Search PubMed⌕ Search

Biomedical subjects

C B Wilson

Publications and source records attributed to C B Wilson.

At least 487 records · Page 27Linked to original sources
PubMed1980

Indications for angiography in the preoperative evaluation of patients with prolactin-secreting pituitary adenomas.

The preoperative angiograms of 100 patients subsequently undergoing transsphenoidal exploration for prolactin-secreting pituitary adenomas were reviewed in order to assess both the risk of this study and its yield of useful diagnostic information. In these patients with documented hyperprolactinemia, no vascular anomalies contraindicating a transsphenoidal approach were detected. Tumor blush was evident only in large tumors. The appearance of lateral displacement of the carotid siphon in basilar views was not a reliable predictor of lateral extension. When hyperprolactinemia can be documented, the author's current practice is to reserve angiography for patients who have gross sellar expansion or suprasellar extension, or for those who have had prior radiotherapy.

Adenoma↗
PubMed1980

Effect of surgery on BCNU chemotherapy in a rat brain tumor model.

In Fischer 344 rats, 9L tumors were implanted in the left cerebral hemisphere. Compared with control animals not operated on, rats treated with an LD10 dose of BCNU 1 hour before or 1 or 12 hours after surgery on Day 16 postimplant had an increased life span of over 200% (greater than a 6 log cell kill). Minimal effect on survival was found when BCNU was administered during surgery. On the other hand, BCNU administered 12 hours before or 24 or 72 hours after surgery did not show any additive effect of surgery on BCNU treatment. These results suggest that in a clinical setting, a bolus of BCNU administered to tumor patients within 12 hours of surgery might increase substantially the total tumor cell kill compared with surgical resection alone.

Animals↗
PubMed1980

Anterior sacral meningocele. Case report.

A woman presented with a mass in the left groin, which was later shown to be a sliding hernia. A bony sacral defect prompted investigation, which uncovered a massive anterior sacral meningocele. Examination, including ultrasonography and myelography, is discussed, and a surgical approach proposed.

Adult↗
PubMed1980

Analysis of clonogenic human brain tumour cells: preliminary results of tumour sensitivity testing with BCNU.

Biopsies from 6 patients with glioblastoma multiforme were disaggregated and single cells were treated in vitro with various concentrations of BCNU and plated for cell survival. One patient's cells were sensitive to BCNU in vitro; after a single dose of BCNU her brain scan reverted to normal and she was clinically well. Five tumours demonstrated resistance in vitro. Three of these tumours progressed during the first course of chemotherapy with a nitrosourea and the patients died at 2 1/2, 4 and 8 1/2 months after operation. Two patients who showed dramatic responses to radiation therapy were considered unchanged after the first course of nitrosourea therapy (although one demonstrated tumour enlargement on brain scan). The correlation of in vitro testing of tumour cell sensitivity with actual patient response is encouraging enough to warrant further work to determine whether such tests should weigh in decisions on patient therapy.

Aged↗
PubMed1980

Cerebrospinal fluid polyamines in patients with Glioblastoma multiforme and anaplastic astrocytoma.

Eighteen cerebrospinal fluid polyamine determinations in 12 patients with glioblastoma multiforme and 76 determinations in 37 patients with anaplastic astrocytoma were evaluated. Cerebrospinal fluid polyamine levels showed no significant relationship to the degree of malignancy or to enhanced tumor volume or volume of tumor central low density as determined by contrast-enhanced computerized tomography. A significant correlation was found between polyamine levels and the proximity of the tumor to the cerebral ventricles. Polyamine levels were correlated with clinical status as determined by neurological examination, radionuclide scan, and computerized tomography. Compared with those of stable patients, cerebrospinal fluid polyamine levels were significantly elevated in patients with recurrent tumors; however, elevation of polyamine levels did not appear to precede tumor recurrence. A large fraction of the results were false-positive or false-negative results. In contrast to our findings in patients with medulloblastoma, it appears that cerebrospinal fluid polyamine levels determinations may be of little use for monitoring tumor progression in patients with glioblastoma multiforme and anaplastic astrocytoma.

Astrocytoma↗
PubMed1980

Brain tumor chemotherapy: an evaluation of agents in current use for phase II and III trials.

The reported English-language literature since 1969 on chemotherapy for malignant brain tumors has been collated, and reports of drugs or drug combinations used in phase II or III trials or with adjunctive therapies are reviewed. A significant fraction of the literature contained only anecdotal information, and even in the reports of more systematic trials, the criteria used to evaluate response were variable, ranging from subjective evaluation of clinical improvement to more stringent evaluations using one or more neurodiagnostic tests. A more consistent method of determining response is needed to facilitate comparison of different treatment protocols in the future, and guidelines for this are suggested. It appears that drugs of small molecular size (less than 450 daltons) and high lipid solubility have been the most effective. Single-agent chemotherapy using cell-cycle-specific drugs has, however, been disappointing. The nitrosoureas (especially BCNU) used either singly or in combination have consistently been the most effective agents in phase II and III trials. The combination of irradiation with adjunctive BCNU remains, for the present, the standard against which all other phase II and III protocols should be compared. New drugs for phase II evaluations are sorely needed. There is also need for new combination-drug and sequential-drug protocols for evaluation. The use of radiosensitizing agents with more novel radiation therapy fractionations and in combination with adjunctive drug therapies holds some promise for improving the disappointing results obtained thus far with chemotherapy for malignant brain tumors.

Antibiotics, Antineoplastic↗
PubMed1980

Microsurgical Vascular Decompression for Trigeminal Neuralgia and Hemifacial Spasm.

Vascular cross-compression of cranial nerves has been proposed as the cause of cranial neuropathies, including trigeminal neuralgia and hemifacial spasm. Over the last decade we have used microsurgical vascular decompression to treat these two disorders. Results in 50 patients treated for trigeminal neuralgia have been excellent in 42, good in 5 and poor in 2; and 1 patient was cured after a second operation. Results in 22 patients treated for hemifacial spasm have been excellent in 18, good in 2 and fair in 1. One patient died. There were no late recurrences of symptoms. The pathophysiological mechanisms of trigeminal neuralgia and hemifacial spasm remain unknown.

Adult↗
PubMed1980

Development of adverse sequelae in children born with subclinical congenital Toxoplasma infection.

Most infants born with congenital Toxoplasma infection are asymptomatic in the newborn period, and therefore their infection is not recognized. We performed follow-up evaluations on 24 such children. The mean age of these children at least examination was 8.5 years. In group I (13 children), the diagnosis was made prospectively. In group II (11 children), no symptoms or signs were noted in the newborn period and the diagnosis was made only after the first sign developed. Eighty-five percent of the children in group I and all of the children in group II have developed chorioretinitis. In group I, three children (23%) have unilateral blindness; in group II, three children (27%) and five children (45%) have unilateral and bilateral blindness, respectively. One child (8%) in group I and two children (18%) in group II developed severe, permanent neurologic sequelae after they initially presented with eye disease. Two of the children in each group are now retarded (IQ score range, 36 to 62). Six of the children in group I who were tested sequentially have had lower IQ scores (mean change from 97 to 74) on repeat tests performed an average of 5.5 years later. Less severe neurologic, intellectual, and audiologic deficits were observed in other children in each group. Treatment of some children may have had a beneficial effect on their outcome.

Adolescent↗
PubMed1980

Parasellar tumors in children. I. Clinical presentation, preoperative assessment, and differential diagnosis.

This paper reviews the clinical presentation, neuro-ophthalmologic, endocrinologic, and radiographic findings of 74 children (0-20 years) harboring parasellar lesions who were treated on our service between 1968 and 1977. Our data support the conclusion that earlier diagnosis is occurring, although there is still a significant lag between onset of symptoms and treatment, especially in histologically benign lesions. The differential diagnosis is facilitated by recognition of key features of four major tumor types: craniopharyngioma, parasellar glioma, germinoma, and pituitary adenoma.

Adenoma↗
PubMed1980

Parasellar tumors in children. II. Surgical management, radiation therapy, and follow-up.

Despite the predominance of histologically benign tumors in the parasellar region of children, their proximity to the hypothalamus, optic nerves and tracts, and the internal carotid artery and its branches often renders surgical removal exceptionally difficult. The possible presence of a variety of tumor types makes biopsy verification of tumor diagnosis essential. The surgical management, radiotherapeutic treatment, and clinical follow-up of a group of 74 children whose preoperative findings were reviewed in the preceding paper are presented to illustrate the management of four major tumor types encountered: craniopharyngioma, pituitary adenoma, germinoma, and diencephalic glioma. Both subfrontal and transsphenoidal surgical approaches were used. Although total resection of benign tumors is desirable, prudent use of a variety of techniques can achieve effective neurosurgical management and optimal long-term results.

Adenoma↗
PubMed1979

The stathmokinetic (mitostatic) effect of vincristine and vinblastine on human gliomas.

Twelve patients with gliomas received 3H-thymidine intraarterially in combination with an i.v. mitostatic agent (Velban: 0.1 mg/kg or 3 mg/M2 of Vincristine) prior to tumor biopsy. The labeling index (LI) of each tumor was compared with the mitotic index divided by the elapsed time from administration of the mitostatic agent to biopsy (MI/t). Most of the malignant gliomas that had an LI of 5-15%, also yielded an MI/t value of 4-5 x 10(-3), whereas tumors with an LI of less than 5% generally showed very slight (0.1 x 10(-3) mitotic accumulation. Use of a mitostatic agent is suggested to differentiate the proliferative activity of various gliomas.

Adult↗
PubMed1979

Prolactin-secreting pituitary adenomas in women. II. Menstrual function, pituitary reserves, and prolactin production following microsurgical removal.

A prospective study of 46 women with prolactin-secreting pituitary adenomas and amenorrhea and/or galactorrhea was performed to determine the influence of the selective transsphenoidal removal of these tumors on pituitary and reproductive function. This procedure was effective in restoring menstrual function in 34 of 41 women and in eliminating lactation in 30 of 40 women. Tumor size and preoperative serum prolactin concentrations were the most important factors in predicting the postoperative disappearance of symptoms. Normal menstrual function returned in 33 of 34 women with tumors less than 2 cm in diameter but in only one of seven women with tumors greater than 2 cm. Similarly, galactorrhea disappeared in 29 of 34 women with tumors less than 2 cm but in only one of six women with larger tumors. Menses returned in 31 of 32 women and galactorrhea disappeared in 25 of 31 women with preoperative serum prolactin levels below 200 ng/ml; conversely, menses returned in only three of nine women and lactation ceased in one of six women with preoperative serum prolactin concentrations above 200 ng/ml. Prolactin concentrations decreased in 42 of 43 patients following the removal of pituitary adenomas and returned to normal in 30. Postoperative pituitary reserves of adrenocorticotropic hormone, growth hormone, luteinizing hormone, and follicle-stimulating hormone were normal in most patients. These data indicate that the removal of prolactin-secreting pituitary adenomas by a neurosurgeon accomplished in this surgical technique is effective in restoring menstrual function and eliminating lactation in most women, especially if the tumor is less than 2 cm in diameter and the preoperative serum prolactin concentration is less than 200 ng/ml.

Adenoma↗