Treatment of malignant glioma by a new therapeutic principle.

L-2, 4 diaminobutyric acid (DAB) is a non-physiological, cationic amino acid transported into cells by System A with potent antitumour activity in vitro against human glioma cells. This activity was the result of the pronounced concentrated uptake of DAB in glioma cells to the extent that a cellular lysis could occur due to osmotic reasons. We describe the treatment of 3 patients with inoperable malignant glioma by direct and continuous administration of DAB in tumour tissue employing a microdialysis technique.

Induction of complete and irreversible damage to malignant glioma cells by L-2,4 diaminobutyric acid.

L-2,4 Diaminobutyric acid (DAB), a non-physiological amino acid, induced an irreversible injury to human malignant glioma cells when incubated for 24h at an amino acid concentration of 6 mmol/l at 37 degrees C. The same treatment of the human glia cells did not result in any cellular damage; not even a concentration as high as 20 mmol/l of the amino acid under the same incubation conditions did affect these cells. However, a further increase in amino acid concentration above that level resulted in a gradual loss of viability among the human glia cells.

Naloxone as an adjuvant in chemotherapy of an experimental tumor.

The antitumor effect of DAB (L-2,4 diaminobuturic acid) has been demonstrated in a previous study. Severe side-effects (especially weight loss and severe neurological symptoms) accompanying DAB treatment have raised the theory that DAB, through a direct effect on the hypothalamus, might cause a diabetes insipidus-like condition, which in turn would activate endogenous opiate systems. This study has verified this state of dehydration and hemoconcentration in a group of 41 mice treated daily with 0.

Ultrasound sector scanning for the localization and biopsy of intracerebral lesions.

A technique is described for the intraoperative use of ultrasound sector scanning in intracerebral neoplasms (mainly gliomas) for biopsy and for the localization of minor lesions. Altogether, 13 patients underwent sonographic examination: nine had gliomas, one had a meningioma, and three had metastases. Through a trephine hole or a bone flap over the tumor, the ultrasound transducer easily localized the lesion in all cases but one.

Perspectives of adenylate kinase activity and glutathione concentration in cerebrospinal fluid of patients with ischemic and neoplastic brain lesions.

Adenylate kinase (AK) activity and glutathione concentration were measured in cerebrospinal fluid (CSF) on three different occasions after the ictus in 16 patients with cerebral infarction. All patients displayed an unambiguous AK activity in their CSF within 48 h after the ictus while glutathione was present in 10 of the 16 patients. The mean AK activity among these patients was reduced by about 60% after 1 week and an additional smaller reduction took place after 3-4 weeks.

Follow-up study with computerized tomography and clinical evaluation 5 to 10 years after surgery for pituitary adenoma.

This study was based on 24 consecutive patients operated on for pituitary adenoma with suprasellar extension, and treated postoperatively with radiotherapy. The follow-up period was 5 to 10 years. A clinical examination, endocrine evaluation, perimetry, computerized tomography (CT) and sellar roentgenography were performed in 19 of 20 surviving patients.

Antitumor activity of L-2,4 diaminobuturic acid against mouse fibrosarcoma cells in vitro and in vivo.

Mouse fibrosarcoma cells were grown in vitro and incubated with L-2,4 diaminobuturic acid, a non-metabolizable amino acid. The tumor cells were irreversibly and totally damaged by incubation with 10 mM DAB for 24 h at 37 degrees C. The cell-destructive effect by DAB was probably due to an osmotic lysis induced by the non-saturated intracellular accumulation of DAB.

Pituitary adenomas: computed tomography and clinical evaluation in a follow-up after surgical treatment.

A study of the recurrence rate in 41 patients operated and postoperatively treated with irradiation for a pituitary adenoma was performed 10-15 years after operation. 15 of the 41 patients are now deceased among whom 1 had a known recurrence. 25 out of the now 26 living patients were investigated with a clinical examination, perimetry, computed tomography (CT), roentgen examination of the sella turcica and an endocrine evaluation.

Carotid ligation for the treatment of carotid artery aneurysms. Pre- and peroperative studies of the cerebral blood flow with an intravenous isotope technique.

Carotid ligation was performed in a series of 30 consecutive cases of infraclinoid aneurysms, of which 6 had not ruptured, and 9 cases of supraclinoid aneurysms. Fifteen of the ruptured aneurysms were operated on before, and 18 after, the eleventh day after bleeding. The internal carotid artery was primarily ligated in four cases, with two deaths, and in one case lasting hemiparesis occurred.

Malignant brain tumours associated with adenylate kinase in cerebrospinal fluid.

Adenylate-kinase activity was measured in cerebrospinal fluid (C.S.F.

High-energy protons in the postoperative treatment of malignant glioma.

Fractionated irradiation with high-energy protons was given postoperatively to seven patients with malignant glioma. In four cases in which detailed microscopic examinations were performed, radiation induced tumour necrosis was evident but in all four cases viable tumour cells were also observed. No abnormalities that could be attributed to radiation were observed in brain tissue free from tumour.

Measurement of intracardiac pressure through a valve-tipped catheter. Technical note.

Intracardiac pressure recording is a simple and effective way of obtaining optimal placement of the cardiac catheter during shunting procedures. We have also found this method applicable when using a catheter with a slit in its tip. Pressure waves can be accurately recorded by means of a constant rate liquid flow through the catheter.

The value of reinforcing intracranial aneurysms with plastic coating.

Plastic coating of a ruptured intracranial aneurysm is a surgical measure which may be considered if, for anatomical or technical reasons, ligation of the base of the aneurysm is not possible. After the coating operation, there is still some risk of recurrent haemorrhage. Thus, the late results in a series of 35 patients subjected to this operation have been compared with those in patients treated conservatively.

A wasted hand. Case with uncommon neurological and radiological features caused by a cervical band.

The symptomatology in the thoracic outlet syndrome is well known. A patient is reported in whom the finding of a unilateral pulse deficit was the alerting sign that led to the correct diagnosis. Angiography, performed with injections during different respiratory phases, visualized the pathogenetic mechanism underlying some of the clinical findings.

Surgical treatment of dural arteriovenous malformation in the region of the sigmoid sinus.

The dural arteriovenous malformation in the occipitomastoid region usually has multiple arterial tributaries from the internal and external carotid and vertebral arteries. They converge towards the proximal segment of the sigmoid sinus, where the arterial blood is shunted into the venous channel. Five cases of this malformation are described.