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Editorial: What is important?
Ono et al: Suprasellar Embryonal Carcinoma
~0. 31. 32. 33. 34. 35. 36. 37. 38.
NH, Riishede J: Alpha-fetoprotein and human chorionic gonadotropin in a patient with a primary intracranial germ cell tumor. Cancer 41:2315-2320, 1978 Prioleau G, WilsonCB: Endodermalsinus tumor ofthe pinealregion. Case report. Cancer 38:2489-2493, 1976 Rubinstein LJ: Tumors of the central nervous system, in Atlas of Tumor Pathology. Washington DC: Armed Forces Institute of Pathology, 1972, Fasc 6 Russell DS: The pinealoma; its relationships to teratoma. J Pathol Bacteriol 56:145-150, 1944 Sakata K, Yamada H, Sakai N, Hosono Y, Kawasako T, Sasaoka I: Extraneural metastasis of pineal tumor. Surg Neurol 3:49-54, 1975 Sampi K, Hayashi Y, Tari K, Takeuchi S, Machida T, Miki M, Yanagisawa M: Phase 1 study of cis-diamminedichloroplatinum(11). Gan To Kagakuryoho 8:1909-1916, 1981 Scully RE, McNeely BU: Case records of the Massachusetts General Hospital: case 41-1974. N Engl J Med 291:837-843, 1974 Shinomiya Y, Toya S, Iwata T, Hoscxia Y: Radioimmunoassay of alpha-fetoprotein in children with primary intracranial tumors. Childs Brain 5:450-458, 1979 Takei Y, Mirra SS, Miles ML: Primary intracranial yolk sac tumor: report of 3 cases and an ultrastmctural study (abstract). J Neuropathol Exp Neurol 36:633, 1977 Takeuchi J, Handa H, Oda Y, Uchida Y: Alpha-fetoprotein in intracranial malignant teratoma. Surg Neurol 12:400-404, 1979
443
39. Takeuchi J, Hirai O, Konishi T, Gi S, Watanabe H, Handa H, Ohta T, Nishimura S: Value of blood AFP and HCG levels in the diagnosis of intracranial germ cell tumors. Neurol Med Chir (Tokyo) 20:1197-1202, 1980 40. Tanaka R, Takeda N, Ueki K, Itoh J, Handa H: Computerized tomography in the diagnosis and management of pineal region tumors. Neurol Med Chir (Tokyo) 20:1103 1114, 1980 41. Tavcar D, Robboy SJ, Chapman P: End(xiemlal sinus tumor of the pineal region. Cancer 45:2646-2651, 1980 42. Teilum G: Classification of endodennal sinus tumor (mesoblastoma vitellinum) and so-called "embryonal carcinoma" of the ovary. Acta Pathol Microbiol Scand 64:407-429, 1965 43. Tsuchida Y, Saito S, lshida M, Ohmi K, Urano Y, Endo Y, Oda T: Yolk sac tumor (en&vlermal sinus tumor) and a[pha-fetoprotein. A report of three cases. Cancer 32:917 92 I, 1973 44. Ueki K, Tanaka R: Treatments and prognosis of pineal tumors. Experience of 110 cases. Neurol Med Chir (Tokyo) 20:1-26, 1980 45. Ventureyra ECG: Pineal region: surgical management of tumours and vascular malformations. Surg Neurol 16:77 84, 1981 46. Wood JH, Zimmerman RA, Bruce I)A, Bil;iniuk LT, Norris LY,3, Schut L: Assessment and management of pineal-region and related tumors. Surg Neurol 16:192-210, 1981 47. Yo~hikiT, ltoh T, Shirai T, Noro T, Tomino Y, Hamajima I, Takeda T: Primary intracranial yolk sac tumor. Immunofluorescent demonstration of alpha-fetoprotein synthesis. Cancer 37:2343-2348, 1976
Editorial: What Is Important? A t a t i m e w h e n neurosurgeons find t h e m s e l v e s c o n f r o n t e d by an ever-increasing n u m b e r of malpractice lawsuits, w h e n they h e a r rumblings of increasing g o v e r n m e n t a l interfere n c e in the practice of m e d i c i n e and c o m e to fear that some ill-informed bureaucrat will dictate more and more what they can do and what they c a n n o t do, it is n o t surprising if some of us lose sight of w h a t is truly i m p o r t a n t . T h i s we must not do. T o do so will only bring greater criticism u p o n us. O u r most i m p o r t a n t responsibility is to give the best possible care to our patients with the greatest possible compassion. Neurosurgery is growing and improving. In order to give the best possible care we must keep abreast of the advances being made. W e must also m a k e every effort to see t h a t advances c o n t i n u e to be made. It is not possible for each of us to be i n v o l v e d in making these advances, but we must ensure that those w h o h a v e the ability and desire to do research are supported in their endeavors, are encouraged, and are given t h e necessary training and facilities to do so. H o w can e a c h of us do this? O u r first responsibility is to
our patients. W e must also strive to c o n t i n u e our o w n education. T o do this we must read and understand reports of what is being done. W e must attend neurosurgical meetings and c o n t i n u i n g educational courses. W e must support the Research F o u n d a t i o n of the A m e r i c a n A s s o c i a t i o n of N e u r o l o g i c a l Surgeons with our own funds. W e must all h a v e a sufficient i n c o m e to support ourselves and our families and to travel and a t t e n d meetings and courses that will e x p a n d our knowledge. T h i s is seldom a p r o b l e m W h e n we spend t o o m u c h t i m e and c o n c e r n ourselves too m u c h with e c o n o m i c matters, we give the general public the impression t h a t we are more c o n c e r n e d with m o n e y t h a n with patient care. T h i s must be avoided. W e may n e v e r regain the respect, admiration, and affection which the family doctor o n c e enjoyed, but we can try. T h a t is " W h a t Is I m p o r t a n t . "
Paul C. Bucy, M . D . , Editor
~0. 31. 32. 33. 34. 35. 36. 37. 38.
NH, Riishede J: Alpha-fetoprotein and human chorionic gonadotropin in a patient with a primary intracranial germ cell tumor. Cancer 41:2315-2320, 1978 Prioleau G, WilsonCB: Endodermalsinus tumor ofthe pinealregion. Case report. Cancer 38:2489-2493, 1976 Rubinstein LJ: Tumors of the central nervous system, in Atlas of Tumor Pathology. Washington DC: Armed Forces Institute of Pathology, 1972, Fasc 6 Russell DS: The pinealoma; its relationships to teratoma. J Pathol Bacteriol 56:145-150, 1944 Sakata K, Yamada H, Sakai N, Hosono Y, Kawasako T, Sasaoka I: Extraneural metastasis of pineal tumor. Surg Neurol 3:49-54, 1975 Sampi K, Hayashi Y, Tari K, Takeuchi S, Machida T, Miki M, Yanagisawa M: Phase 1 study of cis-diamminedichloroplatinum(11). Gan To Kagakuryoho 8:1909-1916, 1981 Scully RE, McNeely BU: Case records of the Massachusetts General Hospital: case 41-1974. N Engl J Med 291:837-843, 1974 Shinomiya Y, Toya S, Iwata T, Hoscxia Y: Radioimmunoassay of alpha-fetoprotein in children with primary intracranial tumors. Childs Brain 5:450-458, 1979 Takei Y, Mirra SS, Miles ML: Primary intracranial yolk sac tumor: report of 3 cases and an ultrastmctural study (abstract). J Neuropathol Exp Neurol 36:633, 1977 Takeuchi J, Handa H, Oda Y, Uchida Y: Alpha-fetoprotein in intracranial malignant teratoma. Surg Neurol 12:400-404, 1979
443
39. Takeuchi J, Hirai O, Konishi T, Gi S, Watanabe H, Handa H, Ohta T, Nishimura S: Value of blood AFP and HCG levels in the diagnosis of intracranial germ cell tumors. Neurol Med Chir (Tokyo) 20:1197-1202, 1980 40. Tanaka R, Takeda N, Ueki K, Itoh J, Handa H: Computerized tomography in the diagnosis and management of pineal region tumors. Neurol Med Chir (Tokyo) 20:1103 1114, 1980 41. Tavcar D, Robboy SJ, Chapman P: End(xiemlal sinus tumor of the pineal region. Cancer 45:2646-2651, 1980 42. Teilum G: Classification of endodennal sinus tumor (mesoblastoma vitellinum) and so-called "embryonal carcinoma" of the ovary. Acta Pathol Microbiol Scand 64:407-429, 1965 43. Tsuchida Y, Saito S, lshida M, Ohmi K, Urano Y, Endo Y, Oda T: Yolk sac tumor (en&vlermal sinus tumor) and a[pha-fetoprotein. A report of three cases. Cancer 32:917 92 I, 1973 44. Ueki K, Tanaka R: Treatments and prognosis of pineal tumors. Experience of 110 cases. Neurol Med Chir (Tokyo) 20:1-26, 1980 45. Ventureyra ECG: Pineal region: surgical management of tumours and vascular malformations. Surg Neurol 16:77 84, 1981 46. Wood JH, Zimmerman RA, Bruce I)A, Bil;iniuk LT, Norris LY,3, Schut L: Assessment and management of pineal-region and related tumors. Surg Neurol 16:192-210, 1981 47. Yo~hikiT, ltoh T, Shirai T, Noro T, Tomino Y, Hamajima I, Takeda T: Primary intracranial yolk sac tumor. Immunofluorescent demonstration of alpha-fetoprotein synthesis. Cancer 37:2343-2348, 1976
Editorial: What Is Important? A t a t i m e w h e n neurosurgeons find t h e m s e l v e s c o n f r o n t e d by an ever-increasing n u m b e r of malpractice lawsuits, w h e n they h e a r rumblings of increasing g o v e r n m e n t a l interfere n c e in the practice of m e d i c i n e and c o m e to fear that some ill-informed bureaucrat will dictate more and more what they can do and what they c a n n o t do, it is n o t surprising if some of us lose sight of w h a t is truly i m p o r t a n t . T h i s we must not do. T o do so will only bring greater criticism u p o n us. O u r most i m p o r t a n t responsibility is to give the best possible care to our patients with the greatest possible compassion. Neurosurgery is growing and improving. In order to give the best possible care we must keep abreast of the advances being made. W e must also m a k e every effort to see t h a t advances c o n t i n u e to be made. It is not possible for each of us to be i n v o l v e d in making these advances, but we must ensure that those w h o h a v e the ability and desire to do research are supported in their endeavors, are encouraged, and are given t h e necessary training and facilities to do so. H o w can e a c h of us do this? O u r first responsibility is to
our patients. W e must also strive to c o n t i n u e our o w n education. T o do this we must read and understand reports of what is being done. W e must attend neurosurgical meetings and c o n t i n u i n g educational courses. W e must support the Research F o u n d a t i o n of the A m e r i c a n A s s o c i a t i o n of N e u r o l o g i c a l Surgeons with our own funds. W e must all h a v e a sufficient i n c o m e to support ourselves and our families and to travel and a t t e n d meetings and courses that will e x p a n d our knowledge. T h i s is seldom a p r o b l e m W h e n we spend t o o m u c h t i m e and c o n c e r n ourselves too m u c h with e c o n o m i c matters, we give the general public the impression t h a t we are more c o n c e r n e d with m o n e y t h a n with patient care. T h i s must be avoided. W e may n e v e r regain the respect, admiration, and affection which the family doctor o n c e enjoyed, but we can try. T h a t is " W h a t Is I m p o r t a n t . "
Paul C. Bucy, M . D . , Editor