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대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회> 대한뇌종양학회지> 임상 : 악성 뇌교종의 유전자 검사 : 방사선학적 특징과 예후와의 관계

임상 : 악성 뇌교종의 유전자 검사 : 방사선학적 특징과 예후와의 관계

Chromosomal Karyotype of Malignant Gliomas : Its Relationship with Radiological Features and Prognosis

유재원 ( Jae Won Yu ) , 김영준 ( Young Zoon Kim ) , 송영진 ( Young Jin Song ) , 김대철 ( Dae Cheol Kim ) , 한진영 ( Jin Yeong Han ) , 김기욱 ( Ki Uk Kim )
  • : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회
  • : 대한뇌종양학회지 11권2호
  • : 연속간행물
  • : 2012년 09월
  • : 88-95(8pages)

DOI


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Objectives:Numerous genetic alterations are related to tumorigenesis and influence the radiological features of malignant glial tumor. We performed a cytogenetic analysis from a fresh tumor specimen and analyzed its relationship with radiological features and prognosis. Materials and Methods:Among the 29 patients with malignant glial tumor involved in cytogenetic analysis, 19 cases showing chromosomal abnormality were analyzed. Cytogenetic analysis was performed with pathologically proven fresh surgical specimen. Both medical records and radiological findings were reviewed to define the tumor, to evaluate peritumoral edema and to assess treatment results. Results:The most frequent genetic abnormality was observed in chromosome 7 (57.8 %). Complex karyotype presenting three or more abnormalities was noted in 11 cases (57.8 %). Chromosomal abnormalities, noted in more than three cases, were whole loss of Y (7 cases), whole gain of 7 (6 cases), whole gain of 2, whole gain of 5, whole gain of 12, 19q gain, 6p loss, 9p loss, and whole gain of 13 (3 cases). We reported that loss of chromosome 7 related to MDR-1 (Multidrug resistant gene) were correlated with good response of chemotherapy. Conclusions:A chromosomal analysis of malignant glioma can be perfomed to discover tumorigenic factors and to evaluate radiological features. Results of karyotyping is closely related to the clinical outcome and may be utilized in developing new therapeutic modalities.

UCI(KEPA)

I410-ECN-0102-2015-500-000240715

간행물정보

  • : 의약학분야  > 신경외과학
  • :
  • :
  • : 반년간
  • : 1598-530x
  • :
  • : 학술지
  • : 연속간행물
  • : 2002-2012
  • : 269


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1임상 : 내시경을 사용한 경비적 경접형동 수술에서의 뇌척수액 유출 예방에 대한 고찰

저자 : 박준상 ( Jun Sang Park ) , 강석구 ( Seok Gu Kang ) , 홍용길 ( Yong Gil Hong ) , 전신수 ( Sin Soo Jeun )

발행기관 : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 간행물 : 대한뇌종양학회지 11권 2호 발행 연도 : 2012 페이지 : pp. 77-82 (6 pages)

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Objectives:The endoscopic endonasal transsphenoidal approach (EETSA) is increasingly being used to treat pituitary adenomas and other sellar/suprasellar pathologies. One important complication of the transsphenoidal approach is cerebrospinal fluid (CSF) leakage, which occurs in 0.4 to 9% of cases. We report our experience with EETSA and describe the me-thods that we use to prevent CSF leakage. Methods:A single surgeon performed EETSA on 170 consecutive patients between Feb 2004 and Apr 2011. Patients were divided into three groups based on their CSF leakage status as follows: no CSF leakage, minor CSF leakage, and major CSF leakage. Sellar floor reconstruction was performed according to this classification. In the no-CSF leakage group, sellar floor reconstruction was performed with oxidative cellulose (Surgicel®) only. In the second group (minor CSF leakage), sellar floor reconstruction was performed using autologous fat and bone grafts. Patients in the third group (major CSF leakage) underwent an additional reconstructive procedure of the skull base using the pedicled septal mucosal flap. Results:Of 170 patients, 30 (17.6%) showed CSF leakage in the operation field ; 24 (14.1%) were classified as having minor CSF leakage and 6 (3.5%) patients were classified as having major CSF leakage. Post-operative CSF leakage occurred in only two cases. Conclusion:CSF leakage, though relatively common in the operation field, can be prevented effectively with adequate reconstruction techniques. Assignment of patients to one of three groups based on their CSF leakage in the operation field and sellar floor reconstruction based on this classification resulted in favorable postoperative outcomes.

2임상 : 원발성 신경교육종에 대한 단일기관의 임상성적

저자 : 변준호 ( Joon Ho Byun ) , 윤정호 ( Jung Ho Yun ) , 조영현 ( Young Hyun Cho ) , 김정훈 ( Jeong Hoon Kim ) , 김창진 ( Chang Jin Kim )

발행기관 : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 간행물 : 대한뇌종양학회지 11권 2호 발행 연도 : 2012 페이지 : pp. 83-87 (5 pages)

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Objectives:Primary gliosarcoma (GSM) is a rare central nervous system tumor with few reports described in the literature. Here, we present our clinical experience and the outcome of primary GSM patients in a single medical center. Method:Primary GSM patients who were treated at our institution between 1990 and 2011 were selected retrospectively. All patients were analyzed by meticulous chart review including clinical and pathologic data. Overall survival was analyzed by Kaplan-Meier survival analysis. Results:Eleven patients were diagnosed with primary GSM. It was 1.7% of glioblastoma (GBM) during the same period. The overall median survival of the 11 patients was 12 months (range : 3 to 177 months). Patients who underwent maximal safe resection had a prolonged median survival compared to those who only underwent biopsy of the tumor (12 vs. 6 months, p=0.288). All patients received adjuvant postoperative radiotherapy and 7 of 11 patients received chemotherapy with temozolomide. Four patients received gamma-knife radiosurgery for local recurrence; however, treatment method by gamma-knife radiosurgery was not significantly associated with prolonged survival in this study. Patients who received re-explorative surgery for resectable recurred tumors had a prolonged median survival compared to those who had non-resectable recurred tumors (14 vs. 6 months, p=0.0082). Conclusion:We present 11 primary GSM patients who were treated according to the standard treatment for GBM. Despite aggressive multimodality treatment, the life expectancy of GSM is very short until now. Therefore, large and comprehensive clinical investigations are needed to establish the standard treatment for primary GSM.

3임상 : 악성 뇌교종의 유전자 검사 : 방사선학적 특징과 예후와의 관계

저자 : 유재원 ( Jae Won Yu ) , 김영준 ( Young Zoon Kim ) , 송영진 ( Young Jin Song ) , 김대철 ( Dae Cheol Kim ) , 한진영 ( Jin Yeong Han ) , 김기욱 ( Ki Uk Kim )

발행기관 : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 간행물 : 대한뇌종양학회지 11권 2호 발행 연도 : 2012 페이지 : pp. 88-95 (8 pages)

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Objectives:Numerous genetic alterations are related to tumorigenesis and influence the radiological features of malignant glial tumor. We performed a cytogenetic analysis from a fresh tumor specimen and analyzed its relationship with radiological features and prognosis. Materials and Methods:Among the 29 patients with malignant glial tumor involved in cytogenetic analysis, 19 cases showing chromosomal abnormality were analyzed. Cytogenetic analysis was performed with pathologically proven fresh surgical specimen. Both medical records and radiological findings were reviewed to define the tumor, to evaluate peritumoral edema and to assess treatment results. Results:The most frequent genetic abnormality was observed in chromosome 7 (57.8 %). Complex karyotype presenting three or more abnormalities was noted in 11 cases (57.8 %). Chromosomal abnormalities, noted in more than three cases, were whole loss of Y (7 cases), whole gain of 7 (6 cases), whole gain of 2, whole gain of 5, whole gain of 12, 19q gain, 6p loss, 9p loss, and whole gain of 13 (3 cases). We reported that loss of chromosome 7 related to MDR-1 (Multidrug resistant gene) were correlated with good response of chemotherapy. Conclusions:A chromosomal analysis of malignant glioma can be perfomed to discover tumorigenic factors and to evaluate radiological features. Results of karyotyping is closely related to the clinical outcome and may be utilized in developing new therapeutic modalities.

4임상 : 경접형동 접근에 의한 뇌하수체 선종 제거술 후 발생한 지연성 저나트륨혈증 : 임상 연구

저자 : 김정재 ( Jung Jae Kim ) , 김선호 ( Sun Ho Kim ) , 김의현 ( Eui Hyun Kim )

발행기관 : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 간행물 : 대한뇌종양학회지 11권 2호 발행 연도 : 2012 페이지 : pp. 96-101 (6 pages)

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Objective:Delayed hyponatremia is a common complication after transsphenoidal surgery (TSS) for pituitary adenomas. We retrospectively evaluated our patients and tried to find possible associated risk factors of delayed hyponatremia. Methods:From 2006 until 2010, total 575 cases of pituitary adenomas were operated with TSS in a single institution. Thirty-one patients (5.3%) with delayed hyponatremia were compared to other 544 patients without delayed hyponatremia in the aspects of age, sex, Hardy classification, tumor size, hormonal type and activity on preoperative combined pituitary function test. Their postoperative outcomes were also evaluated in the aspects of tumor removal fashion and hormonal outcome on postoperative combined pituitary function test. Results:In 31 patients, delayed hyponatremia started 7.0 days after surgery (range : postoperative day 3-10). At the time of diagnosis of hyponatremia, serum level of sodium ranged from 111 mmol/L to 132 mmol/L (mean : 120.5 mmol/L) and mean duration of treatment was 4.l days (range : 2-9 days). Piecemeal tumor removal was more frequent in a group with delayed hyponatremia (p=0.035). The presence of postoperative hypopituitarism and aggravation of pituitary function were observed more frequently in a group with delayed hyponatremia (p=0.002 and p=0.017, respectively). Conclusion:Delayed hyponatremia is a common complication after TSS and potentially fatal. Piecemeal fashioned tumor removal, postoperative hypopituitarism and aggravation of pituitary function are associated with higher chance of delayed hyponatremia.

5임상 : 뇌실질 전이가 있는 비소세포성 폐암 환자에서의 연수막 전이 빈도 및 예후 인자

저자 : 나영철 ( Young Cheol Na ) , 김지희 ( Ji Hee Kim ) , 김창환 ( Chang Hwan Kim ) , 장원석 ( Won Seok Chang ) , 장진우 ( Jin Woo Chang ) , 박용구 ( Yong Gou Park )

발행기관 : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 간행물 : 대한뇌종양학회지 11권 2호 발행 연도 : 2012 페이지 : pp. 102-107 (6 pages)

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Objectives:The object of this study is to evaluate the incidence, survival and the prognostic factors in patients with leptomeningeal metastasis from non-small cell lung cancer. Methods:The study included fifty-five consecutive patients diagnosed with brain parenchymal metastasis on magnetic resonance image (MRI) clinically from non-small cell lung cancer between July 2010 and February 2011. All the patients underwent lumbar puncture for cerebrospinal fluid examination including cytology examination with cytokeratine immunostain. If the patients showed positive in cerebrospinal cytology or leptomeningeal enhancement on T1 weighted gadolinium enhanced MRI, whole spine MRI with gadolinium enhancement was also taken for evaluation of spinal disease. For evaluation of prognostic factors, we investigated the patient's age, interval from the time of diagnosis of systemic disease to the time of diagnosis of leptomeningeal metastasis, interval from the time of diagnosis of parenchymal metastasis to the time of diagnosis of leptomeningeal metastasis, performance status of the patients, and following treatment modality after diagnosis of leptomeningeal metastasis. Result:In eleven (20%) of the fifty-five patients, the diagnosis of leptomeningeal metastasis was made on the basis of MRI findings and the results from cerebrospinal fluid cytology. Among those eleven patients, eight (72.7%) had positive cerebrospinal fluid cytology at the time of initial examination. Eight of the eleven patients underwent an operation for intraventricular catheter and reservoir placement in order to receive intraventricular chemotherapy. In six (75%) of the eight intraventricular chemotherapy patients, the negative conversion of cerebrospinal fluid cytology was achieved during induction chemotherapy of four weeks. The overall median survival for the eleven patients after the diagnosis of leptomeningeal metastasis and the eight subsequent intraventricular chemotherapy patients was 62 days (95% confidence interval 27.4 96.6). The most possible prognostic factor was the intervals from primary disease to leptomeningeal metastasis (p=0.071). Conclusion:In this study, we found that relatively high proportion of the patients of non-small cell lung cancer with parenchymal metastases were co-morbided by leptomeningeal metastases, and revealed that the interval from primary disease to leptomeningeal metastasis could be an important factor for survival. However, further well-designed investigations, with larger sample sizes, must be conducted to evaluate other prognostic factors as well as new drugs, and to define the optimal treatment combinations and route.

6임상 : 측뇌실 삼각에 발생한 뇌실내 수막종에 있어 상부 두정-후두 피질경유 접근법의 임상 결과 ; 24례 보고

저자 : 박세환 ( Se Hwan Park ) , 조진모 ( Jin Mo Cho ) , 김의현 ( Eui Hyun Kim ) , 김선호 ( Sun Ho Kim ) , 이규성 ( Kyu Sung Lee ) , 장종희 ( Jong Hee Chang )

발행기관 : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 간행물 : 대한뇌종양학회지 11권 2호 발행 연도 : 2012 페이지 : pp. 108-113 (6 pages)

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Introduction:Intraventricular meningiomas are uncommon subtype of intracranial meningiomas. Trigonal meningiomas consist of the majority of intraventricular meningiomas. The superior parieto-occipital transcortical approach is the most popular approach for removal of them. We analyzed our experience in removal of the trigonal meningiomas that were resected using the superior parieto-occipital transcortical approach. Patients and Methods:Twenty-four patients underwent surgical removal of trigonal meningioma from 1997 to May 2012. Demographics, clinical features, surgical outcomes, histopathologic results and prognosis were analyzed. Results:Study population had a mean age of 51.2 years and a female preponderance of 1 : 1.7. The most common presenting symptom was chronic headache, which was followed by memory impairment, visual disturbance and hemiparesis. Total removal of the tumor was achieved in all cases. Twenty-two (91.7%) tumors were World Health Organization (WHO) grade I while two cases were WHO grade III. There were two cases of intracerebral hemorrhage in the surgical corridor, one case of transient contralateral hemiparesis with cognitive decline, one case of transient contralateral homonymous hemianopsia, one case of aggravation of visual field defect, and one case of hydrocephalus which was successfully treated by ventriculo-peritoneal shunt. Conclusion:The superior parieto-occipital approach is suitable for most of the trigonal meningiomas and total removal of them can be achieved safely.

7임상 : Leksell Gamma Knife Perfexion과 Model C의 치료계획 효용성 비교 : 임상연구

저자 : 김정재 ( Jung Jae Kim ) , 김기홍 ( Gi Hong Kim ) , 박용구 ( Yong Gou Park ) , 장종희 ( Jong Hee Chang )

발행기관 : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 간행물 : 대한뇌종양학회지 11권 2호 발행 연도 : 2012 페이지 : pp. 114-117 (4 pages)

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Objective:The purpose of this study was to compare the dose planning between the Leksell Gamma Knife Perfexion (LGK PFX) and the Leksell Gamma Knife C (LGK C) using variable indices. Methods:A total of 100 cases, which were composed of 35 meningiomas, 20 vestibular schwannomas, 35 metastases, and 10 pituitary adenomas, were enrolled in this study. First, these cases were treated with the LGK PFX and then, were re-planned with the LGK C. We compared these two models in terms of the number of shots, the percentage of coverage, the conformity index (CI), Paddick's conformity index (PCI), the gradient index (GI), and the beam on time. Results:The LGK PFX completely outperformed the LGK C in terms of GI and the LGK PFX tended to have a longer beam on time than that of the LGK C. However, in patients with schwannomas, the LGK PFX outperformed the LGK C in terms of the CI, PCI, and GI, and in patients with pituitary adenomas, the LGK PFX outperformed the LGK C in terms of the percentage of coverage, PCI, and GI with statistical significance. Conclusion:The LGK PFX is an entirely redesigned radiosurgery unit accompanied by the development of software. The LGK PFX is supposed to achieve highly conformal dose prescription consisting of many isocenters with a reasonable treatment time.

8증례 : 신경섬유종증 제1형, 2형과 구분되는 신경집종증에 대한 1례

저자 : 양순범 ( Soon Bum Yang ) , 장웅규 ( Ung Kyu Chang ) , 윤상민 ( Sang Min Youn )

발행기관 : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 간행물 : 대한뇌종양학회지 11권 2호 발행 연도 : 2012 페이지 : pp. 118-121 (4 pages)

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Multiple schwannomas without vestibular schwannomas (schwannomatosis) are new classification of neurofibromatoses. Understanding of this disease entity is emerging, recently. We experienced a case of schwannomatosis, and reviewed some literatures related to schwannomas. A 45-year-old woman visited our hospital with low back pain and radiating leg pain. The patient's spine MR images revealed that she had multiple intradural extramedullary masses in lumbar spinal canal, extending to paravertebral space through neural foramen. On brain MR images, there were no vestibular schwannomas. We took a operation to resolve her symptoms. After we removed the intradural extramedullary masses in lumbar spinal canal, her symptoms were improved.

9증례 ; 적갈색방사선학적 악성이나 조직학적으로 양성을 보인 신경절교종 - 증례보고 -

저자 : 김환수 ( Hwan Soo Kim ) , 정세헌 ( Se Heun Joung ) , 허원 ( Weon Heo ) , 이동열 ( Dong Youl Rhee )

발행기관 : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 간행물 : 대한뇌종양학회지 11권 2호 발행 연도 : 2012 페이지 : pp. 122-126 (5 pages)

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Gangliogliomas are rare tumors of the central nervous system, composed of neoplastic ganglion cells and neoplastic glial cells. They are characterized by slow growing, low incidence of malignancy, surgically curable, and usually occurred in children and young adults. We report a case of ganglioglioma occurred in 21 year-old male which radiological findings were compatible with the malignancy but histologically diagnosed as benign, with review of literatures.

10증례 : 송과체에 발생한 교모세포종

저자 : 강무성 ( Moo Sung Kang ) , 홍창기 ( Chang Ki Hong ) , 김세훈 ( Se Hoon Kim ) , 이규성 ( Kyu Sung Lee )

발행기관 : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 간행물 : 대한뇌종양학회지 11권 2호 발행 연도 : 2012 페이지 : pp. 127-132 (6 pages)

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Pineal gland tumors comprise 0.4-1% of adult intracranial tumors. Glioblastoma, which is the most frequent glioma in brain tumors, is extremely rare in the pineal region. A 74-year-old man complaining of gait disturbance, urinary incontinence, and memory disturbance underwent ventroperitoneal (VP) shunt under the impression of obstrctive hydrocephalus that occurred secondarily to a tumor in the pineal gland. He refused treatment for the tumor. The symptoms were improved after the VP shunt. Six months postoperatively, he experienced a reaggravation of symptoms. An increase in tumor size was disclosed in brain imaging studies. The patient underwent an occipital craniotomy with occipital trans-tentorial approach. Pathological findings were consistent with glioblastoma. This case emphasizes the importance of considering glioblastoma as a differential diagnosis of pineal gland tumors, particularly if peritumoral heterogenous enhancement is observed. The role of surgery, chemotherapy, and radiotherapy on survival duration is not yet well established. Therefore, studies exploring the effect of each modalities on survival duration are needed.

12
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간행물명 수록권호

KCI등재

Brain Tumor Research and Treatment
8권 2호 ~ 8권 2호

KCI등재

Brain Tumor Research and Treatment
8권 1호 ~ 8권 1호

KCI등재

Brain Tumor Research and Treatment
7권 2호 ~ 7권 2호

KCI등재

Brain Tumor Research and Treatment
7권 1호 ~ 7권 1호

KCI등재

Brain Tumor Research and Treatment
6권 2호 ~ 6권 2호

KCI후보

한국신경인지재활치료학회지
10권 1호 ~ 10권 1호

KCI등재

Brain Tumor Research and Treatment
6권 1호 ~ 6권 1호

KCI후보

한국신경인지재활치료학회지
9권 0호 ~ 9권 0호

KCI등재

Brain Tumor Research and Treatment
5권 2호 ~ 5권 2호

KCI등재

Brain Tumor Research and Treatment
5권 1호 ~ 5권 1호

KCI후보

한국신경인지재활치료학회지
8권 0호 ~ 8권 0호

KCI등재

Brain Tumor Research and Treatment
4권 2호 ~ 4권 2호

KCI등재

Brain Tumor Research and Treatment
4권 1호 ~ 4권 1호

KCI후보

한국신경인지재활치료학회지
7권 0호 ~ 7권 0호

KCI등재

Brain Tumor Research and Treatment
3권 2호 ~ 3권 2호

KCI후보

한국신경인지재활치료학회지
6권 0호 ~ 6권 0호

KCI등재

Brain Tumor Research and Treatment
3권 1호 ~ 3권 1호

KCI등재

Brain Tumor Research and Treatment
2권 2호 ~ 2권 2호

대한뇌종양학회지
11권 2호 ~ 11권 2호

KCI등재

Brain Tumor Research and Treatment
2권 1호 ~ 2권 1호
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자료제공: 네이버학술정보
발행기관 최신논문
자료제공: 네이버학술정보

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