Tomio Tsuchida

Cerebral retroflexion in holoprosencephaly developed following ventriculo-peritoneal shunting: A case report

Retroflexion of the hypoplastic fused cerebrum is a rare condition in holoprosencephaly. We describe a new case of this entity in a 7-year-old boy with alobar holoprosencephaly whi developed retroflexion of the holosphere 7 years after a ventriculo-peritoneal shunt was placed. The radiological findings revealed retroflexion of the cerebrum anchored to the cranial vault between the precerebral space and the dorsal sac, which were open to each other. In patients with holoprosencephaly, the possibility of retroflexion of the holosphere should be considered after placement of a ventriculo-peritoneal shunt for associated hydrocephalus.

FAR Therapy in Brain Tumors

FT207 is retained for long periods in tumor tissues and is gradually released as 5FU in an activated form. This 5FU has antitumor effects as an antimetabolite, and also blocks the repair mechanism of DNA by radiation therapy (potentiation). On the other hand, vitamin A has been said to cause lysosome release and cell coat changes of tumor cells, and also activation of immunological responses. Through these subcellular alterations provided by vitamin A treatment, drug affinity or drug sensitivity and radiosensitivity of tumor tissues can be achieved. For these reasons a new therapeutic method combining FT207, vitamin A and Radiation (FAR therapy) is introduced. This therapy was applied to 32 brain tumor patients. Four to five hours before daily radiation of 200 rads, 800 to 1, 200 mg of FT207 and 50, 000 to 60, 000 IU of vitamin A were orally administered until total radiation doses of 5, 000 to 6, 000 rads were achieved. Marked improvement was observed in 12 patients out of 32 (37.5%). The total efficacy rate was calculated as 75%. Side effects from this therapy were anorexia in 28%, leucopenia in 25% and slight elevation of transaminase in 9% of the cases. FT207 uptake by C6 rat experimental brain tumors was investigated. A high concentration of 5FU in brain tumor tissues was maintained until 6 hours after intraperitoneal administration of FT207 and vitamin A. The tendency toward high concentrations of 5FU was much more pronounced in cases of pretreatment with vitamin A. FT207 uptake by eight brain tumor patients was investigated. Before surgery, 50, 000 to 60, 000 IU of vitamin A and 1, 000 to 1, 200 mg of FT207 were administered orally. At various intervals surgical specimens were obtained under the same anesthetic conditions. Blood loss during the operation was negligible. Generally 4 to 5 hours after administration of these drugs, a high concentration of 5FU in tumor tissues was achieved and maintained. In our FAR therapy, vitamin A and FT207 were easily and safely administered orally without noticeable side effects and readily indicated for use in children.