The ocurrence of complications after brain tumor surgery often lead to death. To decrease the incidence of complications, it is desirable to identify patients at risk as early as possible prior to surgery. It can be achieved by determining preoperatively those factors known to be of prognostic relevance in the development of such postoperative complications. The prognostic factors may be differ considerably depending on the population studied but the homogeneous population studied in this analysis may help to contribute to the reference guide in identifying those factors. Authors have retrospectively analysed the major complications developed after performing on 150 brain tumor surgeries during last five years to identify the prognostic factors.
Brain Neoplasms* ; Brain* ; Humans ; Incidence ; Postoperative Complications ; Retrospective Studies

BACKGROUND: Antihypertensive agents such as verapamil and esmolol are well known for their effects of hemodynamic stabilization on tracheal intubation. But hemodynamic discrepancies in these agents may result from different techniques of anesthetic induction. The aim of the present study was to compare and evaluate their efficacy in controlling hemodynamic responses to tracheal intubation under the different anesthetic induction agents. METHODS: Seventy-two patients, ASA physical status I or II, were randomly assigned to one of six groups (n = 12 each): a Thiopental-Saline (T-S) group and a Propofol-Saline (P-S) group in saline 10 ml; a Thiopental-Verapamil (T-V) group and a Propofol-Verapamil (P-V) group in verapamil 0.1 mg/kg; a Thiopental-Esmolol (T-E) group and a Propofol-Esmolol (P-E) group in esmolol 1 mg/kg according to the induction agents, thiopental or propofol. Anesthesia was induced with thiopental 5 mg/kg or propofol 2 mg/kg intravenous, respectively. Next, saline, verapamil and esmolol were administered as a bolus, and were immediately followed by succinylcholine 1.5 mg/kg. Tracheal intubation was carried out 60 s and 90 s after the intravenous injections of verapamil and esmolol, respectively. Systolic and diastolic blood pressure and heart rate were measured before induction and every minute for 5 minutes after tracheal intubation. RESULTS: There was a significant attenuation in systolic and diastolic arterial pressure after tracheal intubation in the verapamil groups compared to the esmolol groups. Heart rates were significantly lower in the esmolol groups than in the verapamil groups after tracheal intubation. CONCLUSIONS: Verapamil 0.1 mg/kg and esmolol 1 mg/kg attenuated increases in blood pressure and heart rate after tracheal intubation. The different anesthetic induction agents did not influence the hemodynamic effects of verapamil and esmolol on tracheal intubation.
Anesthesia ; Antihypertensive Agents ; Arterial Pressure ; Blood Pressure* ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Injections, Intravenous ; Intubation* ; Propofol ; Succinylcholine ; Thiopental ; Verapamil*

BACKGROUND: Antihypertensive agents such as verapamil and esmolol are well known for their effects of hemodynamic stabilization on tracheal intubation. But hemodynamic discrepancies in these agents may result from different techniques of anesthetic induction. The aim of the present study was to compare and evaluate their efficacy in controlling hemodynamic responses to tracheal intubation under the different anesthetic induction agents. METHODS: Seventy-two patients, ASA physical status I or II, were randomly assigned to one of six groups (n = 12 each): a Thiopental-Saline (T-S) group and a Propofol-Saline (P-S) group in saline 10 ml; a Thiopental-Verapamil (T-V) group and a Propofol-Verapamil (P-V) group in verapamil 0.1 mg/kg; a Thiopental-Esmolol (T-E) group and a Propofol-Esmolol (P-E) group in esmolol 1 mg/kg according to the induction agents, thiopental or propofol. Anesthesia was induced with thiopental 5 mg/kg or propofol 2 mg/kg intravenous, respectively. Next, saline, verapamil and esmolol were administered as a bolus, and were immediately followed by succinylcholine 1.5 mg/kg. Tracheal intubation was carried out 60 s and 90 s after the intravenous injections of verapamil and esmolol, respectively. Systolic and diastolic blood pressure and heart rate were measured before induction and every minute for 5 minutes after tracheal intubation. RESULTS: There was a significant attenuation in systolic and diastolic arterial pressure after tracheal intubation in the verapamil groups compared to the esmolol groups. Heart rates were significantly lower in the esmolol groups than in the verapamil groups after tracheal intubation. CONCLUSIONS: Verapamil 0.1 mg/kg and esmolol 1 mg/kg attenuated increases in blood pressure and heart rate after tracheal intubation. The different anesthetic induction agents did not influence the hemodynamic effects of verapamil and esmolol on tracheal intubation.
Anesthesia ; Antihypertensive Agents ; Arterial Pressure ; Blood Pressure* ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Injections, Intravenous ; Intubation* ; Propofol ; Succinylcholine ; Thiopental ; Verapamil*

Fractionation dose and number have been known as radiation factor affecting the radiation complication and the effectiveness in radiotherapy for brain tumors. In this study hyperfractionation technique with 115cGy/fractioin 2 fractions daily 5days/wk, upto 5750-6900cGy to partial brain volume was compared with conventional fractionation technique with daily 200cGy/fraction 5 fraction/wk, upto 5400-6000cGy, in regarding to the effectiveness of hyperfractionated radiotherapy and eraly and later radiation reavtion. The survival period was longer in hyperfractionated irradiated group particularly if the tumors were located in the posterior portion of brain, however there was no singificant statistics due to small number of patients. Mean survival period for glioblastoma multiforme was 11.8 months in hyperfractionated group vs 8.7 months in conventional fractionated group and for high grade astrocytoma 36month in hyperfractionated group, but in conventional fractionated group all was died in 18 months. Acute radiation reaction occurred less frequently in hyperfractionated group, 15.8% vs 47.8% in conventional fractionated group(p<0.024). Alopeci was developed in 31.6% of the hyperfractionated group vs 82.6% of the conventional fractionated group(p<0.0031). One case of later radiation necrosis in cancer region was suspected in the hyperfractionated group but we has been in a dilemma for confirmatory diagnosis in present available diagnostic technique. The hyperfractionated irradiation technique was proven to be superior to conventional fractionated technique regarding the radiation reaction and the effectiveness of the treatment.
Astrocytoma ; Brain ; Brain Neoplasms ; Diagnosis ; Glioblastoma ; Glioma* ; Humans ; Necrosis ; Radiotherapy*

PURPOSE: Skin prick test and determination of allergen-specific IgE antibodies in serum are methods commonly used to diagnose allergies. Several studies indicate that skin test and specific IgE have roughly the same diagnostic precision, although discrepancies exist. The objective of this study was to evaluate the influence of total serum IgE on the relation between skin prick test and allergen-specific IgE antibody. METHODS: We performed skin prick tests using 14 major inhalant allergens and measured total IgE and specific IgE for two major allergens [Dermatophagoides farinae(D.f.) and Dermatophagoides pteronyssinus (D.p.)] in serum of 230 children with atopic asthma. RESULTS: Positivity of skin prick test was 92.2% for D.f., 89.6% for D.p., and 22.6% for cockroach. Allergen/Histamine(A/H) ratio and allergen-specific IgE score showed a positive correlation for D.f.(r=0.39, P<0.01), and for D.p.(r=0.38, P<0.01). Total serum IgE and allergen-specific antibody score showed a positive correlation for D.f.(r=0.50, P<0.01), and for D.p.(r=0.53, P<0.01). There was no correlation between total serum IgE and A/H ratio on skin prick test for the two allergens. However, total serum IgE had the tendency to increase according to the number of positive allergens on skin prick test. At each level of A/H ratio for D.f. and D.p. on skin prick test, patients with high total IgE had higher antigen-specific IgE scores than patients with low total IgE. CONCLUSION: Our results show that the relationship between skin prick test and antigen-specific IgE was influenced by the level of serum total IgE. This indicates that the level of serum total IgE should be taken into account when skin prick test and allergen-specific IgE are compared.
Allergens ; Antibodies ; Asthma* ; Child* ; Cockroaches ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Skin Tests ; Skin*

OBJECTIVE: The oxidative stimuli activate NF-kappa B, which is a transcriptional factor inducing the expression of cyclooxygenase-2 (COX-2), an enzyme which involves in the rate-limiting step of prostaglandin (PG) synthesis. This study was performed to investigate whether vitamin C or caffeic acid phenethyl ester (CAPE) suppress COX-2 protein expression, PG synthesis, and NF-kappa B activity in human myometrium at term. METHODS: Human myometrial cells were cultured and stimulated with tumor necrosis factor-alpha (TNF-alpha), and also treated with TNF-alpha plus caffeic acid phenethyl ester, and TNF-alpha plus vitamin C. The expressions of COX-2 protein were assessed by western blot analyses. The activity of NF-kappa B was measured by luciferase assay. PGE2 production was determined by ELISA. RESULTS: The expression of COX-2 protein and the synthesis of PGE2 were promoted by TNF-alpha and peaked after 6 hours of exposure. CAPE and vitamin C significantly inhibited the TNF-alpha-dependent expression of COX-2 protein and the synthesis of PGE2. NF-kappa B activities were also suppressed by the addition of CAPE and vitamin C to TNF-alpha pre-stimulated cells. CONCLUSION: The antioxidants, CAPE and vitamin C, inhibited COX-2 expression, PGE2 synthesis and NF-kappa B activity in human myometrial cells. These results suggest that the antioxidant may play an inhibitory role in human labor.
Animals ; Antioxidants* ; Ascorbic Acid ; Blotting, Western ; Cyclooxygenase 2* ; Dinoprostone ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans* ; Luciferases ; Mice ; Myometrium* ; NF-kappa B ; Tumor Necrosis Factor-alpha

Pennig wrist fixator (Orthofix) is a dynamic external fixator which allows wrist motion in applied state in the treatment of distal radius fracture. The authors have treated unstable distal radius fracture with Orthofix external fixator and additional percutaneous K-wire fixation from January 1990 to June 1996. Among these cases, the authors analysed the clinical result of 40 cases which were available for follow-up for more than one year. The analysis was performed on the basis of the change of radiographic findings and modified Gartland & Werley criteria. The results were as follows; 1. According to Frykmann classification, 3 cases were Type I; 1 case, Type II; 4 cases, Type III; 2 cases, Type IV; 4 cases, Type V; 5 cases, Type VI; 20 cases, Type VII; 1 case, Type VIII. 2. We could get the improved values after operation as radial inclination 22.6degrees, radial length 10.7mm and volar tilt 8.8degrees. 3. There were little differences in value between at the immediate postoperative roentgenogram and at the last follow up one; radial inlclination decreased 1.2degrees, radial length shortened 2.5mm, volar tilt decreased 2.3degrees. 4. In 3 cases, the level of the ball joint of the fixator was not adjusted appropriately, so the initial satisfactory reduction was disrupted. 5. According to modified Gartland & Werley criteria, 34 cases (85%) were excellent and good. Pennig dynamic wrist fixator (Orthofix) allows the wrist motion earlier than the static external fixator without disturbing the initial reduction state, so it could be suggested as one of the good fixation devices for the treatment of the unstable distal radius fracture.
Classification ; External Fixators* ; Follow-Up Studies ; Joints ; Radius Fractures* ; Radius* ; Wrist

Two case of primary intracranial teratomas are presented. One case is right cerebellopontine angle malignant teratoma of 3years old female and the other case is left frontal benign teratoma of 40 years old male. We reviewed the literatures and discussed these cases in the point of the rare sites and pathological characteristic of teratoma.
Adult ; Cerebellopontine Angle ; Female ; Frontal Lobe ; Humans ; Male ; Pathology ; Teratoma*

Usnea longissima has a long history of use as a traditional medicine. Several bioactive compounds, primarily belonging to the polyketide family, have been isolated from U. longissima. However, the genes for the biosynthesis of these compounds are yet to be identified. In the present study, three different types of non-reducing polyketide synthases (UlPKS2, UlPKS4, and UlPKS6) were identified from a cultured lichen-forming fungus of U. longissima. Phylogenetic analysis of product template domains showed that UlPKS2 and UlPKS4 belong to group IV, which includes the non-reducing polyketide synthases with an methyltransferase (MeT) domain that are involved in methylorcinol-based compound synthesis; UlPKS6 was found to belong to group I, which includes the non-reducing polyketide synthases that synthesize single aromatic ring polyketides, such as orsellinic acid. Reverse transcriptase-PCR analysis demonstrated that UlPKS2 and UlPKS4 were upregulated by sucrose; UlPKS6 was downregulated by asparagine, glycine, and alanine.
Alanine ; Asparagine ; Fungi* ; Glycine ; Humans ; Medicine, Traditional ; Polyketide Synthases ; Polyketides ; Sucrose ; Usnea*

We experienced a malignant hyperthermia in 24-year-old male with sevoflurane during the mandibular prognathism surgery. The malignant hyperthermia emerged 150 minutes after induction of general anesthesia using propofol, rocuronium, sevoflurane, N2O and O2. Sevoflurane has been reported that it can induce delayed onset of malignant hyperthermia under absence of succinylcholine. The prognosis of malignant hyperthermia is determined by early recognition, vigorous treatment and the time of dantrolene injection. In our case, when we suspected episode, all anesthetics were stopped and dantrolene injection was immediately given intravenously. The patient recovered normal temperature and consciousness without any complication.
Anesthesia, General* ; Anesthetics ; Consciousness ; Dantrolene ; Humans ; Male ; Malignant Hyperthermia* ; Prognathism ; Prognosis ; Propofol ; Succinylcholine ; Young Adult