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John Calogero, David C. Crafts, Charles B. Wilson, Edwin B. Boldrey, Alan Rosenberg, and K. Jean Enot

✓The authors present three patients who, after excision and irradiation of their brain tumors, were treated with BCNU for recurrence. All three patients responded well and now are without evidence of tumor, 37, 30, and 36 months after BCNU was stopped. Although these patients represent only a small fraction of those treated with BCNU, they indicate the potential role of chemotherapy in the management of glial tumors.

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A. R. Vasantha Kumar, Justin Renaudin, Charles B. Wilson, Edwin B. Boldrey, K. Jean Enot, and Victor A. Levin

✓ A series of 43 patients, all of whom were deteriorating due to progression of primary or metastatic brain tumors, were treated daily with n-isopropyl-α-(2-methylhydrazine)-p-toluamide hydrochloride (matulane, Procarbazine hydrochloride: NSC-77213, 150 mg./m2) for 30 consecutive days, with a 30-day rest interval between treatments. Of 29 patients evaluated, 12 showed a definite clinical response to therapy and two a probable response, for a response rate of 48%. Reversible myelosuppression was the major toxic effect encountered. Combination with other chemotherapeutic agents may enhance the drug's effectiveness against brain tumors.

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Anthony D. Oliver, Charles B. Wilson, and Edwin B. Boldrey

✓ Two cases of spinal arteriovenous malformation (AVM) are reported because of a previously unobserved clinical feature: recurrent transient postprandial paresis of the legs. The authors believe the paresis was caused by chronic shunting of blood away from the cord and into the low-resistance AVM. Symptomatic cord ischemia might then be precipitated by vasodilatation in other areas of the body such as the splanchnic, brachial, or uterine vessels. We believe that in some instances this mechanism should be considered as an explanation for episodic neurological deficits seen in association with spinal AVM's.

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Justin Renaudin, Derek Fewer, Charles B. Wilson, Edwin B. Boldrey, John Calogero, and K. Jean Enot

✓ Twenty patients seriously ill following subtotal excision of brain tumors were given unusually large doses of Decadron to restrain peritumoral edema. The prompt clinical effect was strikingly favorable in 11. The dosage of Decadron above which no additional anti-edema effect occurs must be established for each individual patient. No significant complications occurred under dosages ranging from 32 to 96 mg/day. Brain scintiscans performed after rapid clinical improvement in five cases showed no change.

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Takao Hoshino, Marvin Barker, Charles B. Wilson, Edwin B. Boldrey, and Derek Fewer

✓ Eleven selected patients with brain tumor were given 3H-thymidine intravenously at the time of operation. Parts of the excised tumor were fixed for routine histological studies as well as for simple radioautography. Other parts were minced immediately after excision and incubated at 37°C with 14C-thymidine, and were thus doubly labeled. Simple radioautography of the tumor specimen showed fairly even distribution of labeled cells in the astrocytoma group and uneven labeling of tumor cells in malignant gliomas, including glioblastomas. In most glioblastomas, the labeling index (percentage of cells labeled with 3H-thymidine) varied from near 0% in the necrotic areas to approximately 20% in the most viable parts of the same tumor; the labeling index of viable parts of the tumor ranged from 5% to 10% with the exception of astrocytomas in which the index was 1% or less. The duration of DNA synthesis ranged from 7 to 10 hours in the majority of tumors regardless of the nature or grade of malignancy.