Arachnoid cysts of the middle cranial fossa: experience with 77 patients who were treated with cystoperitoneal shunting

OBJECTIVE

Our surgical results of middle fossa arachnoid cysts are presented, and advantages and disadvantages of cystoperitoneal shunting are discussed.

METHODS

Seventy-seven patients with middle fossa arachnoid cysts, including 20 cases of asymptomatic cyst, were treated by cystoperitoneal shunting. In cases associated with subdural hematoma, the cystoperitoneal shunt was preceded by irrigation of the hematoma. Follow-up periods ranged from 8 months to 16 years (mean, 7.7 yr).

RESULTS

In all cases, postoperative computed tomography and magnetic resonance imaging revealed subsequent expansion of the surrounding brain, concomitant with either the disappearance of or a marked decrease in the size of the cyst. Patients who initially presented with headaches, hemiparesis, choked discs, and diplopia were cured postoperatively. Head enlargement presented preoperatively did not progress after shunting. Mental retardation and behavior problems, however, remained unchanged postoperatively, even though the cyst had disappeared. One cystoperitoneal shunt became infected, and shunt malfunction developed in eight patients. Four of the eight patients presented acute signs and symptoms of intracranial hypertension when the shunt malfunctioned, although the concurrent increase in cyst size was slight and ventriculomegaly was not seen. The observed condition in these four patients could be considered shunt dependency.

CONCLUSION

Cystoperitoneal shunting is a valid method of achieving obliteration of the cyst and clinical improvement and seems to feature low operative risk and few complications. It should be noted, however, that some patients experience shunt dependency after cystoperitoneal shunting.

The incidence of viremia and the heterogeneity of hepatitis C virus genotypes among blood donors, hemophiliacs and patients with chronic liver disease

Hepatitis C Virus (HCV) is the major cause of parentally transmitted non-A, non-B hepatitis. We studied the incidence of HCV Viremia in blood donors, hemophiliacs and patients with chronic liver disease who are positive for antibodies to HCV, and then correlated the HCV genotypes among the three groups. 23 blood donors, 10 hemophiliacs and 97 patients with chronic liver disease were found to be positive for anti-HCV during this study period from June 1993 to December 1993. Only 3 (13%) blood donors, 6 (60%) hemophiliacs and 71 (73%) patients with chronic liver disease were found to be viremic when tested for HCV RNA by reverse transcriptase-polymerase chain reaction (RT-PCR). The low incidence of viremia among blood donors may be due to any one of the following three reasons. 1, the level of viremia was below the level of detection. 2, the viremia was intermittent with persistent infection. 3, the majority of cases represented resolved infection. The HCV genotypes were heterogeneous among the three groups. All the blood donors with viremia and 35 (50%) of patients with chronic liver disease, belonged to type II (1b). However only one (17%) of the hemophiliacs belonged to type II (1b). Studies have shown that the genotype I(1a) is the predominant type in the USA and Europe, whereas type II(1b) is more frequent in the Far East. It is also suggested that type II (1b) is associated with non-responsiveness to interferon therapy. Our hemophiliacs were treated with imported coagulation factors, thus they were probably exposed to the genotypes in the west. There was significant difference in the incidence of HCV type II (1b) among local blood donors and hemophiliacs (P = 0.005). However the difference between the hemophiliacs and the patients with chronic liver disease was not statistically significant. The number of patients in this study was too small to draw any firm conclusions. However the findings highlight the importance of studying the genotypes of patients with Hepatitis C infection due to their relevance in the management of these cases with interferon therapy.

Asymptomatic hemobilia with idiopathic thrombocytopenic purpura

A severe but asymptomatic anemia developed in a patient with idiopathic thrombocytopenic purpura. Urgent upper gastrointestinal endoscopy disclosed massive bleeding from the papilla of Vater and we inferred that the anemia was caused by hemobilia. The bleeding point could not be detected, but the bleeding was stopped with conservative therapy. Although several cases of hemobilia have been reported in patients with bleeding tendency, this is the first case to be reported in a patient with idiopathic thrombocytopenic purpura.

A ground-based animal model of space adaptation syndrome

We examined the effect and aftereffect of acute or chronic load of hypergravity produced by an animal centrifuge, on pica (that is, kaolin intake) in the rat as an index of motion sickness. Although the degree of pica initially induced by acute or chronic hypergravity was not different, the rate of decline of increased kaolin intake over poststimulus days was different. Pica after a 1-h load of 2g decreased rapidly. On the other hand, pica lasted 3 days after a 48-h load of 2g. These findings suggest that the aftereffects of chronic hypergravity application on pica are due to motion sickness induced by readaptation to normal gravity, and they support our idea that after adaptation to a hypergravity environment, return and readaptation to the normal gravity can simulate exposure and adaptation to microgravity. We concluded that motion sickness in rats induced by the aftereffects of chronic hypergravity stimulation can be used as a ground-based animal model of space adaptation syndrome.

[Statistical analysis of recovery from sudden deafness among treatment groups]

This study examined 131 patients with idiopathic sudden deafness in whom the averaged of five frequency hearing levels was greater than 60dB. Since combined pharmacotherapy has been used in the treatment of idiopathic sudden deafness, it is hard to make a quantitative analysis of single-drug efficacy. We used a single-drug treatment in turn to assess the drug efficacy within 30 days after the onset. There was no significant difference among patients treated within 6 days and not less than 7 days after the onset with steroid therapy, PGE1 therapy, and defibrinogenation therapy. Similarly, there was no significant difference among patients treated within 6 days and not less than 7 days after the onset with steroid and defibrinogenation combined therapy, steroid and PGE1 combined therapy, and steroid, defibrinogenation and Lasix-Vitamin combined therapy. In case of no steroid effect, treatment with defibrinogenation, PGE1 and Lasix-Vitamin therapy could achieve hearing improvement.

[Investigation for VP4 region of coxsackie virus A16 RNA sequence from hand-foot-mouth disease patients at eastern district of Shizuoka prefecture in 1995]

In 1995 an investigation was made for VP4 regions of coxsackie virus A16 (CA16) RNA sequence from hand-foot-mouth disease patients in eastern district of Shizuoka Prefecture. Subjects were seven patients who were diagnosed as hand-foot-mouth disease due to CA16 at the Ohashi Pediatric Clinic in Susono City. Throat swabs of patients were extracted to RNA. Extracted RNA were assayed by reverse transcription polymerase chain reaction that primers corresponded to VP4 resion of enteroviruses. PCR products were marked by dye-deoxy terminator methods and assayed by direct sequence methods. RNA sequences were classified into two types. Type 1 were three cases, and type 2 were four. The homology was 90.8% between type 1 and type 2. All cases of sixty-nine amino acids were the same as prototype strain. We concluded that the two type strains of CA16 were prevalented in eastern district of Shizuoka Prefecture in 1995. It was at the same time and was widely noted in the eastern district.

Mice with disrupted GM2/GD2 synthase gene lack complex gangliosides but exhibit only subtle defects in their nervous system

Gangliosides, sialic acid-containing glycosphingolipids, are abundant in the vertebrate (mammalian) nervous system. Their composition is spatially and developmentally regulated, and gangliosides have been widely believed to lay essential roles in establishment of the nervous system, especially in neuritogenesis and synaptogenesis. However, this has never been tested directly. Here we report the generation of mice with a disrupted beta 1,4-N-acetylgalactosaminyltransferase (GM2/GD2 synthase; EC 2.4.1.92) gene. The mice lacked all complex gangliosides. Nevertheless, they did not show any major histological defects in their nervous systems or in gross behavior. Just a slight reduction in the neural conduction velocity from the tibial nerve to the somatosensory cortex, but not to the lumbar spine, was detected. These findings suggest that complex gangliosides are required in neuronal functions but not in the morphogenesis and organogenesis of the brain. The higher levels of GM3 and GD3 expressed in the brains of these mutant mice may be able to compensate for the lack of complex gangliosides.

Myocardial adaptive changes and damage in ischemic heart disease

Changes in two of the elements of myocardial subcellular organelles relating to cardiac energetics, ventricular myosin isozymes and mitochondrial DNA mutations, were examined using left ventricular tissue samples obtained at autopsy from patients with ischemic heart disease. Myosin isozymes were examined in tissues from nine patients with ischemic heart disease and 12 control patients with cancer but no heart disease. Extracted myosin was separated by pyrophosphate gel electrophoresis. The relative concentration of each component was determined by densitometry. Mitochondrial DNA mutations were evaluated in tissues from ten patients with myocardial infarction and 11 control patients with cancer but no heart disease. DNA was extracted and mitochondrial DNA mutations were detected by the polymerase chain reaction. Two bands were revealed by pyrophosphate gel electrophoresis. These contained VM-A, which exhibited faster electrophoretic mobility and was present in lower concentrations, and VM-B, which had a lower mobility and a higher concentration, respectively. SDS polyacrylamide gel electrophoresis showed that these two components contained the heavy chain and light chains 1 and 2 of myosin. VM-A concentrations tended to be higher in patients with ischemic heart disease than in controls. A 7.4-kb deletion was detected between the D-loop and the ATPase 6 genes of mitochondrial DNA from the myocardium of 6 out of 10 patients with myocardial infarction. The relative amounts of the two myosin isozymes could be altered by ischemic heart disease, although the functional significance of these components is unclear. The changes in the two myosin isozymes might be an adaptive change to disordered energy metabolism, but this change was small. The myocardial mitochondrial DNA deletions in patients with myocardial infarction were thought to result from ischemic damage.

Sex and age patterns of quantitative ultrasound densitometry of the calcaneus in normal Japanese subjects

: The speed of sound (SOS), broadband ultrasound attenuation (BUA), and the stiffness index (stiffness), which was derived from SOS and BUA, were measured on the calcaneus using the Achilles ultrasound densitometer (Lunar) in normal Japanese woman (n = 473) and men (n = 218). Sex differences and age-related changes in these variables were investigated. In addition, the bone mineral density (BMD) of the lumbar vertebrae measured by dual X-ray absorptiometry (QDR-2000, Hologic) was compared with SOS, BUA, and stiffness. There were some decreases of ultrasound variables in both young adult men and women. BMD values were similar in young adults of both sexes. BMD was relatively stable in women from 20 to 49 years, then decreased at about 1.5%/year. Ultrasound variables were higher in males than females at all ages, and they decreased from age 20 onward in both sexes with an annual loss of about 0.6%. Age-related changes in SOS, BUA, and stiffness were different from those in BMD in normal Japanese subjects. The correlations between BMD and SOS and BUA and stiffness were higher in women (r = 0.51-0.64) than in men (r = 0. 43-0.49).

Molecular cloning of the rat NADH:ubiquinone oxidoreductase subunit and its up-regulation in the facial muscle after denervation: detected by means of differential display

The differential display method was applied to identify gene expression which is especially up-regulated in the rat denervated skeletal muscle. Total RNA from normal and denervated facial muscles was isolated, amplified by PCR using certain primers, and separated by electrophoresis on polyacrylamide gel. PCR products which were apparently higher in the operated than in the control side were cut out from the gel and subsequently sequenced. One of the cDNA fragments obtained in the present study showed about 80% identity in nucleotide sequence and about 84% identity in amino acid sequence to one of the NADH: ubiquinone oxidoreductase (complex I) subunits from the bovine heart mitochondria (813). Complex I, the first and largest enzyme of the mitochondrial respiratory chain, transfers electrons from NADH to ubiquinone-10 (UQ-10). B13 is a 13 kDa subunit; deficiency of which causes incomplete or incorrect assembly of a functional complex I, resulting in one of the types of human mitochondrial myopathy. Northern blot analysis and in situ hybridization histochemistry confirmed that rat B13 mRNA expression was up-regulated after denervation and was distributed throughout whole muscle cell body. These findings suggest that up-regulation of the rat B13 mRNA expression after denervation plays an important role in the effective electron transfer from NADH to UQ-10 in skeletal muscle cells, resulting in restriction of lipid peroxidation and biological tissue damage.

[An analysis of pelvic and para-aortic lymph node metastasis in ovarian carcinoma by systematic retroperitoneal lymph node dissection]

We performed a systematic retroperitoneal lymph node dissection (RPLND) on 137 patients with primary ovarian carcinoma, of whom 97 had undergone RPLND during the primary surgery before chemotherapy and 40 had undergone RPLND during the secondary cytoreductive surgery after preoperative chemotherapy. The tentative staging of the ovarian carcinoma used in this study was determined according to the FIGO criteria without considering the pathologic findings of retroperitoneal lymph nodes. Nodal metastasis was seen in 21.9% (30/137) of them. Thirteen had positive pelvic lymph nodes (PLN) but no positive para-aortic nodes (PAN). Eleven had both positive PLN and positive PAN. Six had positive PAN but no positive PLN. The PAN was the most frequent site of metastasis (17/137). Next were the common iliac, obturator, and lateral group of deep inguinal nodes. Solitary metastasis in the patients who had undergone RPLND during the primary surgery was seen in a PAN and a common iliac node. Among 24 patients with PLN metastasis, there was a significant (p < 0.05) difference in the number of positive PLN between the patients with PAN metastasis (5.27 +/- 3.00) and the patients without PAN metastasis (2.62 +/- 1.66). These results indicate that the PAN and common iliac nodes are the most important site of nodal metastasis in ovarian carcinoma. The metastasis to PLN such as obturator node and internal iliac node seems to occur independently of the PAN metastasis, and the PAN metastasis occurs not only through the direct route but also as a consequence of extension of PLN metastases. Systematic retroperitoneal lymph node exploration therefore seems to be necessary to clarify the lymph node status.

[Progressive systemic sclerosis associated with massive pleural and pericardial effusion in a 90-year-old woman]

A 90-year-old woman was admitted to our hospital in December 1993 because of dyspnea on exertion and malaise. She had been well until October 1993, when she first noticed Raynaud's phenomenon, skin tightening, digital ulceration and scarring of her hands. On physical examination, generalized edema was found, along with acrosclerosis with contracture, especially in the fingers, wrists, and elbows. Inspiratory crackles were noted. A roentgenogram of the chest and an echocardiogram revealed pulmonary fibrosis, pulmonary congestion, and massive pleural and pericardial effusions. The pleural effusion was a transudate. Progressive systemic sclerosis was diagnosed, and furosemide and isosorbide were given. The edema and pulmonary congestion resolved, but the pleural and pericardial effusions did not. Prednisolone was given, which reduced the pleural effusion but not the pericardial effusin. The pleura and the pericardium are not usually involved in progressive systemic sclerosis, and this disease rarely occurs in patients over 70 years old. To the best of our knowledge, this was one of the oldest patients with progressive systemic sclerosis. The combination of massive pleural and pericardial effusions, and the advanced age of onset make the present case unusual.

Cardiac membrane Ca(2+)-transport in alloxan-induced diabetes in rats

In order to determine if cardiac membrane Ca(2+)-transport activities are altered in chronic diabetes induced by alloxan, rats were given an intravenous injection of 65 mg/kg and the hearts were used 8 weeks later. Some 4 weeks, diabetic animals were injected with insulin (3 U/day) for 4 weeks. Both sarcolemmal (SL) and sarcoplasmic reticulum (SR) membranes were isolated from the ventricular tissue and their Ca(2+)-transporting activities were determined. SL Na(+)-dependent Ca2+ uptake, ATP-dependent Ca2+ uptake and Ca(2+)-stimulated ATPase activities were depressed in the diabetic heart. Likewise, SR ATP-dependent Ca2+ uptake activity in the diabetic heart was markedly decreased in comparison to the control preparations. These defects in diabetic SL and SR Ca(2+)-transport activities were prevented by treatment of diabetic animals with insulin. The results from the alloxan-rat model of diabetes support the view that membrane abnormalities with respect to Ca2+ handling may lead to the occurrence of intracellular Ca2+ overload and the development of diabetic cardiomyopathy.

Mitochondrial DNA mutations in diabetic heart

Mutations of mitochondrial DNA have been found in cardiomyopathic and diabetic patients as well as mitochondrial myopathic patients. Mitochondrial DNA mutations are maternally transmitted. It has also been reported that these mutations can be acquired under the influence of free radicals. This article is a mini-review about mutations of mitochondrial DNA related to the diabetic heart.

Application of a suture anchor technique for flap fixation to bone

The authors have developed a technique for fixation of a flap to underlying bone. Their technique involves an anchor system which has been used for tenodesis and ligament repair in orthopedic bone and joint surgery. The anchor technique provides reliable fixation with simplicity of application. A wider use of this technique in reconstructive flap surgery is expected.

Urinary albumin excretion in short children treated with recombinant human growth hormone

The urinary levels of albumin, beta 2-microglobulin (BMG) and beta-D-N-acetyl glucosaminidase (NAG) were studied in 30 children with short stature due to partial or complete growth hormone (GH) deficiency under treatment. All 30 children had a normal urinalysis and no clinical evidence of renal disease. They were treated with recombinant GH in a dose of 0.5 IU/kg/week given subcutaneously. The mean albumin excretion rate (9.13 +/- 8.33 micrograms/min/1.73 m2) of these children was significantly higher than that (4.2 +/- 2.27 micrograms/min/1.73 m2) of 30 age-, sex- and pubertal status-matched normal children (p < 0.01). BMG and NAG excretion was normal in both groups. There was no correlation between the urinary albumin excretion rate and the duration of GH treatment. Among the GH-treated children, the urinary albumin excretion rate was correlated significantly with circulatory insulin-like growth factor I (IGF-I) (r = 0.65, p < 0.01). In 7 other children analyzed before and three months after start of GH treatment, the mean urinary albumin excretion rate increased significantly from 4.71 +/- 3.95 micrograms/min/1.73 m2 to 8.29 +/- 2.70 micrograms/min/1.73 m2 (p < 0.03). These results suggest the possibility of functional glomerular alterations during GH therapy.

Troponin I phosphorylation in heart homogenate from diabetic rat

Although cardiac myofibrillar ATPase activity has been shown to be depressed during the development of diabetic heart dysfunction, the mechanisms of this alteration are not fully understood. Since phosphorylation of troponin I (TnI) is known to decrease the myofibrillar ATPase activity, the present study was undertaken to examine the TnI phosphorylation capacity in the diabetic heart homogenate. For this purpose rats were made diabetic by injecting streptozotocin (65 mg/kg; i.v.) and the hearts were removed 8 wk later. Some 6 wk diabetic animals were injected with insulin (3 U/day) for 2 wk. TnI content in the heart homogenate was measured by immunoblot assay, the mRNA abundance for TnI gene was determined by Northern blot analysis and the in vitro phosphorylation level of TnI was estimated by the ratio of phosphorylated TnI and total (phosphorylated and unphosphorylated) TnI. No significant changes in TnI content and gene expression of TnI were observed in right and left ventricles from the diabetic rats. However, the phosphorylation of TnI was higher (approximately 40%) in the diabetic hearts; this change was reversible upon insulin treatment. These results regarding TnI phosphorylation measured under in vitro conditions suggest that increased phosphorylation of TnI may contribute toward the depression in cardiac myofibrillar ATPase activity in chronic diabetes.

Development of angiosarcoma at the site of a bone infarct

A 34-year-old man presented with angiosarcoma which developed at the site of a preexisting bone infarct in the metaphysis of the right tibia. A malignant bone tumor may develop at the site of bone infarct, and its histologic type is most frequently malignant fibrous histiocytoma or fibrosarcoma. Few patients with osteosarcoma have been reported: only 2 patients who had angiosarcoma that developed in a preexisting bone infarct have been reported in the English literature. Malignant transformation of bone infarct into angiosarcoma is extremely rare.

A preliminary report of neoadjuvant chemotherapy NSH-7 study in osteosarcoma: preoperative salvage chemotherapy based on clinical tumor response and the use of granulocyte colony-stimulating factor

Eleven patients with high-grade osteosarcoma of an extremity were treated with neoadjuvant chemotherapy with NSH-7 protocol. NSH-7 is a refinement of the T-12 Rosen protocol. Preoperative chemotherapy is initiated with a doxorubicin (ADM) and high-dose methotrexate combination. If the primary tumor progresses after the first cycle, the preoperative chemotherapy is switched to a combination of cisplatin and ADM. Postoperative adjuvant chemotherapy was selected based on histological response of the primary tumor. In addition, recombinant human granulocyte colony-stimulating factor was used to prevent leukocytopenia and to increase the dose intensity of the chemotherapy. In 1 patient, preoperative chemotherapy was switched to salvage treatment. Of the 156 courses given, there were 10 delays and 4 dose reductions. Leukocytopenia accounted for only 1 delay. All 11 patients completed the chemotherapy and 5 patients were fully able to tolerate the protocol without delay or dose reduction. Nine patients remained alive and continuously free of disease at an average follow-up of 35 months. The rate of continuous disease-free survival at 3 years was 81%, which was significantly better than that of the T-12 study of our group. These observations suggest that the NSH-7 protocol is a safe and effective treatment regimen for osteosarcoma.

Beta-adrenoceptor mediated signal transduction in congestive heart failure in cardiomyopathic (UM-X7.1) hamsters

In view of the lack of information regarding the status of beta-adrenoceptor mediated signal transduction mechanisms at severe stages of congestive heart failure, the status of beta-adrenoceptors, G-proteins and adenylyl cyclase activities was examined in 220-275 day old cardiomyopathic hamster hearts. Although no changes in the Kd values for beta 1- and beta 2-adrenoceptors were seen, the number of beta 1-adrenoceptors, unlike that of beta 2-adrenoceptors, was markedly decreased in cardiac membranes from failing hearts. The activation of adenylyl cyclase in the failing hearts by different concentrations of isoproterenol was also attenuated in comparison to the control preparations. The basal adenylyl cyclase activity in cardiac membranes from the failing hearts was not altered; however, the stimulated enzyme activities, when measured in the presence of forskolin, NaF or Gpp(NH)p were depressed significantly. The functional activity of Gs-proteins (measured by cholera toxin stimulation of adenylyl cyclase) was depressed whereas that of Gi-proteins (measured by pertussis toxin stimulation of adenylyl cyclase) was increased in the failing hearts. Not only were the Gs- and Gi-protein contents (measured by immunoblotting) increased, the bioactivities of these proteins as determined by ADP-ribosylations in the presence of cholera toxin and pertussis toxin, respectively, were also higher in failing hearts in comparison to the control values. Northern blot analysis revealed that the signals for Gs- and Gi-protein mRNAs were augmented at this stage of heart failure. These results indicate that the loss of adrenergic support at severe stages of congestive heart failure in cardiomyopathic hamsters may involve a reduction in the number of beta 1-adrenoceptors, and an increase in Gi-protein contents as well as bioactivities in addition to an uncoupling of Gs-proteins from the catalytic site of adenylyl cyclase in cardiac membrane.

Effects Of Caloric Vestibular Stimulation on Parietal and Temporal Blood Flow in Human Brain: A Consecutive Technetium-99m-HMPAO SPECT Study

The effects of caloric vestibular stimulation on regional cerebral blood flow (rCBF) of the parietal and temporal cortex were examined in 10 healthy volunteers. The consecutive 99mTe-hexa-methyl-propyleneamine oxime (99mTc-HMPAO) single-photon emission computed tomography (SPECT) method with region of interest analysis was used. Changes in rCBF induced by caloric stimulation with cold air (25°C) were evaluated in comparison with those induced by control stimulation with air at body temperature (37°C). Caloric stimulation with cold air induced vertigo in 4 subjects, dizziness in 2, and no sensation of self-motion in the remaining 4 subjects, whereas, control stimulation did not induce the sensation of self-motion in any subject. Although both parietal and temporal rCBF were slightly decreased during caloric stimulation, a correlation could be established between the magnitude of left-right differences in change of parietal rCBF and the degree of self-motion perception induced by cold-air caloric stimulation, as compared to control stimulation. Left-right differences in change of parietal rCBF in subjects with vertigo during caloric stimulation were significantly higher than those in subjects without any sensation of self-motion. In contrast, there was no correlation between the magnitude of left-right difference in change of parietal rCBF and maximum slow phase eye velocity induced by caloric stimulation. These findings suggest that the parietal lobe is involved in the perception of vertigo due to vestibular stimulation, but not in the vestibulo-ocular reflex.

The sequential changes in DNA synthesis, glucose utilization, protein synthesis, and peripheral benzodiazepine receptor density in C6 brain tumors after chemotherapy to predict the response of tumors to chemotherapy

BACKGROUND

Monitoring therapy in patients with brain tumors is very difficult and unreliable. It has been shown that there is no good correlation between tumor sensitivity measured in vitro and in situ tumor response to therapies.

METHODS

Sequential changes in tumor size, number of DNA synthesizing cells (labelling index [LI]), glucose utilization (LCGU), protein synthesis (LCPS), and peripheral benzodiazepine receptor (PBR) density were examined after chemotherapy for seven days. This was done using antibromodeoxyuridine immunohistochemical stain and multiple tracer quantitative autoradiography in a C6 rat brain with an implanted glioma. On Day 10 after inoculation, the rats were divided into 5 experimental groups: (1) a nontreatment group (control Group 1); (2) a group received 5% dextrose intraarterial (IA) administration (control Group 2); (3) a group received 1,3-bis-(2-chloroethyl) nitrosourea (BCNU) intravenous (i.v.) administration (Group 3) (5% dextrose was solvent); (4) a group received BCNU IA administration (Group 4) (5% dextrose was solvent); and (5) a group received sarcosinamide chloroethyl nitrosourea (SarCNU) IA administration (Group 5) (solvent as for the BCNU group).

RESULTS

Three treatments showed a significant decrease (P < 0.003) in tumor growth. The most effective treatment was BCNU IA and SarCNU IA was moderately effective. BCNU i.v. showed no effect on tumor growth when compared with the two control groups. The change in the peak LI correlated well with the peak LCGU. These parameters decreased markedly and significantly in both Group 4 and Group 5 from Day 1 after treatment. The rates of the decrease in these biologic factors also correlated well with a decrease in the tumor growth. The LCPS did not correlate with a decrease in the LI or LCGU. The dissociation constant (Kd) and densities of the receptors PBR (B max) did not change significantly in any of the treatment groups during the observation period.

CONCLUSIONS

From the results presented, we concluded that changes in the LI and LCGU represent the most reliable parameters with which to predict the response or sensitivity of this glial tumor to the treatments applied. These data suggest that if changes in peak LCGU were measured in tumors using positron emission tomography, they might be instrumental in providing in vivo information about the sensitivity of a tumor to a given treatment without the need for repeated tumor biopsy.