Search

Prophylactic placement of vena caval filters is recommended in trauma patients at high risk for pulmonary embolism (PE). We present a group of patients with iliofemoral venous trauma, and subsequent complications of deep venous thrombosis (DVT) and PE. Of twelve patients with iliac or common femoral venous injuries, seven underwent primary repair. All received DVT/ PE prophylaxis with mini-dose heparin and/or sequential compression hose. In spite of this, two patients suffered DVT, one patient had DVT and PE and one patient had clinical evidence of PE but did not undergo confirmatory testing. Three patients underwent prophylactic caval filter placement without complication. The DVT/PE complication rate in this small group was at least 43% (3 of 7). Patients with repaired iliofemoral venous injuries represent a high risk subset for DVT/PE and prophylactic caval filter placement is recommended.

Objective: Obtunded patients (Glasgow Coma Scale score of < 13) with normal cervical roentgenograms remain in collars until they can be clinically evaluated. Cervical collars provide incomplete immobilization and have complications. Our hypothesis was that cervical spines could be evaluated in obtunded patients with normal cervical roentgenograms using dynamic fluoroscopy., Design: This study was a prospective clinical evaluation., Methods: Obtunded trauma patients with normal cervical roentgenograms underwent fluoroscopic examination of the cervical spine through a full range of motion., Results: Fluoroscopic evaluations were done in 116 patients. There were 113 true negative examinations. Two patients had facet fractures not diagnosed on cervical roentgenograms, and no instability on fluoroscopy. One patient had a positive exam, with 2 mm of subluxation. There were no neurologic complications. Decubiti were present in 44% and were more frequent when the collar was on > 5 days (p = 0.029)., Conclusions: Dynamic fluoroscopy can safely and effectively clear the cervical spine in obtunded patients. Earlier removal of the collar decreases decubiti.

Measurement of a relative afferent pupillary defect (RAPD) can be carried out by attenuation of light received by the normal eye during the swinging flashlight test. Such measurements may be useful in the management of central retinal vein occlusion (CRVO). In this study a method employing cross polarised filters (CPFs) was tested for reproducibility. In addition the pattern of attenuation of light was compared with that by neutral density filters (NDFs). Finally, the method was used to investigate 74 patients with CRVO. The method was reproducible (8.7% variation) and showed exponential attenuation of light (in contrast to linear attenuation by the NDFs). In unilateral CRVO a sensitivity of 71% and specificity of 69% for the risk of iris neovascularisation was determined by the presence of RAPD requiring 20 degrees of rotation of the CPFs. It is concluded that CPFs provide a useful alternative to NDFs for the measurement of RAPD and have some advantages. They can be employed in the clinical management of patients with CRVO.

Sodium fluorescein staining of the retina following fluorescein angiography may affect the absorption characteristics of argon ion laser photocoagulation. This hypothesis was investigated by performing laser photocoagulation on control and fluorescein stained porcine retinas. The resultant damage was viewed by scanning electron microscopy. In both specimens, argon irradiation produced damage to the pigment epithelium and overlying photoreceptor layer. The control sample showed a deep cylindrical burn, indicative of internal heating, in both retina and choroid. The fluorescein stained sample showed damage consistent with thermal interaction from the surface downwards leaving the choroid relatively spared. This preliminary study demonstrates that fluorescein staining of the retina changes the absorption site of argon laser light and this subject clearly merits further investigation.

Objective: To compare the attitudes and opinions of dietitians and dietary managers in regard to cost-benefit analysis (CBA) and cost-effectiveness analysis (CEA)., Design: A questionnaire was sent nationwide to a sample of 1,074 dietitians and 454 dietary managers., Subjects/samples: The dietitians were randomly selected from three dietetic practice groups of The American Dietetic Association that have practitioners with administrative responsibilities in health care: Clinical Nutrition Management, Consultant Dietitians in Health Care Facilities, and Management in Healthcare Systems. The random sample of dietary managers was drawn from the membership list of the Dietary Managers Association., Main Outcome Measures: We hypothesized that there would be a difference between the dietitians and dietary managers in their attitudes about, and experiences in conducting CBA and CEA., Statistical Analyses: Data analysis incorporated frequencies, means, and standard deviations to describe the respondents. Pearson's pairwise correlations and analysis of variance examined the significance of the relationships among the variables of the study. Scheffe's test was conducted to identify which variables related closely to each other., Results: Seven hundred twenty-two usable questionnaires were returned, which gave an overall response rate of 47%. Although both professional groups had experience with reducing costs at their jobs, they did not think it important to conduct CBA and CEA. Neither group could distinguish between CBA and CEA. Dietitians, who were more positive toward using CBA and CEA, saw them as important techniques that could justify the value of dietetics services. Dietitians were also more likely than the dietary managers to use the techniques in the future. Dietitians were beginning to explore the techniques, but they did not feel that good sources of information were available for conducting CBA and CEA studies., Applications/conclusions: Our findings suggest a strong need to educate dietitians and dietary managers in the techniques and proper use of CBA and CEA in practice settings. Dietitians need to be guided to appropriate teaching materials and educational programs, and dietary managers first have to be educated about the importance and the benefits of using the techniques.

As we look at our nation's drive for technological superiority, global interdependence, major demographic shifts, and changes in consumer values and expectations, it is obvious that these changes will have a profound effect on our profession. Our leaders must be direction setters, change agents, and mentors in helping our members understand the importance of becoming part of this information and technological revolution. Because people often cling to the security of the past, leaders will have to possess the ability to convince others that there is a need for change. We must assume the risks related to making today's critical decisions about the role of infotech to the future of our profession. As individual members and leaders, we must not deny the reality of the technology challenge.

Objective: To report the clinical presentation and response to antimicrobial therapy of presumed bacillary angiomatosis in an AIDS patient., Design: Single case report., Setting: A 1058-bed, university teaching hospital., Patient: 28-year-old HIV-positive man (T4 lymphocyte count < 3/mm3), who was diagnosed with AIDS in 1984., Results: The skin lesions responded promptly to treatment with doxycycline and erythromycin., Conclusions: Bacillary angiomatosis is an infection that occurs with endstage AIDS. Skin lesions have recognizable characteristics and respond promptly to appropriate antibiotic therapy.

The segment polarity genes engrailed and wingless are expressed in neighboring stripes of cells on opposite sides of the Drosophila parasegment boundary. Each gene is mutually required for maintenance of the other's expression; continued expression of both also requires several other segment polarity genes. We show here that one such gene, hedgehog, encodes a protein targeted to the secretory pathway and is expressed coincidently with engrailed in embryos and in imaginal discs; maintenance of the hedgehog expression pattern is itself dependent upon other segment polarity genes including engrailed and wingless. Expression of hedgehog thus functions in, and is sensitive to, positional signaling. These properties are consistent with the non-cell autonomous requirement for hedgehog in cuticular patterning and in maintenance of wingless expression.

The psychological costs of providing care for a parent with Alzheimer's disease are examined, together with the consequences of depression, anxiety, guilt, and resentment in relation to the caregiver's coping style, social support, and sense of control. The use of fantasy by women as a coping mechanism was associated with greater anxiety and depression, adequate social support was somewhat more helpful for men, and a sense of control was more helpful for women.

The ventral furrow and posterior midgut invaginations bring mesodermal and endodermal precursor cells into the interior of the Drosophila embryo during gastrulation. Both invaginations proceed through a similar sequence of rapid cell shape changes, which include apical flattening, constriction of the apical diameter, cell elongation and subsequent shortening. Based on the time course of apical constriction in the ventral furrow and posterior midgut, we identify two phases in this process: first, a slow stochastic phase in which some individual cells begin to constrict and, second, a rapid phase in which the remaining unconstricted cells constrict. Mutations in the concertina or folded gastrulation genes appear to block the transition to the second phase in both the ventral furrow and the posterior midgut invaginations.

Gastrulation is a complex process requiring the coordination of cell shape changes and cell movements. In Drosophila, gastrulation begins immediately upon cellularization of the blastoderm stage embryo with the formation of the ventral furrow and posterior midgut. Cells that form both of these invaginations change their shape via apical constriction. Embryos from mothers homozygous for mutations in the concertina (cta) gene begin furrow formation by forming a zone of tightly apposed cells, constrict some cells, and then fail to constrict enough cells to form an organized groove. The cta gene has been cloned, and sequence analysis suggests that it encodes an alpha subunit of a G protein. G proteins have a role in cell-cell communication as mediators of signals between membrane-bound receptors and intracellular effectors. The phenotype of embryos from homozygous cta mothers suggests that the cta gene plays a role in a signal transduction pathway used during gastrulation.

Matsunone, (2E,4E)-4.6,10,12-tetramethyl-2,4-tridecadien-7-one, is the primary sex pheromone ofMatsucoccus resinosae, M. thunbergianae, andM. matsumurae. The synthetic compound was tested in the laboratory and in field tests with all three species, and significantly more males responded to synthetic matsuone than to controls. The attraction of synthetic matsuone to males in field tests was not significantly different from that of virgin females at the same matsuone release rate. An analog of matsuone previously shown to be biologically active was also tested in the laboratory withM. resinosae andM. thunbergianae, and field tested withM. resinosae. The active analog required a dose approximately 100 times greater than matsuone to yield maximum laboratory bioassay response, and in field tests, attraction was not significantly different from controls at doses at which matsuone was significantly attractive.

The accurate clinical diagnosis of benign mixed tumors of the lacrimal gland is imperative for proper therapeutic management. Although benign mixed tumors of the orbital portion of the lacrimal gland have an established identity, those tumors arising in the palpebral lobe are unusual. Four patients with benign mixed tumors of the palpebral lobe are presented, emphasizing the confusion that exists in making the diagnosis. Palpebral lobe benign mixed tumors should be strongly considered in the differential diagnosis of upper outer eyelid masses. En bloc resection avoids the risk of tumor spillage, recurrence, and/or malignant transformation caused by preliminary biopsy or incomplete resection.

The records of 83 patients with 85 colostomy closures at Charity Hospital, New Orleans from January 1976 through June 1981 were reviewed. There were 47 complications in 30 patients (36 percent) with no deaths. The material used for anastomosis and fascial closure, the precipitating or underlying disease, the site of colostomy, and the length of operation did not influence the complication rate. The major factor affecting the complication rate was the interval of time from creation of the colostomy to its closure. Those patients who underwent closure after a 90 day interval had a lower overall complication rate than comparison groups with less than a 30 day interval and 30 to 90 day intervals (p less than 0.05). Other factors that appeared to influence the complication rate were as follows: loop colostomies had a lower suture line complication rate than divided colostomies, patients who underwent relaparotomy and closure had a higher complication rate than those whose closures were confined to the colostomy site, and wounds left open or that underwent delayed primary closure had a lower infection rate than wounds closed primarily. Thus, loop colostomies appear to have fewer complications at the time of closure than divided stomas. This is most likely related to the necessity for relaparotomy in some of the patients with divided stomas and the need for minimal mesenteric dissection required for most loop colostomy patients. Divided stomas should still be created if indicated, but when a choice exists, loop colostomies are preferable. Contaminated wounds are best managed with secondary closure or delayed primary closure. Because of the significant difference in complication rates between intervals from formation to closure of a colostomy, all patients should have their colostomies closed only after a minimum of 90 days has elapsed.

Dietetic education programs seeking to maintain their enrollment levels may find it necessary to adopt more sophisticated marketing strategies. This article describes the application of the marketing process to an extended degree dietetic program that serves a national audience. It also presents a strategy for initiating a marketing study and marketing orientation by analyzing its internal program data. The article discusses the specific market characteristics of the program's primary market segments, and it presents further implications for dietitians at work in health care facilities, in businesses, or in private practice.

We successfully employed inverse ratio ventilation on a 6-year-old multiple trauma victim with severe adult respiratory distress syndrome after conventional ventilation modes using volume ventilation with high positive peak inspiratory pressure and PEEP had failed to improve oxygenation.

We have used an immunoaffinity system whereby immunoglobulin from patients with prostatic carcinoma was coupled to solid phase protein A; the immobilized IgG was subsequently exposed to radiolabeled antigen from autochthonous or allogeneic primary tumor extracts or to radiolabeled antigen from a nude mouse-supported prostatic carcinoma cell line. Material specifically bound by prostatic carcinoma patient immune IgG was quantitatively eluted from the immunoadsorbent and characterized with regard to molecular weight. Sequential adsorption analyses of patient sera with normal human tissue pools, normal prostatic tissue, prostatic carcinoma tissue, and tissue from other urogenital malignancies has allowed a definition of those antigenic specificities relevant in the immunobiology of prostatic carcinoma. The patient humoral response was observed to be directed primarily toward a complex array of antigens representing normal human tissue components; serorecognition of prostate tumor associated antigens was discernible from that of common tissue antigens only after rigorous adsorption analyses. Preliminary results indicate that the prostatic cancer patient humoral antibody response may be directed toward either altered histocompatibility complex antigens or toward antigens physically associated with histocompatibility complex antigens.

This is a study of the personal support networks of a selected group of formerly hospitalized psychiatric patients now residing in board-and-care facilities in Galt, California. Its purpose was to assess the particular forms of support available to such persons and to suggest ways in which short-comings in needed supportive interaction might be remedied. The article first reviews the circumstances of board-and-care placement. It then examines the concept of support systems and their relevance to the health and well-being of individuals. Following this, the findings of a study of 39 psychiatrically disabled persons residing in board-and-care homes in one rural California community are reported. Several recommendations are offered which illustrate two ways in which agency and community services might affect the support available to board-and-care residents.

Thyroid carcinoma metastatic to the calvaria may result in a lytic, well-circumscribed lesion the appearance of which necessitates differential consideration of lytic lesions of the skull. The merits of angiography in the study of such lesions are noted. Even in young persons, the possibility of metastasis presenting as a solitary lytic defect in the skull must be kept in mind.

The Galt Helping Network Project was a two-year program to augment mental health and community services in a rural California community through the use of natural or informal resources. The experiment made use of a preventive intervention model which identified important needs of local youth and families, board and care residents, the entire community for recreation and for mental health services, and the Mexican American Community for recognition and participation. It brought a number of volunteers into the provision of direct services and created a number of institutional forms by which continued services and enlarged voluntary participation in community affairs are continuing beyond the official end of the project. This article concludes that the Galt Helping Network Model can provide a major contribution to mental health maintenance and community involvement through the recognition of natural helpers and the involvement of the community in an active form of problem solving. Through these methods a community with limited fiscal resources can take a major step toward providing a caring and helping environment for its members.

A study was conducted among practitioners in Pennsylvania to obtain their opinions concerning essential entry-level competencies and those that they considered necessary when hiring and entry-level dietitian, and to determine how they felt about role specialization at the entry level or practice. The competencies identified as most critical for the entry-level dietitian were: (a) an understanding of the managerial processes of planning, organizing leading, evaluating, and controlling and their relationship to the management of human, material, and financial resources; (b) an understanding of the process, functions, and interrelationships of various systems of the human body; and (c) an ability to integrate knowledge of biological, social, and professional sciences into a comprehensive concept of human nutrition. A strong knowledge base, essential for the entry-level generalist, was indicated in the following areas: nutrition and disease, normal nutrition, food selection and planning, and food production systems. There was a perceived need for academic institutions to train both specialists and generalists in the 1980s.

Two adults with beta-galactosidase deficiency were studied. Differences in a number of beta-galactosidase parameters (pH optima, heat denaturation, NaCl kinetics) were noted between the patients. Differences were also noted in beta-galactosidase electrophoretic mobilities and urinary oligosaccharides; however, there was no complementation in cell fusion studies. It is suggested that these two patients have different primary mutations at the beta-galactosidase locus which are probably structural in nature.

From October 1977 through December 1982, 24 patients with lower gastrointestinal tract hemorrhage were diagnosed by visceral angiography as having angiodysplasia of the colon. Seventeen of them underwent surgery for definitive treatment of their hemorrhage. Five patients had lesions on both sides of the colon, and five had coagulation disorders. Three of the 17 patients with lesions isolated to the cecum underwent right hemicolectomy. The rest underwent subtotal colectomy with ileoproctostomy. No patient had recurrent or persistent bleeding. There were three deaths in the subtotal colectomy group (21%); coagulation disorders contributed to two of them. Subtotal colectomy was universally successful in controlling bleeding but had a significant mortality in these elderly patients. Coagulopathy, especially platelet disorders, was a significant risk factor with this diagnosis. A coagulation panel, including platelet function, should be part of the preoperative assessment.

The establishment of cultured cell lines from skin biopsies stored at -196 degrees C for periods up to 1 year has been investigated. Attempts to initiate cell cultures from the frozen tissue samples were uniformly successful. There was no alteration in chromosome constitution, morphological appearance, or specific activities of lysosomal enzymes in cells cultured from the stored samples. This process can safeguard against failure of the initial tissue culture and provide an alternate means of storing viable cells when it is impossible or impractical to initiate a cell culture immediately.

This review examines five measures specifically designed to assess autistic symptomatology: Rimland's Diagnostic Checklist for Behavior-Disturbed Children, the Behavior Rating Instrument for Autistic and Atypical Children, the Behavior Observation Scale for Autism, the Childhood Autism Rating Scale, and the Autism Behavior Checklist. Available studies of reliability and validity issues are discussed. Reliability indices for all scales, except Rimland's Diagnostic Checklist, are at acceptable levels. Each scale has been found to suffer from a lack of demonstrated discriminant and/or content validity. Recommendations for future research are provided.

A case is presented of a patient with a congenital hernia of Morgagni that was diagnosed after a motorcycle accident. These may be confused with a traumatic diaphragmatic hernia. The lateral chest film is helpful in the differential diagnosis. The barium enema is usually diagnostic.

Traditionally, dietitians have communicated the availability of their services to the "public at large." The expectation was that the public would respond favorably to nutrition programs simply because there was a consumer need for them. Recently, however, both societal and consumer needs have changed dramatically, making old communication strategies ineffective and obsolete. The marketing discipline has provided a new model and new decision-making tools for many health professionals to use to more effectively make their services known to multiple consumer groups. This article provides one such model as applied to the dietetic profession. The model explores a definition of the business of dietetics, how to conduct an analysis of the environment, and, finally, the use of both in the choice of new target markets. Further, the model discusses the major components of developing a marketing strategy that will help the practitioner to be competitive in the marketplace. Presented are strategies for defining and re-evaluating the mission of the profession, for using future trends to identify new markets and roles for the profession, and for developing services that make the profession more competitive by better meeting the needs of the consumer.

As part of a study to make a comparative analysis of selected halogenated compounds in man and the environmental media, a quantitative gas chromatography mass spectrometric analysis of the levels of the halogenated compounds found in the breath, blood and urine of an exposed population (Old Love Canal area, Niagara, New York) and their immediate environment (air and water) was undertaken. In addition, levels of halogenated hydrocarbons in air samples taken in the general Buffalo, Niagara Falls area were determined.

Exteriorized repair of selected colonic injuries has been reported to be successful. Eighty-two colonic injuries were reviewed to determine the indications for primary repair, exteriorized repair, or colostomy and to assess the feasibility of early drop-back of the exteriorized repaired colon. Injuries were graded into three stages: stage 1, good risk; stage 2, moderate risk; and stage 3, bad risk. Sixty-seven percent of patients with stage 1 injuries underwent primary repair, 61% of patients with stage 2 injuries underwent exteriorized repair, and 61% of patients with stage 3 injuries received a colostomy. Of 38 patients who had exteriorized repair, 29 (76%) had their colon successfully dropped back on an average of five days postoperatively. Nine patients had their exteriorized colon converted to a colostomy on an average of 5.5 days postoperatively. The overall mortality was 2.4%; however, the mortality of the patients with exteriorized repair was 0%. Exteriorized repair with early drop-back is safe and economical for most patients with stage 2 injuries and selected patients with stage 3 injuries.

The alpha-Pro 13-secreting hybridoma was produced by immunizing mice with an equal mixture of PC-3, DU145, and LNCaP established prostatic carcinoma cell lines. The specificity of alpha-Pro 13 monoclonal antibody was evaluated by the criteria of differential binding to cultured cells; differential binding to extracts of malignant prostate, nonmalignant prostate, and malignant and nonmalignant tissues of various histiotypes in solid phase radioimmunoassay; and by immunoperoxidase staining of primary surgical tissues of varied histiotypes. The data generated by multiple assay investigation indicate that alpha-Pro 13 exhibits preferential binding to the ductal epithelium of prostate tissue; immunoperoxidase evaluation indicates a considerable heterogeneity of staining of ductal epithelial cells. The most prevalent cross-reactivity of alpha-Pro 13 monoclonal antibody with non-prostate tissue occurs with blood vessel endothelium of restricted tissues. Electrophoretic analysis of immunoprecipitates from radioiodinated prostatic tumor extracts indicates that the molecule recognized by alpha-Pro 13 is of 120,000 dalton apparent nonreduced molecular weight. Under reducing conditions, the antigen (p40) consists of a major component of 40,000 dalton apparent MW and a minor component of 17,000 dalton MW. p40 has an isoelectric point of 3.5-4.5. The antigen is intrinsically stable on the PC-3 cell surface; its release into spent culture medium is negligible. p40 is also stable upon complexation with alpha-Pro 13 antibody in that it is not shed from the cell surface as an immune complex nor is it endocytosed to any extent as an immune complex.

Immunoperoxidase staining of frozen sections is a cost-effective technic for immunophenotyping cells of lymphoid tissue. Because this procedure is not performed in many institutions, a simple method to transport fresh tissue to centers performing these studies is required. Tissues in saline at refrigerator temperature may be successfully transported. In addition, in order to minimize laboratory expenses, lymphoid tissue can be kept refrigerated in saline until permanent sections are examined and immunodiagnostic procedures become necessary. In this study reproducible immunophenotyping of 12 samples of lymphoid tissue stored up to seven days was achieved.

Three adult patients from two families have shown slowly progressive neurologic deterioration since the age of 3 years, associated with profound beta-galactosidase deficiency. Although affected individuals from the two different families differ in degree of intellectual deficit, facial coarseness and spondyloepiphyseal dysplasia, all lack visceromegaly and macular red spots. The diversity of phenotypic expression in these patients and others previously reported suggests the existence of composite genotypes (compound and double heterozygosity).

Mouse monoclonal antibodies alpha Pro3 and alpha Pro5 bind to different epitopes on an antigen (p54) of 54 kD reduced and 175 kD nonreduced MW. p54 antigen has been characterized previously with regard to tissue distribution using alpha Pro3 monoclonal antibody; the p54 antigen is present in substantially greater quantities in malignant prostatic tissue extracts than in benign prostatic and nonmalignant nonurogenital tissue extracts. In this report, we have established that alpha Pro5 and alpha Pro3 monoclonal antibodies exhibit same molecule-different epitope recognition. That both antibodies recognize the same molecular entity has been established by partial physiochemical characterization of the antigen recognized by the two antibodies and by sequential immunoprecipitation experiments. Different determinant recognition was established by lack of competitive surface binding between alpha Pro3 and alpha Pro5 to a prostatic carcinoma cell line. The p54 antigen can be labeled with glucosamine and immunoprecipitated from urea-solubilized membrane proteins; however, p54 cannot be detected by immunoprecipitation in a glycosylated form in spent culture medium removed from glucosamine-labeled cells. Experiments using indirect cellular immunoassays and directly radioiodinated monoclonal antibody have shown that both alpha Pro3 and alpha Pro5 form stable complexes with p54 antigen on the prostatic carcinoma cell surface. To the extent that modulation occurs upon interaction of p54 with alpha Pro3 and alpha Pro5; endocytosis of the immune complex appears to be the primary route of modulation. Furthermore, modulation by endocytosis is more intense when alpha Pro3 and alpha Pro5 are used in combination than when either monoclonal antibody is used alone. Although in vivo biologic behavior does not invariably correlate with in vitro behavior, careful in vitro analysis of monoclonal antibodies with respect to cell surface behavior, nevertheless, should precede in vivo evaluation. The data presented in this report indicate that preliminary in vitro analyses will expedite the effectiveness of in vivo immunotherapeutic trials; preliminary in vitro evaluations are absolutely essential if monoclonal-toxic agent (e.g., ricin A) conjugates, which must be internalized by the tumor cell to achieve cytotoxicity, are employed as immunotherapeutic agents.

We have used cell fusion technology to produce second-generation hybridomas which secrete a population of murine monoclonal antibodies (MABs), a portion of which are bifunctional antibodies. The bifunctional hybrid MABs produced are capable of recognizing ricin A-chain (RAC) via one antigen-combining site and a prostate-restricted antigen via the other antigen-combining site of the IgG molecule. The second-generation hybridoma described in this report resulted from the fusion of spleen cells from mice immunized with purified RAC to hybridoma cells which secrete prostate-directed alpha Pro 15 monoclonal antibody. We have demonstrated that the MAB population secreted by the second-generation hybridoma can be physicochemically separated into distinct populations exhibiting differential binding to the cultured prostatic carcinoma cell surface and to RAC immobilized in a solid phase; specifically, a subset of the monoclonal antibody population which exhibits high binding to both prostatic carcinoma cells and to solid-phase RAC can be enriched by physicochemical methods. Binding of hybrid immunotoxin (HIT) MAB population to RAC can be quantitatively reduced by prior adsorption of the antibody population with prostate carcinoma cells; conversely, hybrid MAB binding to prostate carcinoma cells can be quantitatively reduced by prior adsorption with RAC. The biologic impact of the HIT has been evaluated by the ability of the HIT-RAC conjugate to reduce the uptake of 14C-amino acids into cellular protein. This effect is selective, since HIT-RAC conjugates do not exert an effect on labeled amino acid uptake by a cell line that does not express the target antigen recognized by the prostate-directed component of the hybrid MAB. Furthermore, depression of labeled amino acid uptake by prostate carcinoma cells exhibits a stoichiometric relationship with respect to both the concentration of HIT-MAB and to RAC to which the cells are exposed. The biologic impact of HIT-RAC conjugates on prostate carcinoma cells is enhanced markedly in the presence of lysosomotropic amines.