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숨뇌의 신경해부학

Neuronanatomy of the Medulla Oblongata

김범태 ( Bum Tae Kim ) , 황선철 ( Sun Chul Hwang ) , 임수빈 ( Soo Bin Im ) , 신원한 ( Won Han Shin )
  • : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회
  • : 대한뇌종양학회지 2권2호
  • : 연속간행물
  • : 2003년 09월
  • : 55-61(7pages)
대한뇌종양학회지

DOI


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The medulla oblongata is the most caudal part of the brain stem. It is continuous with the spinal cord at the foramen magnum and extends rostrally for 2.5cm to the caudal border of pons. The central canal of the spinal cord is continuous through the medulla, at the point called obex. The rostral part of the medulla occupies the floor of the fourth ventricle. The roof of the ventricle is formed by tela choroidea, choroid plexus and cerebellum. The pyramidal decussation and the inferior olivary complex are the characteristic anatomical features of the medulla. The medulla contains the cranial nerve nuclei of hypoglossal nerve, accessory nerve, vagus nerve, and glossopharyngeal nerve. They are concerned with neurophysiology, regulation of heart rate and respiration. The medulla also serves as a conduits for the passage of ascending and descending tracts connecting the spinal cord to the higher centers of the nervous system. 

UCI(KEPA)

I410-ECN-0102-2014-500-001972712

간행물정보

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


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11권2호(2012년 09월) 수록논문
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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.

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1숨뇌의 신경해부학

저자 : 김범태 ( Bum Tae Kim ) , 황선철 ( Sun Chul Hwang ) , 임수빈 ( Soo Bin Im ) , 신원한 ( Won Han Shin )

발행기관 : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 간행물 : 대한뇌종양학회지 2권 2호 발행 연도 : 2003 페이지 : pp. 55-61 (7 pages)

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The medulla oblongata is the most caudal part of the brain stem. It is continuous with the spinal cord at the foramen magnum and extends rostrally for 2.5cm to the caudal border of pons. The central canal of the spinal cord is continuous through the medulla, at the point called obex. The rostral part of the medulla occupies the floor of the fourth ventricle. The roof of the ventricle is formed by tela choroidea, choroid plexus and cerebellum. The pyramidal decussation and the inferior olivary complex are the characteristic anatomical features of the medulla. The medulla contains the cranial nerve nuclei of hypoglossal nerve, accessory nerve, vagus nerve, and glossopharyngeal nerve. They are concerned with neurophysiology, regulation of heart rate and respiration. The medulla also serves as a conduits for the passage of ascending and descending tracts connecting the spinal cord to the higher centers of the nervous system.

2뇌하수체 종양에 대한 방사선수술

저자 : 임영진 ( Young Jin Lim ) , 박성훈 ( Sung Hun Park )

발행기관 : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 간행물 : 대한뇌종양학회지 2권 2호 발행 연도 : 2003 페이지 : pp. 62-70 (9 pages)

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Pituitary adenomas are relatively common tumors that account for 8-15% of all primary intracranial tumors. In the majority of cases, these tumors are associated with pathological hormonal sectretion. There are two main aims of treatment in respect of pituitary adenomas. The first is to remove a neoplastic process, and the second aim is to control the overproduction of hormone. In these tumors, the first therapeutic option is microsurgery. Despite advances in microsurgical management, postoperative recurrence may occur because of tumor invasion into surrounding structures such as the cavernous sinus. In such cases, conventional fractionated radiotherapy has been known to be effective, but it also carries a significant risk for panhypopituitarism or visual disturbances. Heavy charged particle irradiation taking advantage of the Bragg-peak effect may be also effective. However, proliferation of charged particle irradiation has been restricted by the cost and limited availability of this technology. Stereotactic radiosurgery of pituitary adenoma gained popularity with the introduction and widespread usage of Leksell Gamma Unit. Radiosurgery may be indicated as a secondline therapy after surgery if the tumor volume is small and the distance of the adenoma surface to the optic pathway is sufficiently broad to enable a safe procedure. Radiosurgery can be a safe salvage therapy for recurrent or remnant tumors with effectiveness but with less risk of causing radiation induced injury to the surrounding structures. For the better results, radiosurgical dosimetry is important. It would seem that if the aim of treatment is to halt growth, then an edge dose of 12 to 15Gy is adequate. However, if the aim is to cure an endocrinopathy then the required dose is probably nearer to 35Gy. After radiosurgery, tumor control rate is excellent than endocrine secretion normalization. To clarify the role of radiosurgery for treatment of pituitary adenomas, the author has reviewed related literature, and present the radiosurgical dosimetry, the clinical treatent results and complications.

3거대 뇌하수체 선종의 치료 방침

저자 : 김형동 ( Hyung Dong Kim ) , 송영진 ( Yeung Jin Song )

발행기관 : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 간행물 : 대한뇌종양학회지 2권 2호 발행 연도 : 2003 페이지 : pp. 71-79 (9 pages)

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Pituitary adenomas represent 7-17% of all intracranial tumors. Although they are benign histologically, these tumors are of clinical concern because of their anatomical location or excessive hormone secretion. Especially, pituitary adenomas may grow to considerable sizes before presentation, leading to their designation as giant pituitary adenomas. But the definition of ginat pituitary adenomas has not been clear and also these giant tumors have long been recognized as a formidable surgical lesion. The treatment modelity is still controversy for that formidable lesions. In this letter, the authors have reviewed related literatures, and present the definition, natures, anatomical considerations and various treatment modalities of giant pituitary adenoma, especially intentional stage operation with open sella method.

4뇌종양에서 Telomerase 활성의 억제

저자 : 박동준 ( Dong June Park ) , 강수경 ( Soo Kyung Kang ) , 차승헌 ( Seung Heun Cha ) , 최창화 ( Chang Hwa Choi )

발행기관 : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 간행물 : 대한뇌종양학회지 2권 2호 발행 연도 : 2003 페이지 : pp. 80-85 (6 pages)

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Objective:Telomerase activity was examined in brain tumor tissues and the effects of several catechins on telomerase activity were studied. Methods:Telomerase activity was examined in brain tumor tissues with the TRAP assay and compared with histological diagnosis and the CD68 proliferative cell index(PCI). The effects of several catechins and cisplatin on telomerase activity were studied in a cell-free system. And the effects of several catechins and cisplatin on growth rate were determined using two brain cancer cell lines, SNB19 and T98G human glioblastoma. Results:Telomerase assay revealed telomerase activity in all four glioblastomas, six of seven anaplastic astrocytomas, one of three astrocytomas, all cases of an anaplastic oligodendroglioma, an oligodendroglioma, an anaplastic meningioma, a melanoma and a medulloblastoma, all three metastatic brain tumors, two of six schwannomas and all two craniopharyngiomas. There was no correlation between telomerase activity and CD68 PCI. Telomerase was strongly inhibited by epicatechin gallate(ECG(-)), epigallocatechin gallate(EGCG(-)) and cisplatin at the concentrations of 1mM, 1mM, 20mM respectively. A limitation on the continued growth of two representative brain cancer cell lines, in the presence of 1mM ECG(-) and EGCG(-), was observed. Conclusion:The activation of telomerase is associated with the potential tumor growth in malignant brain tumors. In addition, therapeutic implication of anti-telomerase approach in brain tumors were indicated.

5원발병소불명의 전이성 뇌종양

저자 : 전진호 ( Jin Ho Jeon ) , 이상원 ( Sang Weon Lee ) , 최병관 ( Byung Kwan Choi ) , 차승헌 ( Seung Heon Cha ) , 송근성 ( Geun Seung Song ) , 최창화 ( Chang Hwa Choi )

발행기관 : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 간행물 : 대한뇌종양학회지 2권 2호 발행 연도 : 2003 페이지 : pp. 86-89 (4 pages)

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Background:The prognosis of patients with brain metastasis of unknown primary tumor is controversial. The authors reviewed the results of gross total resection with radiotherapy in this group of patients. Methods:Between 1993-2000, 133 patients admitted to the study department for the treatment of metastatic brain tumor. Gross total resection was done in 33 patients with single brain lesion. Ten patients had solitary brain metastasis without a detectable primary site despite extensive systemic evaluation(Group I), and remaining 23 had previous cancer history or a detectable primary lesion(Group II). Survival analysis and comparison was done. Results:The median survival was 24.1months in group I(range, 6.5-58.5) and 19.0months in group II(range, 4.7- 40.6). The overall survival for group I was better than group II, but not significant. Adenocarcinoma was the most common histology of group I. During the follow-up the primary tumor was found in 7 patients and was located in the lung in 4 patients. Conclusion:Brain metastasis of unknown primary tumor has better prognosis than that of brain metastasis in general. Gross total resection with radiotherapy for local disease control is effective in this group of patients especially in solitary lesion.

6성상세포종과 수막종으로 오인된 유두상 상의세포종 -증례보고-

저자 : 이승준 ( Seung Joon Lee ) , 김정은 ( Jeong Eun Kim ) , 황승균 ( Sung Kyun Hwang ) , 정희원 ( Hee Won Jung ) , 최윤라 ( Yoon La Choi )

발행기관 : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 간행물 : 대한뇌종양학회지 2권 2호 발행 연도 : 2003 페이지 : pp. 90-93 (4 pages)

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The authors report a case of papillary ependymoma, which is known to be rare and difficult to diagnose. A 35-year-old female, who had been previously diagnosed as having anaplastic astrocytoma at the other hospital, was admitted with headache, vomiting and decreased visual acuity. She had a multicystic tumor in the left parietal lobe on magnetic resonance image(MRI), and initial pathologic diagnosis after surgical resection was papillary meningioma. However, the electronmicroscopy( EM) examination showed findings of papillary ependymoma. In spite of adjuvant radiotherapy, postoperative 1-year follow-up MRI showed recurrence of tumor. The tissue obtained from the recurred tumor showed anaplastic features of dedifferentiated tumor cells with a proliferation index(Ki-67 index) of 10%. Supratentorial papillary ependymoma is difficult to be diagnosed only by typical light microscopy or immunohistochemistry. Therefore, ultrastructural study is necessary for diagnosis of papillary ependymoma.

7터어키안 상부의 악성 기형종 -증례보고-

저자 : 강석형 ( Suk Hyung Kang ) , 여상준 ( Sang Jun Yeo ) , 박승원 ( Seung Won Park ) , 황성남 ( Sung Nam Hwang ) , 민병국 ( Byung Kook Min )

발행기관 : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 간행물 : 대한뇌종양학회지 2권 2호 발행 연도 : 2003 페이지 : pp. 94-98 (5 pages)

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Intracranial germ cell tumors are rare lesions that account for 0.3 to 3.4% of all intracranial tumors. Although pure forms are rare, intracranial germ cell tumors are classified into five types:germinomas, teratomas, embryonal carcinomas, endodermal sinus tumors and choriocarcinomas. Teratomas are embryonal neoplasms composed of tissues that are derived from three germinal layers, the endoderm, mesoderm, and ectoderm. They may be solid or cystic and are classified histologically as mature, immature, and malignant. Intracranial teratomas have a predilection for the supratentorial and midline sites, especially pineal area. These are arise commonly in the neonatal period. Advances in neuroradiology and microsurgical techniques now make early diagnosis and successful treatment in many of these patients. We present a rare case of malignant teratoma in suprasellar region of a young boy. A complete excision of the tumor was achieved by pterional approach. Histological diagnosis of the tumor was teratoma with malignant components. The management, pathologic feature and clinical course of this unusual malignancy are discussed with a review of the literatures.

8종양내 출혈을 동반한 선천성 교모세포종 -증례보고-

저자 : 김형중 ( Hyoung Joong Kim ) , 김세혁 ( Se Hyuk Kim ) , 김순기 ( Soon Ki Kim ) , 윤승환 ( Seung Hwan Youn ) , 박현선 ( Hyeon Seon Park ) , 김은영 ( Eun Young Kim ) , 박형천 ( Hyung Chun Park )

발행기관 : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 간행물 : 대한뇌종양학회지 2권 2호 발행 연도 : 2003 페이지 : pp. 99-103 (5 pages)

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Congenital glioblastomas have been rarely reported in the literatures and known to have a higher propensity to cause intratumoral hemorrhage compared to pediatric brain tumors. We report a case of definite congenital glioblastoma, which was not detected by endovaginal fetal sonography until 35+1 weeks gestation and presented with intratumoral hemorrhage after birth. Brain CT and MRI scan showed a intracranial mass with internal hemorrhage and small portion of contrast enhancement. If the rapid growing intracranial lesion with internal hemorrhage is detected by fetal sonography or MRI late in gestation, a congenital malignant tumor as well as vascular malformations should be considered.

9경접형동 접근술 후 삽입한 지방조직으로 인한 시력 손상 -증례보고-

저자 : 조동찬 ( Dong Charn Cho ) , 김충현 ( Choong Hyun Kim ) , 정진환 ( Jin Hwan Cheong ) , 백광흠 ( Koang Hum Bak ) , 김재민 ( Jae Min Kim )

발행기관 : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 간행물 : 대한뇌종양학회지 2권 2호 발행 연도 : 2003 페이지 : pp. 104-107 (4 pages)

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Sellar region tumors are most commonly resected via transsphenoidal approach(TSA). In a patient with Rathke`s cleft cyst, sudden development of visual loss followed by TSA procedure and her vision was recovered incompletely after chiasmal decompression. However iatrogenic compression of the optic nerve and chiasm by fat packing is rarely reported. We also reviewed the pertinent literature.

10라스케씨 열낭종과 동시에 발생한 뇌하수체 선종

저자 : 김정훈 ( Jeong Hoon Kim ) , 권순찬 ( Soon Chan Kwon ) , 안재성 ( Jae Sung Ahn ) , 전상룡 ( Sang Ryong Jeon ) , 나영신 ( Young Shin Ra ) , 김창진 ( Chang Jin Kim ) , 이정교 ( Jung Kyo Lee )

발행기관 : 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 간행물 : 대한뇌종양학회지 2권 2호 발행 연도 : 2003 페이지 : pp. 108-114 (7 pages)

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Objective:The goal of this study was to characterize the clinical, radiological, surgical, and pathological findings in patients with both pituitary adenoma and Rathke`s cleft cyst. Methods:We conducted a retrospective study of patients with concomitant pituitary adenoma and Rathke`s cleft cyst operated on from 1991 through 2001 at our institution. Three patients were identified with this diagnosis. The medical records, neuroradiologic studies, and histologies were reviewed. Results:There were 771 patients with pituitary adenoma and 46 with Rathke`s cleft cyst in the same period. The frequency of the combination was 0.39 % of pituitary adenoma and 6.5% of Rathke`s cleft cyst. One case was associated with hyperprolactinemia. Preoperative diagnosis on the basis of CT/MRI was pituitary adenoma in all three cases. Transsphenoidal approaches were done for these three patients, and postoperative courses were uneventful. Hormonal and visual symptoms were improved. Histologically, the tumor was composed of typical pituitary adenoma and component compatible with Rathke`s cleft cyst. Conclusion:When a non-enhancing cyst-like structure is demonstrated in a patient with pituitary adenoma, the possibility of a coexisting Rathke`s cleft cyst should be considered. Patients with this kind of pituitary tumor can be managed in the same fashion as patients with other types of pituitary adenoma.

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