The interactive image-guided stereotactic system can provide a real-time surgical localization and guidance for complete removal of the tumor. However, this system has limitation with respect to the resection of deepseated tumors because once the tumor is removed, the brain and the margin of tumors shift toward the area previously occupied by the tumor. We present a new operative technique for determining the resection margin of deep-seated tumors using a visual marker called a 'tailed bullet' to overcome the problem mentioned above. Preoperative enhanced computed tomograms or magnetic resonance imagings were performed with the aid of the Leksell frame. The enhancing margin of the tumor was defined as a resection margin. Several points(10-15) of the tumor margin on the enhanced imaging were chosen and localized. After usual craniotomy, multiple tailed bullets were inserted into the target point just before the opening of the dura. As the tumor was removed, the brain began to move along with the tailed bullets, thus enable us to continue tracking the tumor margin by following the bullet's location. There are substantial benefits of this surgical technique. It can be easily applied to any kind of stereotactic frame without incurring other expenses and it is more cost-efficient than the neuronavigation system. This surgical procedure is also safe and simple to use for overcoming the limitation of neuronavigation system, since the movement of the bullets with the brain can be easily traced thus lowering the mortality and morbidity of brain tumor resection. This surgical technique is especially useful in glioma surgery.
Brain Neoplasms* ; Brain* ; Craniotomy ; Glioma ; Mortality ; Neuronavigation

Stereotaxic biopsy is an useful technique as an alternative to craniotomy for the tissue diagnosis of the intracranial tumors, especially such as deep seated tumor or malignant neoplasm in the dominant hemisphere. Such biopsy was more safe and lesser expensive than any other procedures and had high accuracy. For the purpose of more accuracy, the authors inserted small steel ball marker at the biopsy site and performed repeat C-T brain scanning immediately after the operation. We could confirm the marker in the tumor tissue on the C-T scans. The authors had experienced 4 cases of stereotaxic biopsy as follow; 2 cases of thalamic astrocytomas, 1 case of pineocytoma and 1 case of astrocytoma grade II in the dominant hemisphere. Neither mortality nor morbidity was noted.
Astrocytoma ; Biopsy* ; Brain Neoplasms* ; Brain* ; Craniotomy ; Diagnosis ; Mortality ; Pinealoma ; Steel

The authors have performed simple CT-guided free-hand tumor biopsy. CT images and C-arm fluroscopy were taken to determine the coordinates of the target point, which was the center of the tumorous CT findings. This CT-guide stereotaxic approach for biopsy of intracranial tumors have the following advantages: 1) The procedure is simple and safe. 2) The operation can be performed under local anesthesia. 3) The operation can be performed without stereotaxic frame. 4) Tissue biopsy was taken on various sites of tumors. The authors have performed 4 cases as follow: 3 cases of anaplastic astrocytoma, 1 case of metastatic tumor. Neither mortality nor morbidity was noted.
Anesthesia, Local ; Astrocytoma ; Biopsy* ; Brain Neoplasms* ; Brain* ; Mortality

The authors analyzed 50 children(below 15 years old) with intracranial tumors which were confirmed by operation during 5.5 years from Jan, 1983 to Jul. 1989 retrospectively. The results were as follows : 1) Incidence of pediatric brain tumors was 13.1% among the all intracranial tumors(383 cases). 2) Pediatric brain tumors were found most frequently between the age of six and thirteen years(74.0%), and the ratio of male to female was 1.6 : 1. 3) In respect of location, supratentorial and infratentorial tumors were seen in each 25 patients, and the tumor of central neural axis(58.0%) was more frequent than that of lateral portion(42.0%). 4) The most common tumor was astrocytoma(32.0%) in the supratentorium, and medulloblastoma(26.0%) in the infratentorium. 5) Headache and vomiting were the most common complaining symptoms and papilledema was the most common sign. 6) Hydrocephalus associated with tumors was 24.0% in supratentorium and 88.0% in infratentorium. 7) Postoperative mortality within 1 month was 12.0%.
Brain Neoplasms* ; Brain* ; Female ; Headache ; Humans ; Hydrocephalus ; Incidence ; Infratentorial Neoplasms ; Male ; Mortality ; Papilledema ; Retrospective Studies ; Vomiting

Fibromyalgia syndrome after comprehensive treatment of breast cancer is rare and seldom reported. Here we present a case of a 50-year-old female patient,who was admitted to the hospital because of generalized fibromyalgia for 3 months and brain metastasis after the right breast carcinoma surgery for 1 month, and the clinical diagnosis was brain metastasis from breast carcinoma combined with fibromyalgia syndrome. The fibromyalgia were relieved with proper symptomatic treatment but the patient eventually died of tumor progression.
Brain Neoplasms ; mortality ; secondary ; Breast Neoplasms ; complications ; mortality ; therapy ; Carcinoma ; mortality ; therapy ; Female ; Fibromyalgia ; diagnosis ; etiology ; therapy ; Humans ; Middle Aged

PURPOSE: Peritumoral brain edema (PTBE) is a serious causative factor that contributes the morbidity or mortality of brain tumors. The development of PTBE is influenced by many factors, including such tight junction proteins as occludin. We evaluated the PTBE volume and survival time with respect to the occludin expression in various pathological types of brain tumors. MATERIALS AND METHODS: Fresh-frozen specimens from sixty patients who had brain tumors were obtained during surgery and the tumors were confirmed pathologically. The occludin expression was investigated by Western blot analysis. The PTBE volume was measured by using preoperative magnetic resonance (MR) imaging, and the survival time in each patient was estimated retrospectively. RESULTS: Occludin was detected in 41 (68.3%) of the cases with brain tumors and it was not expressed in the other 19 (31.7%) cases. Although the lowest expression was revealed in high-grade gliomas, its expression was variable according to the pathology of the brain tumors (p>0.05). The difference of PTBE volume between occludin-positive and negative brain tumors was statistically significant (2072.46+/-328.73 mm3 vs. 7452.42+/-1504.19 mm3, respectively, p=0.002). The mean survival time was longer in the occludin-positive tumor group than in the occludin-negative group (38.63+/-1.57 months vs. 26.16+/-3.83 months, respectively; p=0.016). CONCLUSIONS: This study suggests that the occludin expression is highly correlated to the development of PTBE in brain tumors and it might be a prognostic indicator for patient survival.
Blotting, Western ; Brain Edema ; Brain Neoplasms* ; Brain* ; Edema* ; Glioma ; Humans ; Mortality ; Occludin* ; Pathology ; Retrospective Studies ; Survival Rate ; Tight Junction Proteins

Brain Neoplasms ; mortality ; secondary ; Ethmoid Sinus ; pathology ; Humans ; Male ; Middle Aged ; Nasal Cavity ; pathology ; Nose Neoplasms ; mortality ; pathology ; Paranasal Sinus Neoplasms ; mortality ; pathology

BACKGROUND: The purpose of this study is to compare the survival time of non-small cell lung cancer (NSCLC) patients with different organ metastasis. Among all cancers, the morbidity and mortality of lung cancer is the highest worldwide, which may caused by local recurrence and distant metastasis, and the location of metastasis may predict the prognosis of patients. METHODS: A total of 117,542 patients with NSCLC diagnosed between 2010 and 2014 were enrolled from Surveillance, Epidemiology, and End Result (SEER) databases, and the relationship between distant metastasis and survival time was retrospectively analyzed. RESULTS: Of all the 117,542 patients diagnosed with non-small cell lung cancer, 42,071 (35.8%) patients had different degrees of distant metastasis during their medical history, including 26,932 single organ metastases and 15,139 multiple organ metastases, accounting for 64.0% and 36.0% of the metastatic patients respectively. Compared with patients with no metastasis, whose median survival time was 21 months, the median survival time of patients with metastases was 7 months (lung), 6 months (brain), 5 months (bone), 4 months (liver), and 3 months (multiple organ) respectively, and the difference was significant (P<0.001, except liver vs multiple organ P=0.650); Most patients with NSCLC (88.4%) eventually died of lung cancer. CONCLUSIONS Distant metastasis of NSCLC patients indicates poor prognosis. In NSCLC patients with single organ metastasis, the prognosis of lung metastasis is the best, and liver metastasis is the worst, and multiple organ metastasis is worse than single organ metastasis.
Aged ; Aged, 80 and over ; Bone Neoplasms ; mortality ; secondary ; Brain Neoplasms ; mortality ; secondary ; Carcinoma, Non-Small-Cell Lung ; mortality ; pathology ; Female ; Humans ; Liver Neoplasms ; mortality ; secondary ; Lung Neoplasms ; mortality ; pathology ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Retrospective Studies

OBJECTIVE: The authors analyze the clinical characteristics of the geriatric brain tumors and suggest the treatment modality. METHODS: Patients older than 65years, managed between Jan 1980 and Feb 2002 in our department, were included in this study and the number of patients was 315. Age, sex, medical history, performance scale, treatment modality, morbidity and mortality as well as the incidence of brain tumor in this age group were analyzed. RESULTS: Geriatric brain tumors were comprised of 7.8% of the adult brain tumors. The mean age was 68.7 years and male to female ratio was 1 : 1.3. The most common one was meningioma(114, 36.2%), followed by metastatic tumor(49, 15.6%), high grade glioma(39, 12.4%), schwannoma(38, 12%) and pituitary adenoma(35, 10.5%) in the order of frequency. The incidence of pre-existing disease, such as hypertension(25%), caridiovascular disease(15%), diabetes melitus(12%) was high. Surgical outcome was good with acceptable operative morbidity and mortality rate 26% and 3% respectively. Frequent postoperative surgical complications were tumor bed bleeding and wound infection. During perioperative course, medical complications such as cardiovascular problem, delirium, pneumonia and sepsis were common. CONCLUSION: Incidence of combined medical problem in the geriatric patients was considerablly high. However, in the case of surgically accesible benign tumor or even malignant tumor, surgical treatment should be considered.
Adult ; Brain Neoplasms* ; Brain* ; Delirium ; Female ; Hemorrhage ; Humans ; Incidence ; Male ; Mortality ; Pneumonia ; Preexisting Condition Coverage ; Sepsis ; Wound Infection

The authors performed a clinical analysis of 80 cases of pediatric brain tumors which were verified by surgical operation during 10 years from Sept. 1978 to Aug. 1987 in the Department of Neurosurgery, Korea University, Seoul, Korea. These tumors were divided according to modified WHO classification. The results were as follows: 1) The male to female ratio was 1.42:1. 2) The most common pediatric brain tumor was gliomas(48.7%), and followed by medulloblastome(17.5%), germ cell tumor(7.5%), craniopharyngioma(6.2%), meningioma(5.0%). 3) Supratentorial tumors(57.5%) were more frequent than infratentorial tumors(42.5%). 4) Headache and vomiting were the most common presenting symptoms and papilledema was the most common sign. 5) Hydrocephalus was developed at supratentorial(58.7%) and infratentorial(73.5%) region. 6) Postoperative mortality was 7%.
Brain Neoplasms* ; Brain* ; Child* ; Classification ; Female ; Germ Cells ; Glioma ; Headache ; Humans ; Hydrocephalus ; Korea ; Male ; Mortality ; Neurosurgery ; Papilledema ; Seoul ; Vomiting