We investigated the electrophysiological changes in the cerebral cortical evoked potentials(CEP's) and subsequent changes in the regional cerebral blood flow(rCBF) following increased intracranial pressure(ICP) in cats. A small balloon connected to a fine polyethylene tube was placed on the epidural space of the left parietal region through a small burr hole and inflated with saline in increment of 0.2 ml to simulate the expanding mass. The ICP was maintained at 150 mmH2O and 250 mmH2O levels during the experimental period. The study was conducted with 30 adult cats, weighing between 2.7 and 4.5kg. The animals were anesthetized with pentobarbital (50mg/kg) intraperitonially and tracheostomy was performed to maintain self respiration. Two small burr holes were made on both frontal regions for rCBF measurement and a small burr hole was made on the right primary sensorimotor cortex for a cerebral cortical stimulating electrode. A recording electrode for CEP's was placed on the dura of the left cerebellar hemisphere. For experiments, animals were divided into 3 groups. Group I:Animals(n=10) with 80mmH2O of ICP, Group II:Animals(n=10) with 150 mmH2O of ICP, Group III:Animals(n=10) with 250mmH2O of ICP. The CEP's and rCBF measurements were carried out in each animal before and immediately after increased ICP(IICP), at the 30th min, 60th min, 90th min, 120th min, 150th min and 180th min after IICP. The rCBF was measured by hydrogen clearance method. The results were as follows ; 1. A significant elevation of the systolic blood pressure was observed after the 60th min in both IICP groups. 2. 1) Group II animals showed a significant reduction of rCBF by 10.5% and 39.5% in the right frontal lobe at the 60th min and 180th min after IICP, and by 19.8% and 57.7% in the left frontal lobe at the 60th min and 180th min after IICP, respectively. 2) Group III animals showed also a significant reduction of rCBF by 18.2% and 54.4% in the right frontal lobe at the 60th min and 180th min after IICP, and by 62.9% and 84.7% in the left frontal lobe at the 60th min and 180th min after IICP, respectively. 3) Reductions of the rCBF of the left frontal lobe in the Group III animals were greater than those of the Group II animals. 3. 1) Changes of amplitude and latency in the CEP's were more prominent in the Group III animals than those of the Group II animals. 2) Changes of the late components of CEP's(N2) might represent derangements of the neural activity of the descending reticular formation in brainstem. 4. A close correlation was found between CEP's and rCBF changes, which suggested being a threshold relationship. In conclusion, it is assumed that the detection of CEP's in the cerebellum is a quite valuable prognostic tool to evaluate the neural activity of the non-specific reticular formation and specific somatosensory pathways in the acute intracranial hypertension. The prolongated latencies and suppressed amplitude in the CEP's indicate the presence of damages in brainstem multisynaptic pathways.
Adult ; Animals ; Blood Pressure ; Brain Stem ; Cats ; Cerebellum ; Electrodes ; Epidural Space ; Frontal Lobe ; Humans ; Hydrogen ; Intracranial Hypertension ; Intracranial Pressure* ; Pentobarbital ; Polyethylene ; Rabeprazole ; Respiration ; Reticular Formation ; Tracheostomy

This study surveyed and measured the level and structure of cancer deaths and their trends over time for offering the fundamental data of the cancer prevention and control in Pusan city in the future. Authors conducted the study of descriptive epidemiology using materials derived from the computerized data of total 3,722 certified cancer deaths in Pusan city from January 1 to December 31, 1993 registered on the National Statistical Office, the Republic of Korea. The obtained results were as follows: 1. According to the total registered cases of deaths(16,331 cases) in Pusan city during 1993, cancer(3,722 cases) and cerebrovascular disease(2,718 cases) were the first and second cause of deaths as 23.1% and 16.9%, respectively. These pattern showed the change between cancer(14.7%) and cerebrovascular disease(18.5%) in order of frequency in comparison to 1982. Also, the total number of cancer deaths was increased in comparison to 1982. The rate of death certification by physicians was 87.1% of all registered deaths, which was increased to 6.8% in comparison to 1982(80.3%). 2. Crude death rate and cancer specific death rate was 4.06 per 1,000 populations and 93.8 per 100,000 populations(male:117.8, female:70.0), respectively. The former was similar to that of 1982, but the latter was increased to 1.6 times as that of 1982. 3. Age-adjusted cancer specific death rate by standardization with whole country population was 111.9(male:141.5, female:106.7) per 100,000 populations, higher than not age-adjusted cancer specific death rate(93.8), and the sex difference was statistically significant with male predominance(p<0.05). 4. Cancer specific death rate by age was generally increased with age and most of cancer deaths(male:91.8%, female:88.5%) occurred since 40 years old. 5. The major cancer(cancer specific death rate per 100,000 populations) in male was liver(30.6) followed by stomach(25.6), lung(21.9), and GB and EHBD(5.7), in female stomach(15.7), liver(9.9), lung(7.3), and uterus(6.9). The relative frequency of the leading three cancer among total cancer deaths marked 66.3% in male and 47.1% in female, and decreased in comparison to 1982(male:72.2%, female:54.5%). 6. The total ratio of male to female cancer specific death rate showed 1.68 to 1 with male predominance. And the ratio was above 2.0 in larynx, oral cavity & pharynx, esophagus, liver, lung, bladder cancer and the ratio was 1.0~1.9 in stomach, pancreas, gall bladder and EHBD, brain, rectum and anus cancer, leukemia, but the ratio was reversed in thyroid and colon cancer. In conclusion, cancer was the first cause of deaths. The proportion of lung cancer was increased, that of stomach & uterine cancer was decreased relatively, and liver cancer was constantly higher proportion. In the future, it is necessary to conduct the further investigations on the cancer risk factors considering areal specificity.
Adult ; Anus Neoplasms ; Brain ; Busan* ; Cause of Death ; Certification ; Colonic Neoplasms ; Epidemiologic Studies* ; Epidemiology ; Esophagus ; Female ; Humans ; Larynx ; Leukemia ; Liver ; Liver Neoplasms ; Lung ; Lung Neoplasms ; Male ; Mortality ; Mouth ; Pancreas ; Pharynx ; Rectum ; Republic of Korea ; Risk Factors ; Sensitivity and Specificity ; Sex Characteristics ; Stomach ; Thyroid Gland ; Urinary Bladder ; Urinary Bladder Neoplasms ; Uterine Neoplasms

In this study, we have investigated the dose characteristics of PTW-LinaCheck designed to detect output of medical LINAC and discussed clinical use of the detector. The reproducibility, linearity, and dose rate dependency of the dosimeter were measured for photons of 6 and 15 MV and the electrons of 4, 6, 9, 12, and 16 MeV. To know the error ranges of the measured data in daily output measurement, the response variations due to geometrical setup errors were measured. As a result of measurement, the error range from the geometrical setup and the reproducibility was less than +/-0.6% for given beam qualities in daily output measurement, where the errors from the linearity and the dose rate dependency were negligible. Finally, we concluded that the LinaCheck dosimeter has a good characteristics in terms of dose and setup convenience in daily output measurement. In addition we have shown an examples of clinical use of this dosimeter for measuring daily output more than 60 days.
Dependency (Psychology) ; Electrons ; Photons

No abstract available.
Carcinoma, Endometrioid* ; Uterus*

The use of brain retractors, unavoidable method in operation of deep intracranial lesions, may lead to focal cerebral ischemia and thereby cause brain infarction. In such operation, the surgical microscope is commonly used to get good surgical field. However, as the time of operation becomes lengthened, it results in longer retraction of the brain and probable greater ischemic infarction. To estimate the risk of ischemic damage, the authors investigated the regional cerebral blood flow(rCBF) and the electroencephalographic(EEG) activity at different forces and durations of the brain retraction in the cat models simulating the frontal approach of the pituitary surgery. Twenty-six adult cats weighing from 2.4 to 4.5 kg were used in this study. The animals were divided into 3 groups : control(n=6), 20g-retraction(n=10), and 30g-retraction groups(n=10) respectively. The brain retraction was produced by applying the lead weight with the stainless steel retractor on the right frontal lobe through a craniectomy over the right frontal bone. The weight(20g or 30g) was supported with the pulley so that its long axis was perpendicular to the cortical surface, The measurements of rCBF activity were carried out in each animal before and immediately after brain retraction at 30 min, 60 min, 90 min, 120 min and 180 min after retraction. The results were as follows ; 1) After brain retraction, there were rise in intracranial pressure, bradycardia, elevation in blood pressure and alteration in respiration at 60 min after brain retraction. 2) Normal control flows(rCBF, ml/100g/min) were 39.7+/-6.1 in the right frontal, 37.8+/-2.6 in the left frontal, 37.5+/-3.6 in the right parietal and 38.8+/-4.1 in the left parietal lobes. 3) A considerable reduction in rCBF was demonstrated at 60 min after brain retraction. A reduction of rCBF to 40% of control flow(19.5+/-7.5ml/100g/min) was found at 60 min after retraction in the right frontal with the 20g-retractor. With the 30g-retractor, rCBF were reduced to 64% of control flow(13.3+/-6.8ml/100g/min) at 60 min and 90% of control flow(4.0+/-2.1 ml/100g/min) at 180 min after retraction in the right frontal lobe. 4) A close correlation was found between EEG activity and rCBF changes, suggesting a threshold relationship. The changes of EEG activity began to be noted at the rCBF value of less than 20.0 ml/100g/min. A 50% suppression of the EEG activity appeared at the rCBF value of 4.0+/-1.2 ml/100g/min. It is concluded that EEG activity is secondarily is secondarily suppressed by reduction in local blood flow which is caused by local compression. It is advisable to retract the brain with the least force necessary and for the shortest time possible. It is also suggested to resect the brain partially before retraction to avoid irreversible ischemic infarction of the brain in consequence of forceful, longtime retraction in exploration of deep intracranial lesions.
Adult ; Animals ; Axis, Cervical Vertebra ; Blood Pressure ; Bradycardia ; Brain Infarction ; Brain Ischemia ; Brain* ; Cats* ; Electroencephalography ; Frontal Bone ; Frontal Lobe ; Humans ; Infarction ; Intracranial Pressure ; Parietal Lobe ; Rabeprazole ; Respiration ; Stainless Steel

Retraction of any part of the brain may damage the cortex as well as the parenchyma, so it is advisable to retract the brain with the least force necessary and for the shortest time as possible. The purpose of this study was to examine in cats the damage caused by retraction of the brain by measuring the regional blood flow and brain edema, and to determine which of two methods, continuous or intermittent brain retraction, is less harmful to the brain. Twenty five adult cats weighting 2.5 to 4.0Kg, were used in this study. The twenty five cats were divided into three groups ; control (n=5), continuous retraction (n=10) and intermittent retraction groups (n=10) respectively. The brain retraction was produced by applying the lead weight with the stainless retractor on the right frontal lobe through a craniectomy at the right frontal bone. The weight (20g) was supported throught the pulley so that its long axis was perpendicular to the cortical surface. In the continuous retraction group, the brain was retracted for 180 min with a retraction force of 20g and in the intermittent retraction group, a 15 min period of retraction was applied, followed by a 5 min release, repeated nine times. The regional cerebral blood flow (rCBF) and brain specific gravity measurements were carried out in each animal before and immediately after brain retraction, at the 30th min, 60th min, 90th min, 120th min, 150th min and 180th min after retraction. The rCBF was measured by hydrogen clearance method and the brain edema was measured by gravimetric technique. The results were as follows : 1) After the brain retraction, there were rise in blood pressure and bradycardia in 60 min. 2) Normal control cerebral blood flow (rCBF, ml/100g/min) were 38.7+/-1.9 in right frontal, 38.7+/-1.7 in left frontal, 38.6+/-2.3 in right parietal and 38.2+/-2,3 in left parietal lobes. 3) A considerable reduction in rCBF at the retraction site, has been demonstrated with continuous brain retraction in 60 min after retraction. A reduction in rCBF to 30% of control (RF ; 28.2+/-2.1ml/100g/min) in 180 min after continuous retraction of the right frontal lobe, however, intermittent retraction resulted in a reduction of flow to 12% of control(RF ; 37.5+/-2.9ml/100g/min) at retraction site in 180 min after retraction. 4) The changes of brain specific gravity relatively began to notice at rCBF less than 23.0ml/100g/min. It might be inferred from these that intermittent retraction was less harmful to the brain, which indicate adequate arterial blood flow under the retractor was vital for the preservation and return of the neuronal function following brain retraction.
Adult ; Animals ; Axis, Cervical Vertebra ; Blood Pressure ; Bradycardia ; Brain Edema* ; Brain* ; Cats ; Frontal Bone ; Frontal Lobe ; Humans ; Hydrogen ; Neurons ; Parietal Lobe ; Rabeprazole ; Regional Blood Flow ; Specific Gravity

It was already reported in else where that a standard linear accelerator, with only slight modification can function in a manner similar to Leksell's Gamma unit device in the treatment of inoperable deep seated intracranial lesions. Using collimated narrow beams, a localization system and special computer programs for precise patient positioning and a high concentration of irradiation dose within the lesions, eleven patients with AVMs and brain tumor have now been treated since 1988. The 6 MeV linear accelerator and Hitchcock stereotactic frame was used of the all procedures. In 10 of the 11 patients, no side effects occurred. The first 7 patients, who could be observed 3 months or longer have been studied radiologically and clinically. In 6 patients marked decrease in contrast enhancement and sometimes dramatic clinical improvement was achieved. In one case a marked increase of the surrounding brain edema occurred 7days after radiosurgery, who was operated on. The radiantion dose was based on the volume, location and radiosensitivity of the lesion which ranged 15-40 Gy.
Brain Edema ; Brain Neoplasms ; Humans ; Particle Accelerators* ; Patient Positioning ; Radiation Tolerance ; Radiosurgery*

PURPOSE: Complex clinical information in cerebral angiointervention unit requires effective management of statistical analysis for the classification of diagnosis and intervention including follow-up data from the interventional treatment. We present an application of Microsoft Access program for the management of patient data in cerebral angiointervention unit which suggests practical methods in recording and analyzing the patient data. MATERIALS AND METHODS: Since January 2002, patient information from cerebral angiointervention was managed by a database with over 4000 patients. We designed a program which incorporates six items; Table, Query, Form, Report, Page and Macro. Patient data, follow-up data and information regarding diagnosis and intervention were established in the Form section, related by serial number, and connected to each other to an independent Table. Problems in running the program were corrected by establishing Entity Relationship (ER) diagrams of Tables to define relationships between Tables. Convenient Queries, Forms and Reports were created to display expected information were applied from selected Tables. RESULTS: The relationship program which incorporated six items conveniently provided the number of cases per year, incidence of disease, lesion site, and case analysis based on interventional treatment. We were able to follow the patients after the interventional procedures by creating queries and reports. Lists of disease and patients files were identified easily each time by the Macro function. In addition, product names, size and characteristics of materials used were indexed and easily available. CONCLUSION: Microsoft Access program is effective in the management of patient data in cerebral angiointervention unit. Accumulation of large amounts of complex data handled by multiple users may require client/sever solutions such as a Microsoft SQL Server.
Classification ; Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Running ; Statistics as Topic

Testicular teratoma is characterized that has more than one germ cell layer in various stages of maturation and differentiation. The incidence of mature teratoma varies from 2 to 9% of all germinal testicular tumor. Only 3 cases of bilateral teratoma have been reported in the literature to date. The teratoma can occurs at all ages but is most common between the age of 15-35 year. It is relatively infrequently seen in childhood and infancy. In these age group, teratoma tends to be a benign. Recently, we experienced one case of bilateral testicular teratoma in 4 month-old infancy. We report a case of bilateral testicular teratoma found infancy with review of related literatures.
Germ Cells ; Humans ; Incidence ; Infant* ; Teratoma* ; Testis

The aim of the present study has been to examine the effect of mannitol on regional cerebral blood flow(rCBF) and brain edema both at normal and increased intracranial pressure and to determine which of two infusion methods, rapid infusion or slow infusion of mannitol, has better effect on brain compression. Thirty five adult cats weighting between 2.7 and 4.2 kg were used in this study. The animals were divided into four groups: Mannitol administered normal control(n=5), brain compression(n=10), rapid mannitol treated-brain compression(n=10) and slow mannitol treated-brain compression groups(n=10) respectively. A small balloon connected to a fine polyethylene tube was placed in the epidural space of the right frontal region through a small burr hole and inflated with on ml of distilled water in increment of 0.2 ml to simulate the expanding mass. The measurements of rCBF and electroencephalography(EEG) activity were carried out in each animal. Mannitol was given in bolus of 1g/kg body weight via the femoral vein and two methods of mannitol infusion were used as rapid infusion which was infused the mannitol within 3 min and slow infusion, infused within 15min. The rCBF was measured by hydrogen clearance method and the brain edema was measured by gravimetric technique. In brain compression group, the ICP rose immediately following brain compression to 133.00+/-9.49 mmH2O from 78.00+/-11.35 mmH2O and maintained the elevation during the experiment. Treatment with mannitol in brain compression animals, decreased the ICP at 5 min after infusion of mannitol, and the decreased ICP was maintained for one hour. Brain compression animals showed a significant reduction of rCBF by 38% and 46% in right parietal lobe at the 60 min and 120 min after brain compression, respectively. In mannitol treated brain compression animals, the administration of mannitol made the reduced rCBF increase to baseline value at 30 min after treatment and the increased rCBF value was maintained for one hour. There was generalized brain edema, as judged by a decreased specific gravity in the brain compression, which was maximal close to the brain compression site. The severity of the brain edema was less in the mannitol treated brain compression group than in brain compression group. This study demonstrated that there was no significant different effects between rapid and slow infusion of mannitol in brain compression.
Adult ; Animals ; Body Weight ; Brain Edema* ; Brain* ; Cats* ; Epidural Space ; Femoral Vein ; Humans ; Hydrogen ; Intracranial Pressure ; Mannitol* ; Parietal Lobe ; Polyethylene ; Specific Gravity ; Water