Evaluation of fluorine-18-BPA-fructose for boron neutron capture treatment planning.

UNLABELLED: Boron neutron capture therapy (BNCT) using 4-[10B]boronophenylalanine-fructose (BPA-Fr) is in Phase II clinical trials to validate BNCT as a treatment for glioblastoma multiforme and melanoma. Successful BNCT depends on knowledge of the distribution of boron-containing agents in both tumor and normal tissue as currently determined by chemical confirmation of boron deposition in surgically removed malignant tissue before BNCT. METHODS: We used PET to noninvasively obtain in vivo information on the pharmacokinetics of the 18F-labeled analog of BPA-Fr in two patients with glioblastoma multiforme. Time-activity curves generated from the bolus injection of 18F-BPA-Fr were coinvolved to simulate a continuous infusion used for BNCT therapy. RESULTS: Distribution of 18F-BPA-Fr by PET was found to be consistent with tumor as identified by MR imaging. The 18F-BPA-Fr tumor-to-normal brain uptake ratio was 1.9 in Patient 1 and 3.1 in Patient 2 at 52 min after injection. The 18F-BPA-Fr uptake ratio in glioblastoma paralleled that of nonlabeled BPA-Fr seen in patients as previously determined by boron analysis of human glioblastoma tissue obtained from pre-BNCT surgical biopsy. CONCLUSION: Knowledge of the biodistribution of BPA-Fr enables pre-BNCT calculation of expected tissue dosimetry for a selected dose of BPA-Fr at a specific neutron exposure. Fluorine-18-BPA-Fr PET is capable of providing in vivo BPA-Fr biodistribution data that may prove valuable for patient selection and pre-BNCT treatment planning.

Plasmid homologies in Edwardsiella ictaluri.

Plasmids from all available non-channel catfish isolates of Edwardsiella ictaluri were classified by gel electrophoresis and hybridization methods. All isolates, regardless of source, contained classes of homologous plasmids with similar but not identical sizes.

Mutagenicity of urine from greenhouse workers.

The mutagenicity of urine from spray applicators in 12 greenhouses in 1986 has been evaluated. The workers served as their own controls. Urine samples reflecting pesticide exposure were collected at the end of the day of application and a corresponding control sample was collected 3 d later. Using Salmonella typhimurium bacterial tester strains TA98 and TA100 with and without S9 activation, seven workers showed no significant differences (p less than 0.05) in the mutagenicity of their exposed and control urine. Of the five remaining workers, three, who wore no respirators, showed significantly higher (p less than 0.05) concentrations of mutagens in their exposed urine sample as compared to their respective controls. The mutagenicity of certain of the compounds applied by these latter workers is discussed.

Posterior sagittal anoplasty combined with ventricular peritoneal shunting: an unusual complication.

This report is intended to point out the potential difficulties in patients with the combined abnormalities of anorectal agenesis and central nervous system disorders requiring diversion of CSF. The potential accumulation of this diverted fluid in and around meticulously approximated pelvic musculature so important to continence was a real concern and prompted immediate reexploration and shunt conversion. It is recommended that future cases with these coexisting abnormalities should be carefully considered for shunt conversion prior to or at the time of posterior sagittal anorectoplasty, particularly if the peritoneum is inadvertantly entered.

Sudden visual loss and a chiasmal syndrome due to an intrachiasmatic vascular malformation.

A 48-year-old woman presented with a chief complaint of visual loss and bitemporal hemianopia. A similar episode of temporal visual field loss had occurred 34 months earlier and spontaneously resolved. Computerized tomography demonstrated a suprasellar mass. Angiography was normal. At surgery a venous angioma of the optic chiasm with a fresh hematoma was found and removed. Intrachiasmatic vascular malformation is an unusual finding which should be considered in the differential diagnosis in patients with a chiasmal syndrome.

Comparison of the infratentorial and transtentorial approaches to the pineal region.

During the past 10 years, two different operative approaches to the pineal region have been recommended by different authors. Numerous reports have appeared in the literature, indicating the safe use of one or the other of these two techniques for the excision of masses in the pineal region. This paper reports experience with both techniques in the treatment of 15 patients with mass lesions in this area. Four patients underwent a supracerebellar infratentorial approach and 11 patients underwent an occipital transtentorial approach to the pineal region. These two approaches are compared in terms of anatomical exposure, technical difficulties, and real or potential complications. The authors prefer the occipital transtentorial approach in dealing with lesions in the pineal region.

A study of religious attitudes of the elderly.

A study is reported of the religious beliefs, attitudes, and practice of old people in the West of Scotland, based on a questionnaire given to 501 people aged 65 years and over randomly selected from those living at home. Almost all had had a full range of religious instruction, and regarded their parents as religious. Weekly church attendance was commoner among Catholics (70%) than Protestants (40%), among women than men, among those whose beliefs were those of organized religion, and among those with unrestricted mobility. The pattern of participation in church organizations and social activities was similar. A firm belief in an after-life was expressed by 80% of Catholics and 60% of Protestants, and higher proportions derived comfort from religion, especially in bereavement. Over 70% expressed no fear of their own death. In this elderly population, religious beliefs and attitudes remain important considerations, which should therefore be of concern to all those involved in the care of the elderly.