OBJECTIVE: Prognostic factors of metastatic brain tumors have been widely reported and their operative indications also have been extended gradually even to the poor grade patients. Authors intended to analyze the causative factors for the clinical outcome of metastatic brain tumors, especially with relevant to the poor prognosis by one year follow-up evaluation. PATIENTS AND METHODS: The authors retrospectively studied the clinical characteristics of 46 cases(35 patients) with metastatic brain tumors among 466 cases(437 patients) which were operated on due to the brain tumor, during the period between January 1994 to June 1999. Statistical analysis was performed by using SPSS 8.0(r). A p-value of less than 0.05 was considered clinically significant. RESULT: Among the variable clinical factors in patients with metastatic brain tumors, Karnofsky Performance Scale (KPS) score of less than 70(16 patients), uncontrolled primary tumor(8 patients), and surgical resection without further adjuvant therapy(9 patients) showed statistically significant poor prognosis; p value of 0.002, 0.032, and 0.001, respectively. Other tested variables, such as old age(greater than 65 years; 10 patients), gender(male; 20 patients), type of primary cancer(primary undefined; 6 patients, lung cancer; 15 patients), location(infratentorial; 9 patients, sellar; 5 patients), number of lesion(multiple; 12 patients), and number of operation(multiple craniotomy; 7 patients) were not related to the poor prognosis. CONCLUSIONS: The most common primary site of distant metastasis was lung. The poorer prognosis was highly correlated with various factors including low KPS score(<70), no postoperative adjuvant therapy, and uncontrolled primary tumors.
Brain Neoplasms* ; Brain* ; Craniotomy ; Follow-Up Studies* ; Humans ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Prognosis* ; Retrospective Studies

No abstract available.
Aneurysm*

No abstract available.
Aneurysm*

No abstract available.
Arteries* ; Intracranial Aneurysm*

No abstract available.
Silicones*

OBJECTIVES: Recently, it was reported that microsurgical fenestration of the lamina terminalis (LT) may reduce the incidence of shunt-dependent hydrocephalus in aneurysmal SAH. The authors investigated the efficacy of the LT opening on the incidence of shunt-dependent hydrocephalus especially in the ruptured anterior communicating artery (ACoA) aneurysms. METHODS: The data of 71 ruptured ACoA aneurysm patients who underwent aneurysmal clipping in acute stage were reviewed retrospectively. The patients were divided into two groups according to the use of intraoperative microsurgical opening of the LT. Group I (n=36) included the patients with microsurgical fenestration of LT during routine pterional approach, Group II (n=35) consisted of patients in whom microsurgical fenestration of LT was not feasible. The rate of shunt-dependent hydrocephalus was compared between two groups by logistic regression to control for confounding factor. RESULTS: Ventriculo-peritoneal shunts were performed after aneurysmal obliteration in 18 (25.4%) patients. Overall conversion rates from acute hydrocephalus on admission to chronic hydrocephalus in each group were 29.6% (Group I) and 58.8% (Group II), respectively. There was no significant correlation between the microsurgical fenestration and the rate of occurrence of shunt-dependent hydrocephalus (p>0.05). CONCLUSION: Although this study cannot provide a definitive answer, the microsurgical fenestration of LT can play a negative role for reducing the incidence of chronic hydrocephalus. Surgeons should carefully decide the concomitant use of LT fenestration during surgery for the ruptured ACoA aneurysms.
Aneurysm ; Arteries ; Humans ; Hydrocephalus* ; Hypothalamus* ; Incidence ; Intracranial Aneurysm* ; Logistic Models ; Retrospective Studies ; Subarachnoid Hemorrhage* ; Ventriculoperitoneal Shunt

A cross-sectional study was conducted to investigate the prevalence and risk factors for symptoms associated with sick building syndrome in four office buildings located in Seoul. Information on personal factors, job-related factors, and medical history were collected using self-administered questionnaires modified from the National Institute for Occupational Safety and Health Indoor Air Quality questionnaire in 321 office workers in these buildings. The prevalence of general and irritant symptom groups was higher than the prevalence of dermatologic and respiratory symptom groups. Daily total work time, work time in the office, and work time with video display terminals(VDT) were identified as the risk factors for symptom groups associated with sick building syndrome by multiple linear logistic regression analysis. In conclusion, these results indicated that the symptom prevalence in this study is similar with the results reported from previous studies conducted in other countries and work time and work with VDT are related to sick building syndrome in Korea.
Air Pollution, Indoor ; Cross-Sectional Studies ; Humans ; Korea ; Logistic Models ; National Institute for Occupational Safety and Health (U.S.) ; Prevalence ; Surveys and Questionnaires ; Risk Factors ; Seoul ; Sick Building Syndrome*

OBJECTIVE: In this preliminary report, the authors investigated whether apoptosis is affected by p53 and/or Bcl-2 in the surgical specimens of the human brain tumors. METHODS: During the period from July 1998 to December 1999, seventy-six cases of surgically resected human brain tumors(meningioma 16, pituitary adenoma 13, glioblastoma 11, metastatic brain tumor 11, vestibular schwannoma 9, astrocytoma 8, anaplastic astrocytoma 6, and pineoblastoma 2) were studied. Apoptosis of the specimens was detected by DNA fragmentation analysis. Bcl-2 and p53 expression was analyzed by Western blot analysis. RESULTS: Apoptosis was found in 16 tumors(21.1%), and Bcl-2 and p53 proteins were expressed in 18(23.7%) and 14(18.4%) tumors, respectively. Among 60 tumors with negative apoptosis, only 8 cases expressed p53(13.3%). Concerning the relationship between p53, Bcl-2 and apoptosis, the influence of Bcl-2 on p53 and apoptosis was not statistically significant(p=0.239). Among three groups of positive p53 expression, sole p53(+) group and combined with and without Bcl-2(+) groups, no significant difference of apoptosis induction was found(p=0.125). p53 seemed to play a more dominant role in the induction of apoptosis than Bcl-2. In 18 tumors with positive Bcl-2 expression, 16 cases(88.9%) did not show apoptosis and p53 expression was detected in 2 cases. Two cases which had Bcl-2 gene with apoptosis showed p53 expression. In our study, p53 was capable of inducing apoptosis despite the presence of Bcl-2 expression (p=0.028). CONCLUSION: Apoptosis seemed not to be affected by Bcl-2 and the anti-apoptotic property of the Bcl-2 appeared to be attenuated by p53. Therefore, the use of p53 gene transfer to enhance the induction of apoptosis might be a potential treatment for human brain tumors irrespective of Bcl-2 expression.
Apoptosis* ; Astrocytoma ; Blotting, Western ; Brain Neoplasms* ; Brain* ; DNA Fragmentation ; Genes, bcl-2 ; Genes, p53 ; Glioblastoma ; Humans* ; Neuroma, Acoustic ; Pinealoma ; Pituitary Neoplasms

OBJECTIVE: In this preliminary report, the authors investigated whether apoptosis is affected by p53 and/or Bcl-2 in the surgical specimens of the human brain tumors. METHODS: During the period from July 1998 to December 1999, seventy-six cases of surgically resected human brain tumors(meningioma 16, pituitary adenoma 13, glioblastoma 11, metastatic brain tumor 11, vestibular schwannoma 9, astrocytoma 8, anaplastic astrocytoma 6, and pineoblastoma 2) were studied. Apoptosis of the specimens was detected by DNA fragmentation analysis. Bcl-2 and p53 expression was analyzed by Western blot analysis. RESULTS: Apoptosis was found in 16 tumors(21.1%), and Bcl-2 and p53 proteins were expressed in 18(23.7%) and 14(18.4%) tumors, respectively. Among 60 tumors with negative apoptosis, only 8 cases expressed p53(13.3%). Concerning the relationship between p53, Bcl-2 and apoptosis, the influence of Bcl-2 on p53 and apoptosis was not statistically significant(p=0.239). Among three groups of positive p53 expression, sole p53(+) group and combined with and without Bcl-2(+) groups, no significant difference of apoptosis induction was found(p=0.125). p53 seemed to play a more dominant role in the induction of apoptosis than Bcl-2. In 18 tumors with positive Bcl-2 expression, 16 cases(88.9%) did not show apoptosis and p53 expression was detected in 2 cases. Two cases which had Bcl-2 gene with apoptosis showed p53 expression. In our study, p53 was capable of inducing apoptosis despite the presence of Bcl-2 expression (p=0.028). CONCLUSION: Apoptosis seemed not to be affected by Bcl-2 and the anti-apoptotic property of the Bcl-2 appeared to be attenuated by p53. Therefore, the use of p53 gene transfer to enhance the induction of apoptosis might be a potential treatment for human brain tumors irrespective of Bcl-2 expression.
Apoptosis* ; Astrocytoma ; Blotting, Western ; Brain Neoplasms* ; Brain* ; DNA Fragmentation ; Genes, bcl-2 ; Genes, p53 ; Glioblastoma ; Humans* ; Neuroma, Acoustic ; Pinealoma ; Pituitary Neoplasms

No abstract available.