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Charles B. Wilson

no cell loss. Most solid tumors have a very high degree of cell loss, however, probably in the region of 80% to 90%. Therefore, an additional calculation is necessary to take the cell loss factor into account. A report from the Helsinki group 8 affords a pragmatic illustration of that calculation. In the Helsinki report, 8 43 patients had tumor recurrence after surgery that had been thought to accomplish total excision. The investigators assumed that the residual tumor leading to recurrence had a volume of approximately 0.1 cu cm. The volume of the recurrent

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A decade of pituitary microsurgery

The Herbert Olivecrona Lecture

Charles B. Wilson

hormone cell adenoma prolactin cell adenoma mixed: growth hormone cell-prolactin cell adenoma corticotropic cell adenoma thyrotropic cell adenoma gonadotropic cell adenoma undifferentiated cell adenoma  non-oncocytic (null cell)  oncocytic (oncocytoma) acidophilic stem cell adenoma * Reproduced with permission from Wilson CB: Surgical management of endocrine-active pituitary adenomas, in Walker MD (ed): Oncology of the Nervous System (series volume in McGuire WL (ed): Cancer Treatment and Research

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Charles B. Wilson

that the symptoms of cauda equina claudication were produced by an increase in pressure on abnormally confined nerve roots due to vasodilatation and a probably negligible increase in volume of the nerve fibers. Evans 17 disputed this hypothesis because he could not cause induced pain to radiate into an inactive limb by exercising the opposite one, an event that he reasoned should occur according to the mechanism proposed by Blau and Logue. Working with rats, Cranefield and colleagues 8 determined the rate of oxygen uptake in peripheral nerves. Oxygen uptake

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Takao Hoshino and Charles B. Wilson

; rapid regrowth indicates that they possess a higher growth fraction and that nonproliferating cells have the capacity rapidly to enter the proliferating pool. Growth in malignant gliomas appears to be depressed by crowding, and partial removal of the tumor stimulates cells in the nonproliferating pool to move into the proliferating pool, rapidly repopulating the tumor. Thus, removal does not significantly reduce the proliferating population, and only temporarily reduces tumor volume. Solid tumors such as glioblastomas respond poorly to cycle-specific or phase

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Sinsuke Hukuda and Charles B. Wilson

arteries at C1–2 and their muscular branches at C2–3 was done by another operation; all procedures were done by one operation in the other three dogs. Tests Done on CVI-I and CVI-II Dogs Acute Bleeding Test This was done before and after the CVI-I operation in eight dogs, before and after the CVI-II operation in five dogs, and before and after the CVI sham operation in five dogs. Total Blood Volume Total blood volume was determined in two dogs before and after the CVI-I operation. The measurement was accomplished with a single intravenous

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Stephen K. Powers and Charles B. Wilson

patient. Clearly, simultaneous tumors are rare, yet the possibility of this occurrence should be recognized. An incision into the remaining anterior pituitary gland is indicated when its volume exceeds that which would be expected after removing an adenoma. In our patient, the tumor was readily recognized because of its exophytic pattern of growth, and this finding supports our practice of exposing the full extent of the anterior lobe on its rostral surface, even when the tumor is known to occupy a far lateral location. Acknowledgment We thank Neil Buckley

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Charles B. Wilson and Takao Hoshino

that at least some of the extracellular fluid originates from within astrocytes, a rupture of cell membranes releasing the fluid into the extracellular compartment. Edema not only contributes to the space-occupying effects of the tumor, but represents disruption of the normal barrier mechanisms imposed between the vascular compartment and extracellular space within the brain. Present diagnostic methods do not permit clear distinction between edema and neoplastic tissue, and reduction in the volume of either element reduces the total mass effect of the tumor

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Charles B. Wilson and Grant Hieshima

of arterial flow is common in the immediate postoperative period and more likely to occur after resection of larger AVM's. The person directing postoperative care may unwittingly promote venous thrombosis by “keeping the patient dry” as a well-accepted means of reducing postoperative reactive edema. Better postoperative management would be to assure an adequate blood volume, assiduously avoid hemoconcentration or even a hematocrit over 35%, and immediately after the operation commence a course of aspirin and low-dose heparin therapy. The known and unknown factors

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Peter Dyck and Charles B. Wilson

meningocele, as shown on the myelogram, was along the right side of the filum terminale. Placing a small probe through this opening resulted in the release of a large volume of CSF. Intraoperative anal electromyelography was employed to evaluate the function of the filum terminale. No evidence of an action potential from the anal musculature was recorded when the nerve root to the right of the filum terminale was stimulated, or when the filum terminale was stimulated directly. Therefore, the filum terminale and the nerve root were sectioned. There was immediate cephalad

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Isabelle L. Richmond and Charles B. Wilson

hormone levels are important in the management of these patients. Plain skull films, tomography, and small volume pneumoencephalography are the key radiological examinations. Important features that help distinguish pituitary adenomas from craniopharyngiomas, the most common parasellar tumors in children, are lack of calcification and a high incidence of focal sellar abnormality, which are best demonstrated with tomography. Significant suprasellar extension or invasiveness were encountered infrequently in this series (36%), in contrast to a previous report of pituitary