Interstitial radiogold implantation for the treatment of recurrent high-grade gliomas.

Thirty-three patients were treated at the Methodist Hospital, Baylor College of Medicine (Houston) between 1983 and 1987, for high-grade gliomas which had recurred after conventional external-beam radiation therapy. The mean dose to the tumor volume from the external-beam therapy was 5800 cGy. Thirteen patients had recurrent astrocytoma Grade 4 (glioblastoma), whereas 20 had recurrent astrocytoma Grade 3 (anaplastic astrocytoma). All patients were treated for their recurrence by the combination of reexcision of as much of the tumor mass as was technically feasible and intraoperative radiogold (198Au) seed implantation of the residual tumor and/or tumor bed. The mean dose to the tumor volume from the implant was 4000 cGy. For the 13 patients treated for recurrent glioblastoma the 1-year, 2-year, and 3-year survival rates were 46%, 15%, and 8%, respectively. For the 20 patients treated for recurrent anaplastic astrocytoma the 1-year, 2-year, and 3-year survival rates were 75%, 50%, and 15%, respectively. Survival was measured from the time of implant. The median survival for patients with glioblastoma was 9 months. The median survival for patients with anaplastic astrocytoma was 17 months. One patient died in the immediate postoperative period from a gastrointestinal bleed. No patient required reoperation for radiation necrosis. The authors believe that this technique is an effective treatment for patients with high-grade gliomas recurring after external-beam radiation therapy, and are now including interstitial irradiation in the initial management of selected patients with high-grade gliomas.

Hospitalized pregnant psychotic women: characteristics and treatment issues.

The medical records of 35 pregnant women hospitalized for nonorganic, psychotic symptoms were reviewed to determine their demographic and psychosocial characteristics as well as patterns of assessment, treatment, and disposition. The review showed that the majority of the women had been hospitalized five times or more and lacked social and economic supports. Almost two-thirds had had two or more pregnancies, but only two were living with their children. The review also showed that the basic issues of birth control methods and infant custody rights were not addressed by the hospital treatment program. The authors urge that discussions of birth control methods be included in the treatment plans of pregnant psychotic patients and that recommendations regarding infant custody be recorded in the patients' charts.

The Slingerland Screening Tests for identifying children with specific language disability: screening for learning disabilities in first grade.

The responses on the Slingerland tests of 29 learning disabled and 11 nondisabled children in Grade 1 distinguished the two groups, except for copying (near vision). Copying (far vision) and auditory, visual, and kinesthetic perception and discrimination together were the strongest predictors of group membership.

Two modes of administration of the Bender Visual-Motor Gestalt Test to kindergarten children.

Using Otis-Lennon IQs 104 kindergarten children were paired and divided into two groups. The first was administered a group Bender test based on transparencies of the Bender designs and 10 to 14 days later the standard individual Bender Test. The second group was administered the Bender tests in reverse order. A significant correlation was found between Koppitz scores from the group and the individual Bender scores. It is suggested that the group Bender test might be used as a screening device without significant loss of information on a later administration of the individual Bender test.

Identification of group a streptococci by reverse passive hemagglutination.

A method for preparing sensitized human O erythrocytes with specific antibody is reported. Whole sera or 40% ammonium sulfate insoluble globulin fractions did not satisfactorily sensitize erythrocytes to agglutinate in the presence of either group specific polysaccharide of group A beta-hemolytic strepticocci or antigen produced during colony formation. Antibody purified by affinity chromatography sensitized the erythrocytes to rapidly agglutinate in the presence of either antigen. No spontaneous or "pseudo-immune" agglutination occured when the sensitized erythrocytes were suspended in human serum. Such sensitized human cells, while more difficult to prepare than sensitized staphylococci, should be suitable for detecting bacterial or viral antigens in vivo.

New method of grouping beta-hemolytic streptococci directly on sheep blood agar plates by coagglutination of specifically sensitized protein A-containing staphylococci.

A technique is described that allows the grouping of beta-hemolytic streptococci directly upon the primary colony. This was accomplished by applying a small drop of specifically sensitized protein A-containing Staphylococcus aureus over a colony of streptococci, rocking the plate to allow mixing of the particles with the soluble group-specific polysaccharide, which in the case of beta-hemolytic streptocicci was produced in abundance during colony formation, and observing for agglutination of the sensitized particles. Such a simple test for group A beta-hemolytic streptococci should allow accurate identification of group A streptococci in small laboratories, such as in clinics or physicians' offices, as well as in the larger public health and private laboratories.

Serological grouping of hemolytic streptococci by counter-immunoelectrophoresis.

The counter-immunoelectrophoresis (CIE) method of grouping streptococci was more sensitive than the capillary precipitin method. The precipitate was easier to read, and the test was simple to perform and required fewer reagents. An autoclave-Pronase-B extraction procedure is described and was found superior to either acid, Pronase-B, or the autoclave extraction procedures for recovering groupable polysaccharide from different strains of streptococcal groups A, B, C, D, F, and E. Data obtained from over 400 strains indicate that the sensitivity of the CIE and a more efficient extraction of groupable polysaccharide provides a simple method for rapid diagnosis of streptococcal infections.