C. Hunter Shelden's research while affiliated with Huntington Medical Research Institutes and other places

Publications (57)

Article
We present interim survival data for a group of 83 adult patients with recurrent malignant glioma treated by implanting stimulated autologous lymphocytes into the tumour bed following surgical debulking. The patients were treated 6 months or more prior to data analysis. Fifty-nine patients were male and 24 female. The mean age for the entire group...
Article
• We present the preliminary results of a phase I trial of adoptive immunotherapy for recurrent or residual malignant glioma. The protocol is based on surgical debulking followed by implantation into the tumor bed of autologous lymphocytes that have been stimulated with phytohemagglutinin-P and then cultured in vitro in the presence of interleukin...
Chapter
Computerized tomography (CT) and magnetic resonance imaging (MRI) have given neurosurgeons the opportunity to visualize intracranial lesions much earlier than was heretofore possible with more invasive techniques. Continued improvement in image resolution has led to the diagnosis of intracranial lesions that are too small to be located and removed...
Article
An immunotherapy protocol based on intracranial implantation of stimulated, autologous lymphocytes into the tumor bed following surgical debulking of malignant glioma is described. Phase I clinical trials in human patients are now in progress. Preliminary data representing the first 39 patients treated are presented briefly.
Article
Photoradiation therapy conditions which have been used to treat subcutaneous and breast tumors are lethal when applied to the head of mice. Treatment of control mice with laser light at 631 nm over an energy density range of 0-90j/cm2 had no measurable effect but mice photosensitized with 5 mg HPD/kg 72 hrs prior to laser treatment showed a thresho...
Article
The successful application of phototherapy to subcutaneous tumors has suggested that a similar procedure should be developed for treating gliomas. As a result, attempts are being made to determine a set of conditions that would optimize the destruction of tumor cells while minimizing injury to surrounding brain tissue. To initiate this task, we dev...
Article
: The successful application of phototherapy to subcutaneous tumors has suggested that a similar procedure should be developed for treating gliomas. As a result, attempts are being made to determine a set of conditions that would optimize the destruction of tumor cells while minimizing injury to surrounding brain tissue. To initiate this task, we d...
Article
We propose a new technique to accurately determine the volume of cerebellopontine angle (CPA) tumors. It has been determined that the measurement of the long axis in a slice plane of the CPA tumor does not adequately measure the total growth of the tumor. Volume measurements are more accurate indicators of the mass of the tumor.
Article
The stereotactic surgical system and its inherent ability to localize and correlate structure with function provide a wealth of possibilities for neurosurgeons in the future. It must be remembered that routine transmission, CT scanning offers only the ability to localize areas of structural change. On the horizon is the exciting technique of topica...
Article
A method of enhancing CT data that enables direct visualization of pituitary microadenomas is presented. The microadenoma can then be three-dimensionally reconstructed to determine its morphology and location.
Article
The authors describe the results of their recently reported computer-based stereotaxic surgical technique for the indentification, enhancement, three-dimensional reconstruction, localization, and removal of small central nervous system lesions. This technique has been applied to patients with various types of central nervous system pathology, and r...
Article
A technique is described for adjuvant therapy of small central nervous system tumors after their removal. The feasibility of direct application of lymphocytes from the thoracic duct to the ventricular system of cats has been explored. Reduction of the antigenic mass by techniques described in part I of this paper is probably crucial. Patients with...
Article
In summary, a unique method of identification, localization, 3-dimensional reconstruction, and removal of minute CNS lesions is described. Intracerebral tumor resection using the herein described apparatus with binocular 3-D vision has been tested in multiple laboratory experiments and in humans and is practical using the dual xenon arc illuminatio...
Article
The authors describe preliminarily an implantable bio-stimulating device for stimulation of peripheral nerves and the central nervous system. The receiving unit is totally implantable. The system works on radiofrequency transcutaneous coupling across the skin. This new telestimulating device has a wider band width and more flexibility than units cu...
Article
The authors describe a novel stereotaxic method for the removal of minute lesions of the central nervous system (CNS). With the development and refinement of computerized tomography (CT), such small lesions can be detected by noninvasive (x-ray) scanning with computer processing of the data. Using a G E 7800 scanner system and a PDP 11/45 computer,...
Article
The authors update a novel method recently utilized in humans with various CNS pathology for stereotactic localization, removal, and adjuvant therapy of small CNS lesions using additional computer processing of the date from a GE 8800 CT Scanner. Multiple computer algorithms developed at Cal Tech enhance regions of interest by filtering, magnifying...
Chapter
The treatment of primary brain tumors is usually unsuccessful. Great effort has been made to improve the statistics, but results have added only slight prolongation of life and some temporary amelioration of symptoms with essentially no cures. Tumors are found too late and too large. They resist complete removal and do not respond favorably to irra...
Chapter
In 1968 BRINDLEY and LEWIN reported their implantation of an 80-elec-trode array activated by radiofrequency transmission on the visual cortex of a blind nurse (3). The pattern of phosphenes seen by this patient when the electrodes were stimulated suggested that technical refinements of this technique might enable blind persons to not only move abo...
Article
The authors describe a new technique for the microsurgical cannulation of the thoracic duct. A small silastic tube is utilized which can be joined to a subcutaneously implanted one-way flow, CSF, Ommaya-type reservoir. Extended drainage is avoided. No deletion or alteration of major venous channels occurs. Lymph collection is accomplished by tappin...
Article
Neural prostheses activated by radiofrequency transmission are currently being implanted to treat a variety of clinical problems. It is essential that neither the materials used in these prostheses, particularly the electrodes, nor the stimulus parameters that are employed will cause neural damage. The experiences of investigators engaged in both t...
Article
Four diabetic patients are presented with alternating facial palsy. The term alternating is meant to imply facial nerve paralysis, the onset of which occurs at different points in time on both sides of the face. Clinical findings are presented and a short review of the literature is summarized. The authors conclude that alternating facial palsy is...
Article
The authors report a case of primary osteogenic sarcoma of the brain. Negative autopsy findings, complete bone radiographs, and bone-scanning techniques were consistent with a primary tumor focus in the right temporopietal region of the brain. The authors suggest an origin from a primitive multipotential mesenchymal cell.
Article
A clinical analysis of three members of a family with documented osteopetrosis and familial paraplegia is presented. All patients had a long history of increased bone density and slowly progressing paraparesis of both legs. A thorough review of the literature has revealed no other cases which presented with paraplegia without spinal cord compressio...
Article
Twenty-seven patients with chronic pain had dorsal column stimulators implanted for pain control over a period of three years. Technical factors of electrode placement and type of unit were not found to correlate with the degree of pain relief. The preoperative psychological attitude of the patient correlated highly with the degree of pain relief a...
Article
While posttraumatic occlusion of the extracranial vertebral and carotid arteries is well known, reports of occlusion of intracranial vessels following closed head trauma are rare. In fact, only 21 cases have been adequately documented. This occurrence is probably much more common than is generally recognized. A case of bilateral posttraumatic middl...
Article
A woman of 27 yr was admitted with a seizure disorder. Subsequent evaluation revealed a left frontal tuberculomatous process which was cautiously biopsied but not removed surgically. The patient has done well on a regimen of antituberculous medicines and steroids. The case is reported to emphasize the possibility of tuberculomas of the central nerv...
Article
Ten patients who underwent operation for compression of spinal nerve roots by the ligamentum flavum were followed for five years. Seven patients were completely cured, and definite improvement resulted in three. Diagnosis was made on the basis of duration (5 to 25 years' back pain) and evidence of root compression. Myelography revealed a large post...
Article
A case of delayed paraplegia due to a traumatic arachnoid diverticulum from a traction injury of the brachial plexus is reported. The authors emphasize the necessity of carrying out proper radiological studies for evaluation of delayed weakness of the legs following trauma to the brachial plexus; by this means, a surgically correctable lesion can b...
Article
During the past nine years we have used experimentally and clinically various types of implantable electronic units to stimulate or block nerve impulses. Tissue tolerance and reliability have been excellent, but electronic design and production factors limited their versatility. Our recent studies, a part of the visual prosthesis program, revealed...
Article
✓ A case is presented in which kinking of the right internal carotid artery simulated an aneurysm in the neck. The patient was 5 years old. The lack of associated tortuosity of the internal carotid artery and the lateral projection of the kinking were unusual findings. When there are no associated neurological symptoms, conservative treatment of th...
Article
The surgical treatment of craniopharyngiomas is extremely difficult. Initial complete surgical removal is seldom accomplished, and a recurrent tumor can never be totally removed without severe endocrine, visual, or other serious residua. The craniopharyngioma is benign histologically, sellar and suprasellar in location, cystic in appearance, and it...
Article
Head injury in infants and young children may produce lesions that are relatively unique for this age group. The uniqueness is generally due to the structural immaturity of the skull, meninges and brain."Derby-hat" and diastatic fractures are common in this age group. Spurious meningoceles result from tearing of the dura which is closely adherent t...
Article
The procedure of hypophysectomy may offer some hope in metastatic carcinoma of the breast. Certainly further clinical trial is indicated. The anterior intracranial approach through the sphenoid sinus was used in eight cases. It offers a technically easier route by which to perform hypophysectomy. The immediate risk of operation does not appear to b...
Article
The jugular foramen transmits the glossopharyngeal, vagus, and spinal accessory nerves. Through this skull aperture also pass the transverse sinus, the inferior petrosal sinus, and meningeal branches from both the occipital and ascending pharyngeal arteries. With the slow encroachment usually found in those cases where this foramen is involved by n...
Article
Intractable pain in the neck and upper extremity is frequently radicular in character and mechanical in origin. Rupture of a cervical intervertebral disc is the most common cause. Diagnosis and localization are more difficult in the cervical than in the lumbar region. Pantopaque myelogram should be considered only as a mean of localization. Operati...

Citations

... The technique has been used to treat patients for over ten years but this potential for selectivity has never been realised for two main reasons ( Laws et al., 1981;McCulloch et al., 1984;Perria et al., 1981). Firstly it is now apparent that the normal brain is damaged by PDT and treatment parameters that do not damage normal brain have not yet been identified ( Berenbaum et al., 1986;Rounds et al., 1982;Cheng et al., 1984). Secondly, the problem of selectivity in the clinical situation of 'sterilising' a tumour bed following macroscopic tumour resection is compounded by the fact that infiltrating tumour tissue receives a lower light dose than normal brain on the surface. ...
... From the aspect of distribution of structural damage, we can classify the injury to focal or diffuse [12]. Focal brain injury is caused by the outside forces acting on the skull and resulting in compression of the tissue underneath the cranium at the site of the impact or the tissue opposite to the impact [13]. The location of the impact to the skull determines the cerebral pathology and neurological deficits. ...
... The bulk motion of the brain in response to impact has been well established in previous studies, whereby this motion of the brain lags that of the skull 2,3,19,20,30,43,46,47 . The addition of markers distributed throughout the brain provided us with further insights into the bulk and local displacements of the brain tissues. ...
... The use of ulnar VNGs to repair avulsion injuries to the median nerve are favoured in heavily scarred environments and when the ulnar nerve is not salvageable (1). While the restoration of protective sensation in the median nerve distribution has been consistently documented (1,2,(4)(5)(6)(7), the return of well-documented significant measurable improvements in median nerve motor function is variable (1,2,(4)(5)(6)(7)(8)(9)(10). Here, we report a case of segmental median and ulnar nerve loss, failed sural nerve graft reconstruction, and subsequently successful restoration of median nerve function using a pedicled ulnar VNG. ...
... In general, the first phase is cathodic (at the activating electrode) and is typically a rectangular pulse defined by the pulse duration (PD) and pulse amplitude. Charge per phase and charge density per phase of the cathodic activating pulse have been identified as primary factors in determining safe stimulus levels [19][20][21][22]. In general, charge densities in the range of 10-100 µC/cm 2 per phase are in the safe region for brain tissue, and even higher charge densities can be tolerated in the peripheral nervous system. ...
... Dans la plupart des cas il s'agit d'une pathologie idiopathique [5,6,7]. Les autres étiologies décrites sont : infectieuses principalement virales (maladie de Lymes, Herpes, HIV,…) d'où le syndrome grippal souvent décrit [8]. Les étiologies sont aussi inflammatoires (sarcoïdose), métaboliques (diabète), néoplasique et neurologiques [8]. ...
... It is suggested that intracerebral sarcomas may arise from the leptomeningeal sheath around blood vessels or from the vessel walls themselves [2]. PIOS can originate from the bone of the sellar region [9], brain parenchyma [6,10,11], or meninges [7]. ...
... Researchers have been studying therapeutic effects of neurostimulation with receiver technologies for over 40 years in order to identify the most beneficial therapies available [6]. Conventional SCS products have either a receiver or an implanted pulse generator (IPG) that can provide a stimulation waveform comprised of a certain amplitude, duration (pulse width), and frequency, resulting in tissue response and nerve innervation [7]. LF stimulation produces paresthesia that overlaps with a subject's pain in a specific area of the body [8]. ...
... Another reported a 53-year-old man who presented after a motor vehicle crash who had right hemiparesis and aphasia. 3 Angiography revealed bilateral MCA occlusions of unknown etiology. He improved to understand some simple words and was discharged to an extended care facility without further neurological improvement. ...
... Thereby the main lytic activity of LAK cells is mediated by CD3 − CD56 + NK cells, while the contribution of CD3 + CD56 − T cells is rather limited (52). The studies with LAK cells in glioma patients reported disease stabilization and partial or even complete responses in some of the patients, without encountering dose-limiting toxicities (53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63)(64). Despite activation with IL-2, LAK cells can still be inhibited by immunosuppressive molecules secreted or presented by GB cells (65), which may explain why, despite the observed clinical activity in some cases, responses after therapy with autologous LAK cells were not durable. ...