1H MRS in acute traumatic brain injury.

The objective of this study was to demonstrate 1H MR spectroscopy (MRS) changes in cerebral metabolites after acute head trauma. Twenty-five patients (12 children, 13 adults) were examined with quantitative 1H MRS after closed head injury. Clinical grade (Glasgow Coma Scale [GCS]) and outcome (Rancho Los Amigos Medical Center Outcome Score [ROS]) were correlated with quantitative neurochemical findings.

Immunotherapy for recurrent malignant glioma: an interim report on survival.

We present interim survival data for a group of 83 adult patients with recurrent malignant glioma treated by implanting stimulated autologous lymphocytes into the tumour bed following surgical debulking. The patients were treated 6 months or more prior to data analysis. Fifty-nine patients were male and 24 female.

Salvage immunotherapy of malignant glioma.

We present the preliminary results of a phase I trial of adoptive immunotherapy for recurrent or residual malignant glioma. The protocol is based on surgical debulking followed by implantation into the tumor bed of autologous lymphocytes that have been stimulated with phytohemagglutinin-P and then cultured in vitro in the presence of interleukin 2. Fifty-five patients with a mean Karnofsky rating of 64 were treated between February 1985 and March 1987.

Preliminary clinical trial of immunotherapy for malignant glioma.

An immunotherapy protocol based on intracranial implantation of stimulated, autologous lymphocytes into the tumor bed following surgical debulking of malignant glioma is described. Phase I clinical trials in human patients are now in progress. Preliminary data representing the first 39 patients treated are presented briefly.

Phototoxicity of brain tissue in hematoporphyrin derivative treated mice.

Photoradiation therapy conditions which have been used to treat subcutaneous and breast tumors are lethal when applied to the head of mice. Treatment of control mice with laser light at 631 nm over an energy density range of 0-90j/cm2 had no measurable effect but mice photosensitized with 5 mg HPD/kg 72 hrs prior to laser treatment showed a threshold for brain damage at 56j/cm2, above which the mice developed cerebral edema and died. Laser treatment caused the same rate and magnitude of temperature rise in both control and HPD-photosensitized mice.

Nuclear magnetic resonance imaging. Review of early clinical experience.

Nuclear magnetic resonance tomography is a powerful new imaging modality which produces cross-sectional images similar to those obtained by computerized tomography. However, unlike computerized tomography, nuclear magnetic resonance imaging does not use ionizing radiation but rather utilizes an apparently safe interaction between magnetic fields, radio waves, and atomic nuclei. Basic principles of nuclear magnetic resonance imaging are discussed briefly and promising early clinical applications are reviewed.

Development of a protocol for photoradiation therapy of malignant brain tumors: part 1. Photosensitization of normal brain tissue with hematoporphyrin derivative.

The successful application of phototherapy to subcutaneous tumors has suggested that a similar procedure should be developed for treating gliomas. As a result, attempts are being made to determine a set of conditions that would optimize the destruction of tumor cells while minimizing injury to surrounding brain tissue. To initiate this task, we developed a novel assay method to assess the amount of phototoxicity induced in normal brain by light exposure of mice treated with hematoporphyrin derivative (HPD).

A three-dimensional and volume determination of tumors of the cerebellopontine angle.

We propose a new technique to accurately determine the volume of cerebellopontine angle (CPA) tumors. It has been determined that the measurement of the long axis in a slice plane of the CPA tumor does not adequately measure the total growth of the tumor. Volume measurements are more accurate indicators of the mass of the tumor.

Computerized three-dimensional stereotaxic removal of small central nervous system lesions in patients.

The authors describe the results of their recently reported computer-based stereotaxic surgical technique for the indentification, enhancement, three-dimensional reconstruction, localization, and removal of small central nervous system lesions. This technique has been applied to patients with various types of central nervous system pathology, and representative cases are reported.

A microstereotactic approach to small CNS lesions. Part II; Adjuvant therapy. Clinical potential and toxicity of intraventricular lymph infusion.

A technique is described for adjuvant therapy of small central nervous system tumors after their removal. The feasibility of direct application of lymphocytes from the thoracic duct to the ventricular system of cats has been explored. Reduction of the antigenic mass by techniques described in part I of this paper is probably crucial.

A microstereotactic approach to small CNS lesions. Part I. Development of CT localization and 3-D reconstruction techniques.

The authors describe a newly designed and utilized stereotactic methodology for the removal of central nervous system lesions as small as a few millimeters in diameter. These small lesions are detected and localized by non-invasive computerized axial tomography (GE 8800 scanner) with additional computer processing of the digital data by means of a PDP-1145 computer. Multiple computer algorithms have been developed to enhance regions of interest on CT scans by three-dimensional reconstruction and magnification techniques.

Development of a new implantable bio-telestimulator.

The authors describe preliminarily an implantable bio-stimulating device for stimulation of peripheral nerves and the central nervous system. The receiving unit is totally implantable. The system works on radiofrequency transcutaneous coupling across the skin.

A computerized microstereotactic method to approach, 3-dimensionally reconstruct, remove and adjuvantly treat small CNS lesions.

The authors update a novel method recently utilized in humans with various CNS pathology for stereotactic localization, removal, and adjuvant therapy of small CNS lesions using additional computer processing of the date from a GE 8800 CT Scanner. Multiple computer algorithms developed at Cal Tech enhance regions of interest by filtering, magnifying, color-coding and 3-dimensional reconstruction based on routine CT scans. This stereotactic approach is calculated by the computer and coordinates are mated to a modified head fixation system; small lesions can be removed with the apparatus described herein under direct binocular vision with minimal tissue damage.

Microsurgical cannulation of the thoracic duct in cats. Technical note.

The authors describe a new technique for the microsurgical cannulation of the thoracic duct. A small silastic tube is utilized which can be joined to a subcutaneously implanted one-way flow, CSF, Ommaya-type reservoir. Extended drainage is avoided.

Kubelka-Munk optical properties of a barium sulfate white reflectance standard.

We have measured the Kubelka-Munk scattering and absorption coefficients for a barium sulfate white reflectance standard. These measurements have been based on measurements of the absolute reflectance for the particular barium sulfate samples whose scattering and absorption coefficients were measured. This method gives results that are different from earlier measurements; the differences are significant for measurements of the optical properties of atmospheric aerosols.

Adverse effects of electrical energy applied to the nervous system.

Neural prostheses activated by radiofrequency transmission are currently being implanted to treat a variety of clinical problems. It is essential that neither the materials used in these prostheses, particularly the electrodes, nor the stimulus parameters that are employed will cause neural damage. The experiences of investigators engaged in both the experimental laboratory and clinical studies of the effects of electrical stimulation are reported herein.

Alternating Bell's palsy associated with diabetes mellitus. A report of four cases.

Four diabetic patients are presented with alternating facial palsy. The term alternating is meant to imply facial nerve paralysis, the onset of which occurs at different points in time on both sides of the face. Clinical findings are presented and a short review of the literature is summarized.

Primary osteogenic sarcoma of the brain. Case report.

The authors report a case of primary osteogenic sarcoma of the brain. Negative autopsy findings, complete bone radiographs, and bone-scanning techniques were consistent with a primary tumor focus in the right temporopietal region of the brain. The authors suggest an origin from a primitive multipotential mesenchymal cell.

Osteopetrosis associated with familial paraplegia: report of a family.

A clinical analysis of three members of a family with documented osteopetrosis and familial paraplegia is presented. All patients had a long history of increased bone density and slowly progressing paraparesis of both legs. A thorough review of the literature has revealed no other cases which presented with paraplegia without spinal cord compression.

Electrical stimulation of the nervous system.

Twenty-seven patients with chronic pain had dorsal column stimulators implanted for pain control over a period of three years. Technical factors of electrode placement and type of unit were not found to correlate with the degree of pain relief. The preoperative psychological attitude of the patient correlated highly with the degree of pain relief and was the single most important factor in patient selection and evaluation.