Ibotenic acid lesions of the thalamic medialis dorsalis nucleus in the cat: effects on the sleep-waking cycle.

Bilateral ibotenic acid lesions of the thalamic medialis dorsalis nucleus in chronically implanted cats produced a significant reduction of slow wave sleep. Rapid eye movement sleep was also affected but in a less significant manner. The lesions were limited to the intermediate portion of the nucleus, which receives projections from the brainstem and prosencephalic structures implicated in sleep mechanisms.

Premarin priming before prednimustine, high-dose folinic acid and 5-fluorouracil as salvage chemotherapy for advanced breast cancer.

Thirty patients with advanced and mainly pretreated breast cancer were treated with a combination of premarin, prednimustine, high-dose folinic acid and 5-fluorouracil. Among the 30 evaluable patients, 9 (30%) achieved an objective response (median duration: 9 months). Oral mucositis was the limiting toxicity, while myelosuppression was quite mild.

Changes in sleep--waking cycle induced by lesions of medialis dorsalis thalamic nuclei in the cat.

Bilateral lesions of medialis dorsalis (MD) thalamic nuclei in chronically implanted cats disrupt the sleep-waking cycle by inducing a reduction of both slow-wave and desynchronized sleep and a corresponding increase of wakefulness. Bilateral lesions of the anterior thalamic group produce some postural deficits but no changes in the percentage of sleep and wakefulness. The hypothesis that MD lesions alter the sleep processes by interrupting an anterior forebrain-MD-cortical link has been put forward.

Results of treatment.

Overall results of management in patients admitted to the 8 Italian centers participating in the International Cooperative Study on Timing of Aneurysm Surgery were rather unsatisfactory, with good recovery in only 42% of patients, and death in 45% of patients. As compared to the other centers included in the Study, Italian centers exhibited a significantly lower recovery rate and a significantly higher mortality rate. There were significant differences also between the individual Italian centers; independently of admission neurological status and timing of surgery, the outcome was better in centers 2 and 6 (a mortality rate under 20%) and worse in centers 1 and 8 (a mortality rate around 60%).

Surgical findings and postoperative therapeutic modalities.

The 8 Italian centers participating in the International Cooperative Study on Timing of Aneurysm Surgery operated upon 68% of their patients eligible for the study. This low operative rate is mainly explained by the prevailing use of a delayed surgical policy. Only 28% of cases were operated on within 3 days of hemorrhage.

Patient characteristics and pre-operative therapeutic modalities.

The International Cooperative Study on the Timing of Aneurysm Surgery included 68 participating centers from 16 different countries. Eight Italian neurosurgical units participated in the Study: Bellaria Hospital, Bologna; Neurological Institute of Milan, Milan; University Hospital, Brescia; University of Milan, Milan; University of Padova, Padova; University of Rome, Rome; Civil Hospital, Verona; and Civil Hospital, Vicenza. The overall case contribution from the Italian centers was 485 cases, 14.

Peptichemio, teniposide and high-dose dexamethasone: a new active combination for relapsing and refractory multiple myeloma. A pilot study.

Twelve patients with refractory (8 pts) and relapsing (4 pts) myeloma were treated with Peptichemio. Teniposide and high-dose dexamethasone. Eight patients experienced an objective response (5 out 8 with refractory and 3 out 4 with relapsing disease) with a median duration of 10+ months.

Brain stem expansive lesions: stereotactic biopsy for a better therapeutic approach.

CT diagnosed brain stem malignant lesions were in the past almost always treated with radiation therapy (RT). Eventually this turned out to be a grave mistake. With stereotactic serial biopsies of all brain stem expanding lesions we have been able to verify the histological nature in all cases but two and to prevent a blind therapeutic approach.

Cisplatin, high dose folinic acid and 5-fluorouracil in squamous cell carcinoma of the esophagus. A pilot study.

We treated 20 patients with squamous cell carcinoma of the esophagus with the following regimen: cisplatin = 100 mg/m2 i.v. day 1, HDFA = 200 mg/m2 i.

Projections from lateral reticular nucleus neurons to trigeminal motor nucleus revealed by antidromic activation in rabbits.

In anesthetized rabbits, electrophysiological experiments were conducted to determine if neurons of the lateral reticular nucleus that modified their activity during masticatory movements project directly into the trigeminal motor nucleus. Of the 125 neurons tested, 50 responded to stimulation of the trigeminal motor nucleus; of these, 22 were antidromically excited. Among this last population, 9 were antidromically driven also by cerebellar stimulation.

Transcerebellar biopsy in the posterior fossa: 12 years experience.

Utilizing the Leksell stereotactic system, the transcerebellar approach was used for posterior fossa biopsies. During a period of 12 years, a total of 29 patients were operated on by this technique, among them 12 children. In the adult, the procedure was carried out with the patient awake and sitting upright; the pediatric patients required general anesthesia and the head was supported either manually or by a clamp.

Cyclophosphamide, epirubicin and cisplatin (CEP) in advanced breast cancer: preliminary results.

Twenty-five patients with advanced breast cancer were treated every 28 days with Cisplatin, 30 mg/m2 iv on days 1,3,5; Epirubicin, 40 mg/m2 iv on day 1; Cyclophosphamide, 200mg/m2 iv on days 1,3,5. Partial remission was achieved by 7 patients (33%), all of whom had been untreated with chemotherapy. Overall toxicity was moderate but manageable.

Cortical and peripheral effects on single neurons of the lateral reticular nucleus in the monkey.

The aim of this study was to extend the anatomical study of the corticoreticular organization in the monkey by means of microelectrophysiological techniques. Considering the relatively modest projection (see companion paper, Wiesendanger and Wiesendanger, '87), it was surprising to see that over 70% of the investigated LRN neurons were influenced from at least one cortical stimulation site. Many neurons responded, however, with long latencies suggesting an indirect transmission line.

5-Fluorouracil and high-dose folinic acid as salvage treatment of advanced breast cancer: an update.

We report an update of our results of a trial of high-dose folinic acid (HDFA) and 5-fluorouracil (5-FU) in advanced breast cancer. Thirty-eight patients with advanced and mainly refractory breast cancer were treated with the following regimen: HDFA (200 mg/m2/day) and 5-FU (340, 370, 400 mg/m2/day) given immediately afterwards, for 5 consecutive days every 4 weeks. Of 36 evaluable patients, 3 achieved complete remission (8%) and 13 partial remission (36%) for an overall response rate of 44%, while 11 patients (30%) had stable disease.

Clinical experience with 5-fluorouracil (5-FU) and high-dose folinic acid in solid tumors.

This paper reports experience with high-dose folinic acid (HDFA) and 5-fluorouracil (5-FU) in the treatment of 130 patients with various types of tumor. While the objective results obtained from gastrointestinal malignancies (response rate = 15%) are no better than those usually gained by 5-FU alone, impressive results were achieved in patients with advanced and mainly pretreated breast cancer (response rate = 44%). Haematological toxicity was generally mild, while oral mucositis, diarrhoea and conjunctivitis were major side effects.

Stereotactic computer graphic system with brain maps.

We have developed a stereotactic computer graphic system with brain maps that runs on a personal computer. This system consists of three parts: 1. firmware for dizitizing radiological films with a TV camera or scanner (when digital image is not directly obtained from floppy disks); 2.

Role of aging on growth hormone and prolactin release after growth hormone-releasing hormone and domperidone in man.

Growth hormone (GH) and prolactin (PRL) secretion after GH-releasing hormone (GHRH) and domperidone (DOM), an antidopaminergic drug which does not cross the blood-brain barrier (BBB), was evaluated in 8 healthy elderly men (65-91 years) and in 7 young adults (23-40 years). All received in random order at 2-day intervals: GHRH(1-40) (50 micrograms i.v.

Restoring abduction of paralyzed vocal cords in the cat using selective laryngeal reinnervation by phrenic motoneurons.

The aim of this work was to reestablish the respiratory function of the paralyzed larynx through reinnervation of the posterior cricoarytenoid (PCA) muscle by phrenic motoneurons. In nine adult cats the adductor branch of the recurrent laryngeal nerve (RLN) of one side was cut and ligated, while the abductor branch was left intact. The whole RLN was then transected lower in the neck and its distal stump anastomosed to the upper branch of the phrenic nerve.

Treatment of advanced colorectal and gastric cancer with cisplatinum and 5-fluorouracil. A pilot study.

Eighteen patients with measurable advanced colorectal cancer and four with metastatic gastric cancer were treated with cisplatin 100 mg/m2 day 1 and 5-fluorouracil (5-FU) 1000 mg/m2 administered over 6 h i.v. infusion from days 2 to 5 every 21 to 28 days.

Phenol injection into cisterna magna for relief of advanced intractable cancer pain in the faciocephalic area.

Between 1973 and 1980 a solution of phenol in glycerin into the cisterna magna was injected in 38 patients suffering from advanced intractable pain due to neoplasm of faciocephalic area. Owing to the poor neurological and general condition of our patients, surgical procedures were discarded. Patient's age ranged from 36 to 76 years and pain diffusion involved many cranial and cervical nerves.

Cytoxan, epirubicin, methotrexate and 5-fluorouracil with hormonal synchronization (tamoxifen/premarin) in advanced breast cancer. Preliminary results.

Thirty-three patients with advanced breast cancer were treated with combination chemotherapy and hormonal synchronization in an attempt to increase the overall response rate generally obtained with traditional modalities of treatment. Among the 31 evaluable patients 1 complete (3%), 7 partial (22%), 13 stable disease (42%) and 10 progression of disease (53%) were obtained. Side effects were quite manageable although there were two episodes of life-threatening hematological toxicity.

Estrogen and progesterone receptors in neoplastic cells of metastatic pleural effusion of breast carcinoma before and after tamoxifen therapy. Correlation with the clinical response.

We have investigated the activity of tamoxifen in 12 post-menopause patients affected by advanced breast carcinoma and, in this specific case, by metastatic pleural effusion. A receptor assay was carried out on all patients to assess the estrogen and progesterone receptor activity in pleural effusion tumor cells, cytologically confirmed. The assay was performed both at the moment of the diagnostic check and after a week of 30 mg/die of tamoxifen therapy.