Yuzuru Oku

Chemotherapy of brain metastases from lung carcinoma: a controlled randomized study.

A controlled randomized study was carried out to evaluate the effects of chemotherapy in patients with brain metastases from lung carcinoma. One hundred patients were randomly divided into three groups at the time of diagnosis or after surgery for metastases. Group A received radiotherapy alone; Group B received radiotherapy and chloroethylnitrosoureas (methyl-CCNU, 100-120 mg/m2, or ACNU 80-100 mg/m2, every 6-8 weeks), and Group C received radiotherapy and a combination of chloroethylnitrosoureas and tegafur (300 mg/m2, daily). Of the 100 patients, 88 could be evaluated. The reduction rates of the tumors of the patients in whom tumor was not surgically removed or not totally removed were compared. Complete resolution of the tumor was noted in 29, 69, and 63% of the patients in Groups A, B, and C, respectively. Tumor regression of greater than or equal to 50% was seen in 36, 69, and 74% of the patients in Groups A, B, and C, respectively. The difference in the response rates of Groups A and C was statistically significant (P less than 0.05). Median survival after the start of treatment for brain metastasis was 27, 30.5, and 29 weeks in Groups A, B and C, respectively. There was 1 long-term survivor (more than 5 years) in Group A, 3 in Group B, and 1 in Group C. The main cause of death was deterioration attributable to the primary lesion or systemic metastasis, and no statistical difference was noted in survival time among the groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Contralateral pterional approach for carotid-ophthalmic aneurysm: usefulness of high resolution metrizamide or blood computed tomographic cisternography.

Four carotid-ophthalmic aneurysms were treated through a contralateral pterional approach. Three of these aneurysms were clipped successfully. Because awareness of the size and shape of the optic chiasm is crucial for the success of this approach, we used metrizamide or blood cisternography with a high resolution computed tomographic scanner. With this technique, the shape of the optic chiasm was delineated before operation to make certain that the prechiasmatic space was large enough for the aneurysm to be approached.

Long‐term effects of radiation for medulloblastoma on intellectual and physical development. A case report of monozygotic twins

Background. Recent advances in treatment have improved the prognosis for medulloblastoma. Although postoperative radiation of the central nervous system (CNS) is widely practiced, late radiation sequelae, especially in long‐term survivors, pose a constant risk.

Benign chondroblastoma of the occipital bone

We report the case of a 14-year-old boy with benign chondroblastoma in the occipital bone associated with a cerebellar hemorrhage. The clinical features, radiologic and histologic appearances, and histogenesis in this case are described. Other reports of benign chondroblastomas of the cranial bones are also discussed.

S-14. A Case of Delayed Radionecrosis developed after Radiation Therapy for a Pituitary Tumor

The patient, a woman aged 63, developed a visual disturbance, underwent radiation therapy for the pituitary tumor by a physician around March in 1963. After a temporary improvement she was treated with COGO for the tumor at the Radiation Department in our hospital in November 1963; she also suffered from the visual disturbanceAt the end of February in 1965 she suddenly developed a motor disturbance of her left arm and leg, and dysarthria. She was admitted to the Radiation Department in our hospital and was transferred to our department on 4/13/1965. At the transferred time neurological examination revealed a clear consciousness, a left homonimous hemianopsia, no papilledema, a left central facial paresis, protrusion of the tongue to the left on extension, and a flaccid paresis with impairment of discriminative sensation of the left arm and leg. One week prior to the surgery her right arm came to show weakness. The spinal fluid was under a pressure of 140 mm.H2O, and its protein was 61 mg.%. A plain skull roentgenogram revealed a ballooned-out sella turcica and typertrophia frontalis interna. The AP-view of a right carotid arteriogram showed no elevation of the A-1, and a positive proximal shift of the anterior cerebral artery to the left. The lateral view disclosed a remarkable backward concave at the A-2, and a slight upward displacement of M-2. The AP-view of a pnenimovenriculogram displayed a parallel shift of the Septum Pellucidum toward the left with a tilting of the upper margin of the 3rd ventricle to the left, the lower margin located in the midline. The PA-view of the pneumogram showed a slight displacement of the atrium of the right lateral ventricle toward the left side and an irregular shape of the posterior horn of the right side. Under the suspicion of a space taking lesion in the right hemisphere a large osteoplastic craniotomy was performed on the right side, revealing no space occupying lesion. The frozen section made from the occipital, parietal, and temporal area indicated degenerative necroses. Unfortunately the patient died of pneumonia postoperatively. The autopsy disclosed half moon-like scleroses with hyaline degeneration of collagenous fibers in arteries in the Sylvian fissure, a selective necrosis of the white matter of the right