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Query: UMLS:C0155339 (Brown)
 12,436 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-six patients with recurrent or unremovable malignant gliomas were treated by interstitial brachytherapy with iridium-192 seeds. Stereotactic implantation of the afterloading catheters using the Brown-Roberts-Wells computed tomography (CT)-guided stereotactic system was performed in 24 patients and surgical implantation in two patients with pontine glioma. The response to therapy was measured by serial CT, magnetic resonance imaging, and clinical examination. Tumor regression was seen in 17 patients 1-3 months after implantation. Tumor progression was seen in only three patients. After interstitial brachytherapy, the most commonly observed CT finding was central low density. Median survival time was 18 months after implantation. Autopsies in five patients revealed the delayed effects of radiation injury such as typical vascular changes, microcalcification, and coagulative necrosis in the implant area and tumor recurrence at the periphery. The results suggest that brachytherapy is not curative but prolonged the median survival time by 6 months.
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PMID:Preliminary results of interstitial 192Ir brachytherapy for malignant gliomas. 128 Jul 75

The authors have developed new devices for stereotactic radiosurgery using a conventional linear accelerator (LINAC). The system of devices consists of a rotatory chair with a base ring holder, a Brown Robert Well's stereotactic apparatus (BRW's apparatus) with a double set of base rings and a number of precise collimators which eliminate penumbra to the greatest extent. A study rotatory chair was manufactured, whose vertical axis of rotation is always set and stable. A strongly built, adjustable holder for the BRW's base ring is attached to the chair. The principle and flow of procedures step by step is as follows; 1). The rotatory chair is carried in under the linear accelerator and the vertical rotatory axis of the chair is precisely adjusted to align with the vertical center of the photon beam from the LINAC. 2) A base ring and a locator of BRW's apparatus are mounted on a patient's head and three coordinates of a target are determined by CT scans. 3) The target indicator of the dummy set of BRW's apparatus is positioned according to X, Y, Z coordinates of the target. The tip of a rod indicator fixed on an instrument bloc on the arc device is precisely adjusted to touch at the tip of the target indicator. 4) The base ring and arc device with rod indicator are transferred together from the BRW's dummy set to the rotatory chair and fixed to the base ring holder. The tip of the rod indicator is precisely adjusted to be positioned at the isocenter of the LINAC. 5) The base ring and arc device are removed and replaced by another base ring mounted on the head of a patient, who is made to sit on the rotatory chair. The target in the brain is now located at the isocenter of the LINAC. Stereotactic radiation is started with rotation of the chair and circular movement of the gantry of the LINAC. The chair is rotated at a speed of 100 degrees per second, and the gantry of the LINAC is moved slowly on a circular trajectory from +115 degrees to -115 degrees. Fourteen cases, including AVM, cavernous angioma, acoustic tumor and glioma have been treated so far. Three cases of large AVM were treated by a combination of artificial embolization and stereotactic radiosurgery.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[A new principle and device for radiosurgery using a linear accelerator; its principle, devices and clinical trials]. 159 34

The M current, IM, a voltage-dependent non-inactivating K current, was recorded in NG108-15 neuroblastoma x glioma hybrid cells, using the whole-cell mode of the patch-clamp technique. We studied inhibition of the M current by bradykinin, phorbol dibutyrate (PDBu), an activator of protein kinase C (PKC), and methylxanthines. Focal application of 0.1-5 microM bradykinin inhibited IM by about 60%; 5 nM bradykinin inhibited by about 40%. Bath application of 0.1 microM and 1 microM PDBu diminished IM to about half of the control value. Staurosporine, a PKC inhibitor, applied for 35-43 min in a concentration of 0.3 microM significantly reduced the effect of 1 microM PDBu. M current blockage by PDBu could be partly reversed by bath application of H-7 (51-64 microM), another PKC inhibitor. These observations suggest that the PDBu effect is really due to activation of PKC. The findings are compatible with the view [Brown DA, Higashida H (1988) J Physiol (Lond) 397:185-207] that the bradykinin effect on IM is mediated by PKC. However, three further observations suggest that this is only true for part of the bradykinin effect. When the suppression of IM by 1 microM PDBu was fully developed, 0.1 microM bradykinin produced a further inhibition of IM. Down-regulation of PKC by long-term treatment with PDBu reduced the effect of 0.1 microM bradykinin significantly but did not abolish it. Staurosporine (0.3 microM, applied for 31-46 min) failed to reduce the effect of 5 nM bradykinin significantly. The M current could be reversibly blocked by methylxanthines (caffeine, isobutyl-methylxanthine, theophylline) in the millimolar range, probably because of a direct action on the M channels.
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PMID:Inhibition of the M current in NG 108-15 neuroblastoma x glioma hybrid cells. 194 51

The local use of radionuclides in the management of neoplastic processes was initially considered over 80 yr ago and has enjoyed increasing enthusiasm in the treatment of somatic and central nervous system tumours during the past 30 yr. The marriage of complex neuroimaging techniques and modern stereotactic devices has markedly enhanced the technical precision of interstitial radiobrachytherapy of malignant cerebral neoplasms. In applying these techniques, it is imperative to achieve an optimal placement of radionuclide sources in order to develop a geometrically homogenous, controlled distribution of radiation. Critical considerations include determination of tumour volume and contour, and development of a homogenous dose rate (dependent upon multiple sources at varying intensity) that will not only effect tumour cell kill but do this without excessive production of radionecrosis which necessitates craniotomy because of mass. Using the Brown-Roberts-Wells (BRW) stereotactic guidance system and an image-defined, volumetrically determined target, implants of multiple iridium 192(192Ir) sources were used to establish appropriate isodose envelopes. A methodology for achieving the described objectives is detailed as it applies to a variety of malignant intracerebral neoplasms (glioblastoma multiforme, malignant astrocytoma, malignant mixed glioma, primary cerebral lymphoma, metastatic carcinoma and malignant pineal region tumours). Technical realization of precision implantation relying upon imaging data may be acheived with this method with satisfactory responses that are dependent upon histological tumour type and the morphology of the tumour distribution as related to the image. Early and late complications related to the surgical technique and radionuclide applications were less than 5%. Although encouraging, these techniques require further definition and greater data accrual before uniform application outside major medical centres can be justified. It is anticipated that improvement in results with intrinsic gliomas and other invasive neoplasms will be realized with further definition of tumour boundaries by tract biopsy techniques and concurrent utilization of hyperthermia and brain protective methods.
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PMID:Interstitial radiobrachytherapy of malignant cerebral neoplasms: rationale, methodology, prospects. 288 48

1. The role of inositol 1,4,5-trisphosphate (InsP3) and diacylglycerol (DAG) as possible mediators of the membrane current responses of NG108-15 neuroblastoma x glioma hybrid cells to bradykinin (BK, Brown & Higashida, 1988b) has been tested using intracellular ionophoresis of InsP3 and external application of phorbol dibutyrate (PDBu) and 1-oleoyl-2-acetylglycerol (OAG). 2. Intracellular ionophoresis of InsP3 into cells clamped at -30 to -50 mV produced (i) a transient outward current, (ii) a transient outward current followed by an inward current, or (iii) an inward current. All currents were accompanied by an increased input conductance. 3. The transient outward current reversed at between -80 and -90 mV. The reversal potential was shifted to more positive potentials on raising extracellular [K+], suggesting that it resulted from an increased K+ conductance. 4. The outward current was inhibited by apamin (0.4 microM) or d-tubocurarine (0.2-0.5 mM); these drugs also inhibit the outward current produced by BK or by intracellular Ca2+ injections (Brown & Higashida, 1988 a, b). The outward current was also slowly reduced in 0 mM [Ca2+] or 0.5 mM [Cd2+] plus 2 mM [Co2+] solution. 5. Ionophoretic injection of inositol 1,3,4-trisphosphate and inositol 1,3,4,5-tetrakisphosphate, guanosine trisphosphate or inorganic phosphate did not evoke an outward current but produced only an inward current with an increased conductance, reversing at between -10 and -20 mV. 6. Bath application of PDBu (10 nM-1 microM) or OAG (1-10 microM) produced an inward current with a fall in input conductance. The inward current was voltage dependent and was accompanied by an inhibition of the time-dependent current relaxations associated with activation or deactivation of the voltage-dependent K+ current, IM. 7. PDBu did not clearly reduce the Ca2+ current or the Ca2+-dependent K+ current recorded in these cells. During superfusion with PDBu, the outward current produced by intracellular ionophoresis of InsP3 was greatly enhanced. 8. The results support the view that the two membrane current responses to BK might both result from accelerated membrane phosphatidylinositide hydrolysis. One product, InsP3, releases Ca2+ and activates an apamin-curare-sensitive outward K+ current; this effect is imitated by intracellular InsP3 ionophoresis. The second product, DAG; activates protein kinase C to inhibit the voltage-dependent K+ current IM and generate an inward current; this effect is imitated by external application of PDBu or OAG.
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PMID:Inositol 1,4,5-trisphosphate and diacylglycerol mimic bradykinin effects on mouse neuroblastoma x rat glioma hybrid cells. 326 93

A simple computed tomography- (CT) or magnetic resonance (MR) imaging-guided stereotactic method for guided microsurgical resection of either deep-seated gliomas or tumors adjacent to an eloquent area is described. The technique employs the Brown-Roberts-Wells stereotactic system and twist drills, 2.7 mm in diameter, for the stereotactic placement of 2.4 mm diameter scaled guidance catheters through the calvaria. In a patient with a deep-seated small glioma, less than 2 cm diameter, one catheter was implanted into the center of the enhanced mass through the cerebral cortex. In the other 14 patients, three to six catheters were used which made the tumor border clearer. After implantation of the guidance catheters, the stereotactic frame was removed and a standard open craniotomy performed. Target localization is not affected by brain movement, which is inevitable during open surgery. The tumor involved the frontal lobe in eight patients, the parietal lobe in two, and the thalamus in five. In all cases the lesion was quickly localized and radical removal was achieved. Neurological complications occurred in only one patient who suffered transient hemiparesis after the resection of a lesion in the pyramidal tract. The results demonstrate that microsurgery combined with CT- or MR imaging-guided stereotactic placement of guidance catheters is a new option for surgery of deep-seated gliomas or tumors adjacent to an eloquent area.
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PMID:Resection of deep-seated gliomas using neuroimaging for stereotactic placement of guidance catheters. 777 Jan 8

Craniotomy using stereotactic techniques has the potential to improve the extent of tumor resection and to reduce wound and neurologic morbidity. Most reports of stereotaxy-assisted craniotomy (SC) for tumor resection have focused on techniques using sophisticated computer hardware and volumetric software. Results of nonvolumetric SC in 50 consecutive cases for tumor using the Brown-Roberts-Wells or Cosman-Roberts-Wells stereotactic systems are presented. Tumor type included malignant glial neoplasms (20 cases), metastases (19), benign glial tumors (5), meningiomas (4), and radiation necrosis (1). Results in the SC group were compared to a concurrent series of 50 conventional craniotomies (CC) for brain tumor by other surgeons. Sustained neurologic deficits were 4% in the SC group while 10% for CC. Wound complications were 4 and 8%, respectively. Median hospital stay was 5 days (mean 5.9, range 2-20) for SC and 7 days (mean 10.4, range 3-75) for CC. Low morbidity resections of many brain lesions can be performed using conventional stereotactic systems, the operating microscope and standard CT software.
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PMID:Nonvolumetric stereotaxy-assisted craniotomy. Results in 50 consecutive cases. 819 30

Precise localization of subcortical targets contributes to the technical challenge of craniotomies. To address this challenge, the application of readily available stereotactic localization techniques to open craniotomies was investigated. Over a 2-year period, 62 consecutive stereotactic craniotomies were performed successfully using the CT-compatible Brown-Roberts-Wells (BRW) apparatus. Standard BRW hardware and software were employed. This series consists of craniotomies in 50 patients for resection of subcortical mass lesions. Targets were consistently and precisely localized by the stereotactic frame. Pathology revealed 32 metastases, 18 glial tumors, 5 nonglial tumors, and 7 nonneoplastic lesions. Histology differed from presumptive diagnoses by neurodiagnostic imaging studies in 30.6% of cases. The average volume of tumors resected was 55,903 mm3. Gross total resection of all solid tumor tissue was consistently confirmed by postoperative contrast-enhanced CT. Postoperatively, 38 patients with masses were neurologically improved, 22 were unchanged, and 2 were worse. Median postoperative survival for glioblastoma multiforme after adjuvant therapy was 58.7 weeks and for metastases was 39.2 weeks. There were no postoperative deaths. Overall surgical morbidity was 3.7%. CT-directed stereotactic craniotomy using the BRW system is a safe, efficacious, and readily available technique. It successfully confers the precision of stereotactic methodology on open microneurosurgical procedures.
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PMID:Tumor resection by stereotactic craniotomy using the Brown-Roberts-Wells system. 907 47

The safety of stereotactic biopsy (STB) was studied in this article. CT-guided STB (Brown-Roberts-Wells; BRW) was performed 58 times for 56 patients (male: 29, female: 27) at Hyogo Cancer Center between 1988 and 2007. The age distribution ranged from 15 to 83 (mean: 55) years old. Histological diagnoses were established for 58 samples, with 35 cases of glioma, eight of metastatic brain tumor, nine of malignant lymphoma and leukemia, two of germ cell tumor, two of abscess, one necrosis, and one case with normal tissue. There were 3 cases (5.2%) in which an intratumoral hemorrhage with neurological deficits was occurred. They were needed surgically removal and those histological pathology revealed glioma. Concerning location of biopsy, STB for basal ganglia (putamen or globus pallidus) and thalamus were caused complication of the intratumoral hematoma after biopsy. The review of the 575 cases indicates that glioma was the relative risk factor for morbidity associated with CT-guided STB (odds ratio 5.36). The overall morbidity rate was 6.4% (37/575). We considered that tumors of the basal ganglia (putamen or globus pallidus), thalamus and glioma were risk factors of morbidity for CT-guided STB.
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PMID:Morbidity of stereotactic biopsy for intracranial lesions. 2193 61