Stereotactic neurosurgery planning on a personal-computer-based work station

Stereotactic surgery requires knowledge of cerebral structures derived from more than one image source. We have developed a PC-AT-based workstation that accepts patient images, made with the stereotactic frame in place, from CT, MRI, and DSA modalities. Reference markers on the frame are identified in the images to establish the coordinate geometry for each modality. Target points may be identified on each image type and trajectories of probe paths to these points defined. Targets identified on one set of images may be transferred automatically to other images of the same patient in order to guarantee a vessel-free path of approach to a target point deep within the brain. To date several hundred patients have had stereotactic surgery performed on the basis of plans using this system. Procedures included biopsy and aspiration of lesions, implantation of electrodes for the recording of deep EEG signals, and radiosurgical techniques. We present clinical examples of the use of this system in typical stereotactic neurosurgery procedures, address stereoscopic applications, and discuss the results of intermodality tests to establish the accuracy of the technique.     

Clinical and cerebrospinal fluid findings in lymphocytic meningo-radiculitis (Bannwarth's syndrome)

11 patients with lymphocytic meningo-radiculitis (Bannwarths syndrome) are described. The disease is characterized by intensive pain, often radiating and migrating, and neurological deficits, i.e. peripheral facial palsies, as well as disseminated radiculopathies. In 4 patients the onset was preceeded by an arthropode bite, close to which 3 patients exhibited an erythema chronicum migrans.
In the cerebrospinal fluid there was a mononuclear pleocytosis, predominately by lymphocytes. In the early stages, a plasma cell reaction was frequently encountered. Protein analysis indicated a defect in the blood brain barrier and an intrathecal synthesis of IgG.
All patients recovered almost completely from their neurological symptoms within 1–2 months, irrespective of treatment.     

Productive Aging: A Quality of Life Agenda

Although the fact that, in general, the US population is living longer is said to be the public health success story of the 20th century, the boom in the population aged 65 years and older is having and will continue to have major implications for all age groups as well as for the nation's health, social, and economic institutions. The concept of productive aging can provide guidance in addressing these implications. The assumptions of productive aging reflect today's reality that older people are repositories of wisdom and experience and important assets for society; relatively healthy, with the potential for maintaining that condition until late in life; capable of making economic and social contributions that benefit themselves, their families, and their communities; and in need of purposeful and meaningful roles and activities in life. A productive aging activity model emphasizes involvement in paid work, volunteerism, education, fitness and exercise, leisure and travel, advocacy and political action, and consumerism. This article discusses the concept of productive aging, a related activity model, and qualitative focus group research undertaken in conjunction with the 1995 White House Conference on Aging. J Am Diet Assoc. 1998;98:1445–1448.     

Tumor Markers in Colorectal Carcinoma An Evaluation of Carcinoembryonic Antigen, Tissue Polypeptide Antigen, Placental Alkaline Phosphatase and Pseudouridine

The biologic markers carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), placental alkaline phosphatase (PLAP) and pseudouridine were analysed in 37 patients with colorectal carcinoma. CEA, TPA and PLAP were derived from the serum and pseudouridine from the urine. The incidence of all four markers increased with advancing stages of the disease. Patients with distant metastases had elevated levels of CEA, TPA, PLAP and pseudouridine in 85, 27, 18 and 33 per cent of the total cases, respectively. When survival was compared, patients with 2 to 4 elevated markers had shorter survival than those with none or only one elevated marker.