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Ten patients with findings at computed tomography (CT) suggesting intracranial supratentorial glioma were investigated to compare the diagnostic efficacy of this technique with that of positron emission tomography (PET) using 11C-methionine and exminations with magnetic resonance (MR). The findings were related to histopathologic examination of serial stereotactic biopsies, which were guided by the appearance of the lesions on PET examination. To obtain corresponding slice orientation with the different examination techniques, an individually shaped helmet fixation was used. However, in 3 cases this fixation device could not be used for MR. Histopathologic diagnosis, obtained in all cases from multiple target stereotactic biopsies, included glioma in 9 patients and reactive gliosis in one case. A detailed comparison of the three imaging techniques and the findings at stereotactic biopsies was possible in 7 patients, while in 3 patients comparison with MR was less exact due to the patient's refusal to wear the helmet during this examination. MR was the most accurate method for outlining the total extent of a lesion, i.e. the tumor and the edema surrounding it. Four lesions had homogeneous signal characteristics and in 6 lesions two (or more) compartments could be distinguished with MR. In 5 cases the MR findings were in complete agreement with the histopathologic findings. However, a thorough correlation between signal characteristics and histology was not possible. Using PET the occurrence and the extent of tumor tissue was correctly predicted in 7 patients. The PET was normal in one case. Findings at CT were in agreement with the histopathologic diagnosis in 5 patients. MR was the most sensitive method for the detection of lesions. PET using methionine appeared to have a somewhat higher capacity to outline correctly the true extent of a tumor. The combination of CT and PET was superior to MR for determining the type and grade of the tumors.

A selected group of 36 patients with suspected supratentorial gliomas were investigated with positron emission tomography (PET) using 11C-methionine and transmission computed tomography (CT) before and after intravenous injection of contrast medium. Every examination was performed with the head fixed in a plastic helmet and a baseplate to guarantee that the slice orientation was the same at examinations with the two modalities and over time. Guided by the examinations, multiple stereotactic biopsies were performed with the biopsy instrument mounted on the baseplate. Regional accumulation of methionine was compared with histology of the corresponding samples and with attenuation before and after injection of contrast medium as well as mass effect on CT. Typically, there was a low attenuating lesion with a slight mass effect on CT. There was an increased accumulation compared with normal brain tissue in 31 cases of tumours and ordinary or decreased accumulation in 3 cases of tumours. In 22 cases with increased accumulation of methionine the extension of the tumour judged by PET corresponded with that of histology. In 4 cases tumour cells were found outside the area with pathologic methionine uptake. In 5 patients there were areas with increased methionine accumulation where no tumour cells were found. In 22 cases PET using methionine was more accurate than CT in defining the tumour boundaries as determined from the histologic findings. Four groups of biopsy specimens with different amounts of methionine accumulation are described. The uptake in a single biopsy gives good but not exact information about the histology of the specimen.

Serum and CSF calcium, magnesium, potassium and sodium were analyzed in 14 patients suffering from subarachnoid haemorrhage and in 10 healthy controls. The calcium and potassium concentrations in serum and CSF were decreased while magnesium unchanged and sodium were unchanged. A deranged electrolyte homeostasis was thus detectable in the CSF following subarachnoid haemorrhage. It could not be established whether symptoms of delayed cerebral ischemia were related to CSF calcium and/or potassium levels.

Five patients with glioma were examined with positron emission tomography after the administration of 11C-L-methionine and at a following day with 11C-D-methionine. The rates of accumulation of the tracers were determined in the tumor and in the normal brain tissue according to a graphical technique of Patlak et coll. (24). The accumulation rates for L-methionine were on the average 2.4 times higher than those of D-methionine in the tumors. The corresponding ratio for normal brain tissue was 2.3. It is concluded that in this group of tumors without obvious blood-tumor-barrier breakdown, a stereospecific process with similar properties as in the normal brain tissue, is responsible for the accumulation of the labelled methionine.

Summary The effects of Leucotrienes C4 (LTC4), D4 (LTD4), Prostacyclin (PGI2) and Thromboxane A2 (TXA2) were studied on superfused human cerebral artery strips. LTC4 and LTD4 neither contracted nor relaxed the strips. PGI2 caused a dose-dependent relaxation from 0.2 nmol to 0.8 nmol. When given simultaneously with a vasoconstrictor substance, PGI2 had an almost complete inhibitory effect. TXA2 caused a dose-dependent contraction from 0.03 nmol to 0.15 nmol. Also, TXA2 was more potent than 5-Hydroxytryptamin (5-HT) and prostaglandin E2 (PGE2) with a contraction threshold of about 0.1 nmol. Prostaglandin E1 (PGE1), H2 (PGH2), and F2a (PGF2a) had contraction thresholds of about 1 nmol. Only a stable endoperoxide analogue (EPA), was more potent than TXA2, with a contraction threshold of 0.005 nmol. The possible role of these substances in producing ischaemic manifestations after subarachnoid haemorrhage (SAH) is discussed.

Based on animal research suggesting that nerve growth factor (NGF) can stimulate central cholinergic neurons, the known losses of cholinergic innervation of the cortices in Alzheimer's disease (AD), and our experience of infusing NGF to support adrenal grafts in parkinsonian patients, we have initiated clinical trials of NGF infusions into the brain of patients with AD. Here we report a follow-up of our first case, a 69-year-old woman, with symptoms of dementia since 8 years. Intraventricular infusion of 6.6 mg NGF during three months resulted in a marked transient increase in uptake and binding of11C-nicotine in frontal and temporal cortex and a persistent increase in cortical blood flow as measured by PET as well as progressive decreases of slow wave EEG activity. After one month of NGF, tests of verbal episodic memory were improved whereas other cognitive tests were not. No adverse effects could be ascribed to the NGF infusion. Taken together, the results of this case study indicate that NGF may counteract cholinergic deficits in AD, and suggest that further clinical trials of NGF infusion in AD are warranted.

Four cases with lesions suspected to be low-grade intracerebral tumours but later proved to be cavernous haemangiomas are described. The patients were examined with contrast enhanced CT and with positron emission tomography (PET). The lesions were partly calcified with a mild or no mass effect and a slight contrast enhancement at CT. There were signs of disrupture of the blood-lesion barrier also on radionuclide studies. PET with 11C-methionine and 11C-glucose showed a normal or decreased accumulation of the tracers. This combination of findings has not been encountered in intracranial tumours. As a comparison, one case of glioblastoma is described. In this patient, the CT findings suggested a cavernous haemangioma. However, PET showed a markedly increased accumulation of 11C-methionine, which is compatible with brain tumour but not with haemangioma.

Endotoxins from Gram-negative bacteria have been shown to be potent biological activators and are involved in many pathological reactions (Yagoda et al.1990). Since endotoxins are ubiquitous compounds, they can create serious problems for the pharmaceutical industry. There are several examples of unavoidable drug contamination and of endotoxins that cannot be removed from recombinant procedures involving Escherichia colibacteria (Yagoda et al.1990). It is difficult to establish a true threshold dose at which endotoxins will cause clinical effects, but doses less than or equal to 3 ng/kg body weight (bw) can cause fever, chills and headache in humans (Elin et al.1981). Another reference gives 5 endotoxin units (EU)/kg bw for similar clinical symptoms (Anon.1987). Vaccines prepared using E. colibacteria have a high potential for endotoxin content. This is important because endotoxin contamination in general can distort analyses of pharmacological studies and produce unpredictable and erratic effects on animals that receive contaminated vaccines. It is therefore important to identify possible effects of endotoxin-containing vaccines on various physiologic endpoints. It is also pertinent to assess the magnitude of any potential risks involved in using such vaccines. The purpose of this study was to evaluate the blood chemical and clinical response of castrated young boars to commercially available vaccines to E. coliwhere the bacteria have been formaldehyde killed and the endotoxins have not been removed.

Presents several letters to the editor on North Carolina convention. Information constitutional convention; Difference between fundamental law and ordinary enactments; Action by State legislature.

Presents several letters to the editor. Comments on the book "Constitutional and Political History of the United States"; Significance of the Lord's Day in the Primitive Church; Discussion on the system of accrediting practiced by the University of California.