioxide study of the liver 18 years prior to death, and a striking correlation existed between the sites of tumor involvement and the still-radioactive thorium deposits; another patient suffered from visceral lesions as well as typical Kaposi cutaneous lesions. Report of CasesCase 1.\p=m-\A27-year-old white female factory worker was admitted to Duke Hospital in December of 1957 with a rapidly progressing illness characterized by extreme emaciation and an enlarging abdominal mass. She had been well until two months prior to admission when she noted marked abdominal swelling. She was seen by an obstetrician for suspected pregnancy and hos¬ pitalized elsewhere because of the finding of a large right abdominal mass. An examination at that time by one of us (EHE) who saw the patient in consultation disclosed evidence of weight loss, pallor, pedal edema, hyperdynamic circulation with bounding pulses and wide pulse pressure, and a large smooth liver which was nontender. A loud continuous bruit was heard in the left lower abdominal quadrant anteriorly and posteriorly as well as in the right parasternal area. She be¬ came increasingly dyspneic and edematous and was transferred to Duke Hospital for further diag¬ nostic study.On examination, she appeared acutely and chronically ill with cachexia, slight icterus, and marked respiratory distress. The blood pressure was 190/70 mm. Hg, the pulse rate 100 per minute, the temperature normal, and the respira¬ tory rate 28 per minute. There was marked venous distention and cyanosis. Her face and extremities were edematous. The lungs were filled with fine inspiratory rales, and the heart was enlarged to the left anterior axillary line. A loud continuous murmur was heard over the entire precordium but was loudest over the right parasternal area. The abdominal murmurs heard on the previous ex¬ amination were no longer audible. The abdomen was distended by a huge, firm, nonpulsatile, nontender mass extending to the iliac crests and filling the entire upper quadrants.Admission laboratory data included a hemo¬ globin of 10.2 gm. % and a white blood cell count of 8,800 per cu. mm. with a differential count showing 71% polymorphonuclear cells, 4% stab forms, 2% myeloblasts, 12% small lymphocytes, and 5% monocytes. A prothrombin time was llrfc of normal. Clotting and bleeding times and retrac¬ tion of the clot were normal as was a tourniquet test for capillary fragility. The venous pressure as measured in an antecubital vein was 300 mm.water.X-ray of the chest showed cardiomegaly and a pathological rib fracture. Abdominal x-rays re-

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Granuloma of the neck following thorotrast angiography

Lévy

1956

Journal of British Surgery

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Late Effects of Thorium Dioxide in Man

Cited by 13 publications

References 16 publications

A Comparison Between the Late Effects of Thorotrast and a Non-Radioactive Zirconium Hydroxide Sol in Mice

A Comparison Between the Late Effects of Thorotrast and a Non-Radioactive Zirconium Hydroxide Sol in Mice

Unusual Clinicopathological Syndromes with Kaposi's Visceral and Related Sarcomata

Granuloma of the neck following thorotrast angiography

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