In general, meningiomas are slowly growing benign neoplasms originating from specialized meningothelial cells in arachnoid granulation, but have a tendency to be locally invasive and recurrent. Meningiomas very rarely metastasize outside the nervous system, occurring in less than 0.1%. We report the CT and MR findings of a case of a solitary benign syncytial meningioma showing recurrent multiple tumors and malignant progression with eventual bone metastasis to rib after six surgical extirpations during six years.
Arachnoid ; Meningioma* ; Neoplasm Metastasis* ; Nervous System ; Ribs

BACKGROUND: Propofol is useful agents for anesthesia induction and maintenance, but pain on injection and possible hypotension are a commonly encountered problems during induction. Meanwhile, ketamine has potent analgesic and sympathomimetic effect. Therefore, we evaluated the effect of ketamine pretreatment on injection pain and hemodynamic changes during induction with propofol. METHODS: Premedicated one hundred and twenty ASA physical status I or II patients scheduled for elective surgery were randomly allocated into one of four groups (group 1; propofol only, group 2, 3, 4; pretreatment with 25%, 50%, 75% dose of hypnotic ED50 of ketamine, respectively) groups. Intensity and frequency of injection pain, mean arterial pressure and pulse rate were checked for evaluation of ketamine pretreatment on injection pain and hemodynamic changes during induction with propofol. RESULTS: Incidence of pain on injection was significantly reduced in group 2,3 and 4 compared with group 1. Group 2 and 3 showed more stable hemodynamic changes than Group 1 and 4. CONCLUSIONS: 25-50% of hypnotic ED50 of ketamine (0.17-0.33 mg/kg) pretreatment reduced pain on injection and hemodynamic changes during propofol induction significantly.
Anesthesia* ; Arterial Pressure ; Heart Rate ; Hemodynamics* ; Humans ; Hypotension ; Incidence ; Ketamine* ; Propofol* ; Sympathomimetics

BACKGROUND: Both propofol and ketamine are useful hypnotics for induction of anesthesia, and the combination of propofol and ketamine has been used for total intravenous anesthesia. The aim of this study was to evaluate the dose response of propofol, ketamine and combination of these drug, and determine possible interaction between two drugs in patients. METHODS: The effect of ketamine on the dose response curve for propofol was studied in unpremedicated 165 ASA physical status I or II patients who were scheduled for elective operation. As an endpoint of hypnosis, ability to open eyes on verbal command was checked. Dose response curves for propofol and ketamine were determined with a probit procedure and their type of pharmacologic interaction was determined by fractional and isobolographic analysis. RESULTS: At the hypnotic endpoint, the ED50s were 1.13 mg/kg propofol, 0.66 mg/kg ketamine, and the ED95s were 1.67 mg/kg propofol, 1.09 mg/kg ketamine. The type of interaction between two drugs for hypnosis was found to be additive and ketamine was 1.7 times potent than propofol as an equieffective dose of hypnosis. CONCLUSIONS: The type of interaction between propofol and ketamine for hypnosis was additive.
Anesthesia* ; Anesthesia, Intravenous ; Humans ; Hypnosis ; Hypnotics and Sedatives ; Ketamine* ; Propofol*

The gene ftsH encodes a membrane-bound and ATP-dependent protease that is involved in a variety of cellular functions including heat-shock and stress response. Streptococcus pneumoniae DNA encompassing most part of the ftsH gene was cloned in Escherichia coli and sequenced. Due to the unsuccessful cloning as seen in other pneumococcal promoters, the 5'-end of the gene including the upstream promoter region was amplified by inverse polymerase chain reaction and then sequenced by cyclic sequencing. The amino acid sequence that is deduced from the 1,959 bp-long ftsH gene is very similar to FtsH of several gram-positive bacteria and E. coli within the region responsible for the AAA (ATPase associated with diverse cellular activities) function. Except for the N-terminal domain that contains a short extracellular region between two mernbrane-spanning segments, pneumococcal FtsH shows striking sequence similarity to that of a closely related species Lactococcus lactis within the conserved cytoplasmic domain where two ATP-binding motifs, the AAA Signature motif, and a zinc-binding motif are found.
Amino Acid Sequence ; ATP-Dependent Proteases ; Base Sequence* ; Clone Cells* ; Cloning, Organism* ; Cytoplasm ; DNA ; Escherichia coli ; Gram-Positive Bacteria ; Lactococcus lactis ; Polymerase Chain Reaction ; Promoter Regions, Genetic ; Streptococcus pneumoniae* ; Streptococcus* ; Strikes, Employee

We treated a case of extramammary Paget's disease that affected the scalp of a 45-year-old female. It is extremely rare that the disease arises in areas other than the anogenital region and the axillae. The lesion was a round erythematous oozing crusted hairless patch. Histopathologically, many pagetoid cells were found within the epidermis and dermis. The cytoplasms of these cells stained with alcian blue at pH 2.5, CEA, EMA and low-molecular-weight-cytokeratin. The patient underwent a wide local excision. We used a mapping technique to reveal the distribution of microscopically involved lesions.
Alcian Blue ; Axilla ; Cytoplasm ; Dermis ; Epidermis ; Female ; Humans ; Hydrogen-Ion Concentration ; Middle Aged ; Paget Disease, Extramammary* ; Scalp*

BACKGROUND: The prevalence of cancer pain was 64% in advanced or terminal cancer patients. In the world, about 25% of all cancer patients had been died without pain control despite of severe pain. We relieved cancer pain with the three methods of treatment such as continuous epidural morphine infusion, alcohol sympathetic block and continuous epidural morphine infusion with alcohol block in the patients requested from other departments. The change of pain was investigated retrospectively. METHODS: The alteration of cancer pain in 26 terminal cancer patients were recorded in visual analogue scale from June 1996 to May 1998 retrospectively. RESULTS: Patients lived average 38.5 days from beginning of pain control. All patients complained severe pain at the point of time requested to pain clinic. But 2 days after pain control, most patients were comfortable or tolerable to pain. At 1 week before death, pain were aggravated and sometimes uncontrolled. CONCLUSIONS: At first time, cancer pain was controlled but it becomes uncontrollable and aggravated in the patients time was drawing near.
Humans ; Morphine ; Pain Clinics ; Prevalence ; Retrospective Studies

BACKGROUND: Epidural morphine has been commonly used to provide postoperative pain relief, but it has many side effects such as nausea, vomiting, respiratory depression, and pruritus. The purpose of this study was to evaluate the analgesic efficacy and side effects by combination use of epidural morphine and butorphanol. METHODS: Forty five patients were randomly divided into 3 groups. For group I, a bolus of 4.7 ml of saline and 3 mg of morphine were administered. For group II, a bolus of 4.2 ml of saline and 3 mg of morphine and 1 mg of butorphanol were administered. For group III, a bolus of 3.2 ml of saline and 3 mg of morphine and 3 mg of butorphanol were administered. Continuous epidural analgesia were administered for all groups; group I (saline 99.4 ml and morphine 6 mg), group II (saline 98.4 ml, morphine 6 mg, and butorphanol 2 mg), group III (saline 96.4 ml, morphine 6 mg, and butorphanol 6 mg) by two day infuser, 2 ml/hr. We compared the side effects and analgesic effect of the three groups for 2 days. RESULTS: The incidence of pruritus, nausea and vomiting was reduced significantly in the group II and III, but the incidence of somnolence increased in the group III. There were no significant differences in analgesic effect and the other side effects among the three groups. CONCLUSION: Above results suggest that the addition of butorphanol to morphine in epidural infusion reduce the incidence of pruritus, nausea and vomiting, but increase the incidence of somnolence.
Analgesia* ; Analgesia, Epidural ; Anesthesia, Epidural* ; Butorphanol* ; Humans ; Incidence ; Morphine* ; Nausea ; Pain, Postoperative ; Pruritus ; Respiratory Insufficiency ; Vomiting

BACKGROUND: Epidural morphine has been commonly used to provide postoperative pain relief, but it has many side effects such as nausea, vomiting, respiratory depression, and pruritus. The purpose of this study was to evaluate the analgesic efficacy and side effects by combination use of epidural morphine and butorphanol. METHODS: Forty five patients were randomly divided into 3 groups. For group I, a bolus of 4.7 ml of saline and 3 mg of morphine were administered. For group II, a bolus of 4.2 ml of saline and 3 mg of morphine and 1 mg of butorphanol were administered. For group III, a bolus of 3.2 ml of saline and 3 mg of morphine and 3 mg of butorphanol were administered. Continuous epidural analgesia were administered for all groups; group I (saline 99.4 ml and morphine 6 mg), group II (saline 98.4 ml, morphine 6 mg, and butorphanol 2 mg), group III (saline 96.4 ml, morphine 6 mg, and butorphanol 6 mg) by two day infuser, 2 ml/hr. We compared the side effects and analgesic effect of the three groups for 2 days. RESULTS: The incidence of pruritus, nausea and vomiting was reduced significantly in the group II and III, but the incidence of somnolence increased in the group III. There were no significant differences in analgesic effect and the other side effects among the three groups. CONCLUSION: Above results suggest that the addition of butorphanol to morphine in epidural infusion reduce the incidence of pruritus, nausea and vomiting, but increase the incidence of somnolence.
Analgesia* ; Analgesia, Epidural ; Anesthesia, Epidural* ; Butorphanol* ; Humans ; Incidence ; Morphine* ; Nausea ; Pain, Postoperative ; Pruritus ; Respiratory Insufficiency ; Vomiting

The fruit body of Ramaria botrytis DGUM 29001 was used to determine enzyme activities of fruit body. The specific activity of laccase was the highest(6.5 unit/mg.protein) and that of alpha-amylase and xylanase was relatively high. However, little or no enzyme activity of beta-glucosidase, CMCase, exo-beta-1,4-glucanase, chitinase, lipase and protease was found.
alpha-Amylases ; beta-Glucosidase ; Botrytis* ; Chitinase ; Fruit* ; Glucan 1,4-beta-Glucosidase ; Laccase ; Lipase

The culture conditions for the enhanced mycelial growth of Ramaria botrytis was investigated. The optimal temperature and pH for the mycelial growth were 24degrees C and 5.0, respectively. It was shown that starch was best of several carbon sources in Czapek-Dox medium as a minimal medium for the enhanced mycelial growth. Organic nitrogen sources were better than inorganic ones for mycelial growth. The appropriate vitamin and mineral salt were biotin and FeCl3, respectively. When this strain was cultured with FeCl3 for 30 days, 19.23 g/l of dry mycelium of R. botrytis was obtained.
Biotin ; Botrytis* ; Carbon ; Cultural Characteristics* ; Hydrogen-Ion Concentration ; Mycelium ; Nitrogen ; Starch ; Vitamins