No abstract available.
Humans* ; Interleukin-10*

No abstract available.
Twins, Conjoined*

We evaluated the renal function could be estimated by the visual analysis of the perfusion images of Tc-99m DTPA renal scan. Renal scan, creatinine clearance(CCr) and serum creatinine(s-Cr) were obtained in 105 patients. Intensity of renal activity(RA) at 6 sec perfusion image after the first visualization of abdominal aortic activity(A or A) was considered as the parameter for estimating renal function. Intensity of RA was scored from grade(Gr.) 1 to 3(Gr. 1: RAsplenic activity(SA), Gr. 2: RA A or A, Gr. 3: RA60 mL/min. The P.P.V. of Gr. 2 RA was 92% for s-Cr from 1.5 to less than 3.5mg/dL and 83% for CCr value from 20 to less than 60mL/min. The P.P.V. of Gr. 3 RA was 95% for s-Cr3.5mg/dL and 95% for CCr<20mL/min. As the intensity of RA of perfusion images decreased, renal function more decreased. We could detect renal dysfunction by visual analysis of perfusion images of renal scan.
Creatinine ; Humans ; Pentetic Acid* ; Perfusion*

BACKGROUND: External ventricular drainage (EVD) is an important procedure for draining excessive cerebrospinal fluid (CSF) and monitoring intracranial pressure. Generally, EVD is performed in the operating room (OR) under aseptic conditions. However, in emergency circumstances, the operation may be performed in the intensive care unit (ICU) to save neuro-critical time and to avoid the unnecessary transfer of patients. In this study, we retrospectively analyzed the risk of EVD-induced CNS infections and their outcomes according to the operating place (ICU versus OR). In addition, we compared mortalities as well as hospital and ICU days between the CNS infection and non-CNS infection groups. METHODS: We reviewed medical records, laboratory data and radiographic images of patients who had received EVD operations between January, 2013 and March, 2015. RESULTS: A total of 75 patients (45 men and 30 women, mean age: 58.7 +/- 15.6 years) were enrolled in this study. An average of 1.4 catheters were used for each patient and the mean period of the indwelling catheter was 7.5 +/- 5.0 days. Twenty-six patients were included in the ICU group, and EVD-induced CNS infection had occurred in 3 (11.5%) patients. For the OR group, forty-nine patients were included and EVD-induced CNS infection had occurred in 7 (14.3%) patients. The EVD-induced CNS infection of the ICU group did not increase above that of the OR group. The ICU days and mortality rate were higher in the CNS infection group compared to the non-CNS infection group. The period of the indwelling EVD catheter and the number of inserted EVD catheters were both higher in the CNS infection group. CONCLUSIONS: If the aseptic protocols and barrier precautions are strictly kept, EVD in the ICU does not have a higher risk of CNS infections compared to the OR. In addition, EVD in the ICU can decrease the hospital and ICU days by saving neuro-critical time and avoiding the unnecessary transfer of patients. Therefore, when neurosurgeons decide upon the operating place for EVD, they should consider the benefits of ICU operation and be cautious of EVD-induced CNS infection.
Catheter-Related Infections ; Catheters ; Catheters, Indwelling ; Cerebrospinal Fluid ; Drainage* ; Emergencies ; Female ; Humans ; Intensive Care Units* ; Critical Care* ; Intracranial Pressure ; Male ; Medical Records ; Mortality ; Operating Rooms* ; Retrospective Studies ; Ventriculostomy

Air can be used as a carrier for volatile agent, ether, with a clear airway, normal pulmonary function and normal oxygenation. In 1858 John Snow, the Father of British Anesthesia stated in his book on Chloroform and Other Anesthetics that he believed it to be almost impossible for death to occur from ether administered with ordinary intelligence and attention. Today ether is probably still the safest anesthetic drug we possess. Ether is cheap and easily obtained; with controlled respiration 3% is adequate. Recovery smooth and rapid. Vomiting may be no different from other agents. Most machines depend upon cylinders of oxygen and other gases, and there are difficulties of refilling cylinders and the cost of transporting them. In such circumstances the E.M.O. Inhaler, allowing ether to be vaporized in known concentrations in air, has many advantages as an alternative to the open method administration. From all types of patients chosen at random 22 patients were studied for ether-air anesthesia. Anesthesia was induced with intravenous thiopental and subsequent endotracheal intubation was performed within 30 seconds with the aid of intravenous succinylcholine. SatO2, PaO2, pH, and Base E. were measured 3 times during pre-anesthesia, immediately after the intubation, and post-operatively by Radiometer, using the oxy-hemoglobin dissociation curve and the Siggard-Anderson alignment nomogram. Vital signs were recorded every 5 minutes. It is the purpose of this paper to present this series of 22 anesthetics by the use of the E.M.O. Inhaler with air and to discuss the possibility of hypoxia, advantages and limitations that became apparent. The results obtained may be summarized as follows. 1. It is essential that endotracheal intubation by carried out rapidly and that everything necessary be ready and immediately at hand before starting the anesthetic. 2. In all patients ventilated room air during anesthetic induction, no significant decreases of PaO2 and SatO2 were observed immediately after the endotracheal intubation. 3. The duration of any period of complete apnea inflicted on the patient must be carefully controlled. 4. 100% oxygen prevented the possibility of hypoxia on extubation after all the reflexes had returned. 5. Ether-air anesthesia is recommended without hesitation for use where economy and portability of anesthetic machine are needed.
Anesthesia* ; Anesthetics ; Anoxia ; Apnea ; Chloroform ; Ether ; Fathers ; Gases ; Hand ; Humans ; Hydrogen-Ion Concentration ; Intelligence ; Intubation ; Intubation, Intratracheal ; Nebulizers and Vaporizers ; Nomograms ; Oxygen ; Reflex ; Respiration ; Snow ; Succinylcholine ; Thiopental ; Vital Signs ; Vomiting

No abstract available.
Skin Neoplasms* ; Skin*

Calvarium protects the brain, the most important organ. The defect of calvarium results in not only deformity but also fatal injury from the trauma. The cranial bone defects result from 1) removal of bone flap for intracranial decompression or infection 2) fracture 3) excision of tumor 4) craniectomy for craniosynostosis. The goals of cranioplasty are to protect the brain from trauma and make the aesthetically acceptable contour. From 1990 to 1995, we experienced twelve cases of cranioplasty using autogenous bone graft; 5 cases with rib bone, 3 cases with iliac bone, 2 cases with calvarial bone, and 2 cases with rib and calvarial bones. The result was very excellent without any significant complications.
Brain ; Congenital Abnormalities ; Craniosynostoses ; Decompression ; Ribs ; Skull ; Transplants*

No abstract available.
Dilatation, Pathologic*

No abstract available.
Anaphylaxis* ; Histamine Release* ; Histamine* ; Mast Cells*

BACKGROUND: Recent genome-wide sequencing studies have identified unexpected genetic alterations in cancer. In particular, missense mutations in isocitrate dehydrogenase-1 (IDH1) at arginine 132, mostly substituted into histidine (IDH1-R132H) were observed to frequently occur in glioma patients. METHODS: We have purified recombinant IDH1 and IDH1-R132H proteins and monitored their catalytic activities. In parallel experiments, we have attempted to find new selective IDH1-R132H chemical inhibitor(s) from a fragment-based chemical library. RESULTS: We have found that IDH1, but not IDH1-R132H, can catalyze the conversion of isocitrate into alpha-ketoglutarate (alpha-KG). In addition, we have observed that IDH1-R132H was more efficient than IDH1 in converting alpha-KG into (R)-2-hydroxyglutarate (R-2HG). Moreover, we have identified a new hit molecule, e.g., 2-(3-trifluoromethylphenyl)isothioazol-3(2H)-one as a new selective IDH1-R132H inhibitor. CONCLUSIONS: We have observed an underlying biochemical mechanism explaining how a heterozygous IDH1 mutation contributes to the generation of R-2HG and increases cellular histone H3 trimethylation levels. We have also identified a novel selective IDH1-R132H chemical hit molecule, e.g., 2-(3-trifluoromethylphenyl)isothioazol-3(2H)-one, which could be used for a future lead development against IDH1-R132H.
Arginine ; Glioma ; Histidine ; Histones ; Humans ; Mutation, Missense