A prospective and randomized trial has been performed in order to evaluate combined modality therapy in patients with astrocytomas grade 3 and 4. Follow-up information is available on 244 patients. One half of the series received radiation therapy twice a week (40.00 Gy/5 weeks), the other half five times a week (50.00 Gy/5 weeks). Misonidazole 1.2 g/m2 was given orally to one half of the patients in the first radiation treatment group 3 1/2 to 4 hours before the treatment. The other half received placebo. The second radiation treatment group was also divided in two halves, one receiving 0.48 g/m2 misonidazole and the other placebo 3 1/2 to 4 hours before radiation. The randomization also included a subdivision of the material into eight groups of which four were given CCNU and four no chemotherapy, beginning 3 months after operation. The dose of CCNU was 120 mg/m2 body surface every 6 weeks. All eight treatment groups showed practically identical periods of median survival, and no statistically significant differences were observed with regard to performance status, side effects, or complications. Another dosage and timing of misonidazole administration in relation to the irradiation schedule, and a consideration of effects of concomitant drugs like dexamethasone and phenytoin are discussed.
A case of benign intracranial hypertension occurring in an 11-year-old boy, and due to lateral sinus obstruction, is reported. Computerized tomographic scan was conclusive, revealing a normal ventricular system and no evidence of a neoplastic lesion. Disappearance of the mastoid air cells and disruption of the trabecular pattern were also shown on the affected side. The diagnosis was confirmed at operation, and the course was favourable. In accordance with other studies cited, our findings suggest that patients suspected of benign intracranial hypertension can be spared invasive neuroradiological procedures if the computerized tomographic scan of the head is normal.
In a double-blind crossover pilot study with placebo, choline chloride, the physiologic precursor of acetylcholine, was tested in six patients with cerebellar ataxia. Neither subjectively nor objectively could any statistical significant difference be demonstrated.
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