In a controlled, prospective, randomized investigation, started in 1974, 118 patients with supratentorial astrocytoma Grade III--IV were divided into three groups. Groups 1 and 2 received 45 Gy postoperatively to the whole supratentorial brain. Bleomycin in 15-mg doses and a total dose of 180 mg or placebo was given intravenously three times a week, one hour prior to radiotherapy, during weeks 1, 2, 4 and 5. Group 3 received conventional care but no radiotherapy or chemotherapy. Median survival rates of patients were 10.8 months in Groups 1 and 2, and 5.2 months in Groups 3, a statistically significant difference. With regard to performance, the patients in Group 3 deteriorated faster than patients in Groups 1 and 2. Bleomycin had no positive or negative influence on survival.
Summary
In sixty‐five patients with asthma or allergic rhinitis, intracutaneous tests and provocation tests were performed with birch pollen, timothy pollen and/or dog epithelium allergen. The clinical diagnosis was compared with RAST results obtained with identical allergen preparations for in vivo as well as in vitro testing in two different laboratories. An overall correlation between in vitro and in vivo diagnosis was found in 85% of the cases. It is suggested that a scoring system using the sum of case history score and RAST values could be used for screening allergic patients with different allergens, making in vivo tests necessary only in a limited number of the cases.
A 30-year-old Caucasian male with systemic lupus erythematosus suffered acute catastrophic-onset transverse myelitis. Two years earlier aseptic meningitis, another rare CNS lupus manifestation, had been diagnosed. MRI showed involvement of the medulla oblongata and the entire spinal cord. Therapy with intravenous high-dose methylprednisolone and intravenous cyclophosphamide is discussed.
The first day of the symposium was devoted to coma (J. Brihaye); the second day dealt with injury scalling (S. Lindgren and G. Stroobandt); the third day was concerned with brain death (E. A. Walker and E. Pillen) but no firm conclusion was reached and another meeting on brain death was planned in near future.
A device is described for sudden application of a mechanical load to the brain in animals by displacing a column of fluid within a plunger system towards its connection with a hole in the skull. Velocity and displacement of the piston, moving the fluid into the skull cavity, were varied in a series of experiments in rabbits. Simultaneous recordings were made of the pressure pulses produced in the fluid near the parietal site of loading of the brain and at several places within the contents of the skull cavity and spinal canal. By adjusting the fluid input to the skull cavity it was possible to produce intracranial pressure pulses predictable with respect to peak amplitude and duration within a range between 0.1 and 4.0 atm. and one and several hundred msec, respectively. The pressure pulses produced extracranially and in the major part of the skull contents were similar. Simultaneous recordings of the pressure course in the vicinity of the cranio‐spinal junction and in the spinal canal revealed however, that peak amplitude and duration of the pressure pulse then decreased continuously at increasing distance from the site of application of the load. No pressvire changes were found to occur caudally to the level of the fifth cervical vertebra. This method seems suitable for studying the effects of controlled and varied sudden mechanical loading of the brain in animals and the relations between subsequent brief intracranial pressure changes and pathological alterations, similar to those occurring in skull trauma.
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