thromboembolic phenomena was accentuated by the young age (early 20's) of both patients with pulmonary emboli, because pulmonary emboli are rare in young people. The suspicion was raised that hypothalamic impairment might predispose to thromboembolic disease particularly since recent experiments in the cat have shown that a hypercoagulable state may result from hypothalamic stimulation. 1 The present study was undertaken to explore the relationship between brain tumor localization and thromboembolic complications. Method Data were examined from autopsy and clinical

blood-brain barrier, and the sink action of the cerebrospinal fluid (CSF), have been suggested as possible or partial explanations for this failure in brain-tumor chemotherapy. Although there is a fair amount of literature on the penetration of various isotopes and molecules into brain and brain tumor in animals and man, only a few brief reports 1, 8, 11 offer any quantitative information on the blood-tissue exchange processes that occur in brain neoplasms. 17 In the present experiments, monkeys with an intracerebrally implanted choriocarcinoma 4, 12 were used as

P reliminary studies of the relationship between tumor cell kill and animal survival in the 9L rat brain-tumor model have shown that a 90% cell kill (cytotoxic threshold) is necessary to produce an increased animal life span. 19 The cytotoxic threshold is caused by delayed removal of dead cells and early proliferation of surviving clonogenic cells following treatment. 7, 9, 19 Therefore, the 90% threshold level should represent a finite limit to any short-term treatment course, regardless of the specific therapy utilized. This suggests that, contrary to

) of patients with several kinds of primary and secondary brain tumors. 10 The results are promising, and further studies may show TK to be of practical value as a CSF marker of brain tumors. There are no exact figures for the frequency of cystic brain tumors, but it is estimated that about 10% of all brain tumors are cystic. Little attention has been paid to the fluid that accumulates in cystic tumors, although chemical analysis has yielded important information about the tumor. The use of the cyst fluid for malignancy grading has been suggested by Szliwowski and

: Rational planning of brain tumour therapy based on laboratory investigations: comparison of single- and multiple-dose BCNU schedules. Br J Cancer 41 ( Suppl IV ): 253 – 254 , 1980 Rosenblum ML, Dougherty DV, Wilson CB: Rational planning of brain tumour therapy based on laboratory investigations: comparison of single- and multiple-dose BCNU schedules. Br J Cancer 41(Suppl IV): 253–254, 1980 20. Rosenblum ML , Knebel KD , Vasquez DA , et al : Brain-tumor therapy. Quantitative analysis using a model system. J

T he efficacy of conventional external radiation (teletherapy) for the treatment of primary brain tumors is well established. 12, 18, 20 The major limitation of teletherapy derives from the relative intolerance of normal tissues to radiation, making the delivery of potentially curative doses impossible. Brachytherapy by permanent or removable radionuclide implants, which confine the radiation to the tumor area, has been used in many body sites with good results in terms of both increased longevity and palliation. 5 Brachytherapy has not, however, been

the surgery. Fig. 1. Rickman J. Godlee, Esq., F.R.C.S. The operation itself was performed at “the Hospital at Regents Park,” ( Fig. 2 ) a small, three-story house which was first renovated and converted to a hospital in 1873. (This building was subsequently destroyed and its exact location is not now known.) Fig. 2. The Hospital for Epilepsy and Paralysis, Regents Park, London, where the first primary brain-tumor operation took place in 1884. Despite the rather inauspicious location and surroundings, this operation was not performed

-mortem material. Cancer 3: 705–708, 1950 5. Hosobuchi Y , Phillips TL , Stupar TA , et al : Interstitial brachytherapy of primary brain tumors. Preliminary report. J Neurosurg 53 : 613 – 617 , 1980 Hosobuchi Y, Phillips TL, Stupar TA, et al: Interstitial brachytherapy of primary brain tumors. Preliminary report. J Neurosurg 53: 613–617, 1980 6. Huk W , Baer U : A new targeting device for stereotaxic procedures within the CT scanner. Neuroradiology 19 : 13 – 17 , 1980 Huk W, Baer U: A

T o date, most efforts to control the growth of malignant brain tumors have been disappointing. Surgical extirpation alone is rarely, if ever, curative. 13 When administered singly, several chemotherapeutic agents have shown significant antitumor activity. However, the most effective of these agents, 1,3-bis (2-chloroethyl)-1-nitrosourea (BCNU), 33, 37 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU), 8, 22 procarbazine, 15 and 4′-demethyl-epipodophyllotoxin-β-D-thenylidene-glucoside (PTG), 29 result in only a 40% to 50% remission rate and 6 to 9

treated primarily by 1 surgeon (M.S.B.E.) for continued medically refractory epilepsy despite an earlier resection of a brain tumor. Six patients were boys and 3 were girls. The mean age at the time of the initial tumor surgery was 7.3 years (range 5–14 years). The mean age at subsequent epilepsy surgery was 13.7 years (range 9–17 years), resulting in a mean time from original operation to reoperation of 6.3 years (range 2–13 years). All 9 children had medically refractory seizures based on failure of at least 2 appropriately chosen antiseizure medications to control