THE WORD "BREAKTHROUGH" is rearing its head again. This year, it has popped up in descriptions of a radical treatment for Parkinson's disease: the transplantation of tissue from the adrenal medulla to the right caudate nucleus of the brain (Associated Press, 4/16/87).
Its evocation is inspired by early reports indicating that the first patients to undergo the procedure on this continent have demonstrated a marked improvement in neurological function. Nonetheless, the surgeons who have performed the procedure caution that neither the mechanism of action nor the long-term effects of the grafts have been identified. Moreover, two graft recipients have died unexpectedly within two months of surgery.
The publication by surgeons at the Universidad Nacional Autonoma de Mexico, Mexico City, of favorable results in two patients (N Engl J Med 1987;316:831-834) appears to have stimulated activity among surgeons in the United States. On April 9 and 21, similar operations were performed