• Title/Summary/Keyword: 뇌 수술

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Proteomic analysis of human serum from patients with temporal lobe epilepsy (측두엽 간질환자의 혈청에서 프로테오믹스기법을 활용한 질병관련 단백질 동정)

  • Lee, Chang Woo;Yu, Seung Taek;Choi, Ha Young;Koh, Bun Jeong;Kwak, Yong Guen
    • Clinical and Experimental Pediatrics
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    • v.52 no.5
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    • pp.567-575
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    • 2009
  • Purpose : Epilepsy affects more than 0.5% of the world's population. It has a large genetic component and is caused by electrical hyperexcitability in the central nervous system. Despite its prevalence, the disease lacks definitive diagnostic serological biomarkers. To identify potential biomarkers for epilepsy by a convenient method, we analyzed the expression of serum proteins, reflecting alterations in the patient's proteomes. Methods : We compared two-dimensional electrophoretic band patterns of human sera from eight patients with temporal lobe epilepsy (TLE) with those of eight control subjects. The differentially expressed bands were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and electrospray ionization quadrupole time-of-flight mass spectrometry. esults : Twelve proteins were differentially expressed in the TLE group, of which 6 were identified. Expression of haptoglobin Hp2, PRO2675, immunoglobulin heavy chain constant region gamma 2, an unnamed protein, and three unidentified proteins were upregulated in serum from the patients with TLE, whereas those of major histocompatibility complex (MHC) class I antigen, plasma retinol-binding protein precursor, and three unidentified proteins were downregulated in these patients. After resection of the epileptogenic zone, the expressions of MHC class I antigen, immunoglobulin heavy chain constant region gamma 2, two of the downregulated unidentified proteins, and one of the upregulated unidentified proteins returned to the normal range. Conclusion : The 12 serum proteins in this study are potentially useful biomarkers for the diagnosis and monitoring of TLE.

Significance of Cerebral Venography in Surgery of Petroclival Meningiomas (추체사대 수막종의 수술과 관련하여 뇌 정맥조영상의 의미)

  • Hwang, Sung-Kyun;Gwak, Ho-Shin;Paek, Sun Ha;Oh, Chang-Wan;Lee, Sang Hyung;Kim, Dong Gyu;Kim, Hyun Jib;Jung, Hee-Won
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1200-1209
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    • 2001
  • Objective : A thorough understanding of the related venous structure is mandatory for successful removal of the petroclival meningiomas. This study was planned to investigate the guideline for safe ligation and incision of transverse or sigmoid sinuses and the importance of drainage pattern of vein of $Labb{\acute{e}}$ in surgical removal of petroclival meningiomas. Patients and Methods : The authors reviewed the venogram of the consecutive 37 cases of petroclival meningiomas and retrospectively analyzed their surgical findings. The drainage pattern of confluence of Herophili was classified as Type A(confluent & equal on both sides), Type B(confluent & non-dominant on tumor side), Type C(confluent & dominant on tumor side) and Type D(unilateral drainage only) as these findings gave the information on safe ligation and resection of the sinus. Usefulness of intraoperative test clamping of sinus for safe ligation was also reviewed. The vein of $Labb{\acute{e}}$ was analyzed with respect to its draining point and its collaterals to other superficial veins. Results : Contraindications of the sinus ligation and resection according to the drainage pattern at the confluence of Herophili were Type C(n=10, 27%)and Type D(n=4, 11%). Patients with Type A(n=12, 32%)and Type B(n=11, 30%) were tolerable to sinus ligation ipsilateral to tumor, if the test clamping proved to be safe. Identification of no brain swelling, after intraoperative test clamping of the sinus for more than 30 minutes performed in 7 out of 11 cases, was a reliable indicator of safe sinus ligation. The drainage pattern of the vein of $Labb{\acute{e}}$, especially low-lying type, could predict the possibility of postoperative hemorrhage and infarction. Its drainage into tentorium or superior petrosal sinus, however, made the transtentorial approach impossible, leading to restricted operative field. Conclusion : For a successful removal of the petroclival meningiomas preoperative venogram should be examined carefully. The extent of exposure in a planned approach can be estimated by analyzing the variation of sinuses and the drainage pattern of vein of $Labb{\acute{e}}$.

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A Case of Metastatic Oral Carcinoma from Rectal Cancer (직장암 유래 전이성 구강 암종의 진단예)

  • Shin, Keum-back;Kang, Kee-hyun;Chae, Gyu-sam
    • Journal of Oral Medicine and Pain
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    • v.24 no.2
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    • pp.171-179
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    • 1999
  • The authors experienced a oral carcinoma involving the medial cortex of the right ramus of mandible and the left side of the maxilla which was metastasized from primary rectal adenocarcinoma based on the comprehensive evaluation of data obtained from (1) the past medical history of primary rectal adenocarcinoma, (2) the computerized tomographic views of the homogeneous mass on the anteromedial region of the right ramus of mandible destructing the medial cortex of the right ramus of mandible, and the irregular mass around the clivus spreading into the sphenoid sinus and destructing the left side of the maxilla ; the bone scanning of hot spots on the nasal region and the left side of maxilla ; the posteroanterior chest radiographic view of multiple nodular radiopacities on the lung, (3) the retrospective review of the sonographic view of a hypoechoic, well-demarcated, target-like mass with central hyperechoic focus on right lobe of liver in a Korean female of 49-year-old who complained the ptosis of left eyelid, the swelling on left zygomatic area, the left facial paralysis, the facial asymmetry and a round-shaped, elevated lesion with a hematoma on the mucosa covering the right ramus of mandible.

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Generation Method of Expression Space for Realtime Facial Expression Control of 3D Avatar (3차원 아바타의 실시간 얼굴표정제어를 위한 표정공간의 생성방법)

  • Kim Sung-Ho
    • Proceedings of the Korean Information Science Society Conference
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    • 2006.06a
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    • pp.109-111
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    • 2006
  • 본 논문은 애니메이터로 하여금 얼굴 표정들의 공간으로부터 일련의 표정을 선택하게 함으로써 3차원 아바타의 표정을 실시간적으로 제어할 수 있도록 하기 위한 표정공간의 생성방법에 관하여 기술한다. 본 시스템에서는 약 2400여개의 얼굴 표정 프레임을 이용하여 표정공간을 구성하였다. 본 기법에서는 한 표정을 표시하는 상태표현으로 얼굴특징 점들 간의 상호거리를 표시하는 거리행렬을 사용한다. 이 거리행렬의 집합을 표정공간으로 한다. 그러나 이 표정공간은 한 표정이 다른 표정까지 이동할 때 두 표정간의 직선경로를 통해 이동할 수 있는 그런 공간이 아니다. 본 기법에서는 한 표정에서 다른 표정까지 거쳐 갈 수 있는 경로를 캡쳐된 표정 데이터로부터 근사적으로 유추한다. 우선, 각 표정상태를 표현하는 거리행렬간의 거리가 일정 값 이하인 경우 두 표정을 인접해 있다고 간주한다. 임의의 두 표정 상태가 일련의 인접표정들의 집합으로 연결되어 있으면 두 표정간에 경로가 존재한다고 간주한다. 한 표정에서 다른 표정으로 변화할 때 두 표정간의 최단경로를 통해 이동한다고 가정한다. 두 표정간의 최단거리를 구하기 위해 다이내믹 프로그래밍 기법을 이용한다. 이 거리행렬의 집합인 표정공간은 다차원 공간이다. 3차원 아바타의 얼굴 표정 제어는 애니메이터들이 표정공간을 항해할 때 실시간적으로 수행된다. 이를 도와주기 위해 표정공간을 차원 스케일링 기법을 이용하여 2차원 공간으로 가시화하였고, 애니메이터들로 하여금 본 시스템을 사용하여 실시간 표정 제어를 수행하게 했는데, 본 논문은 그 결과를 평가한다.참여하는 빈들 간의 관계를 분석하여 워크플로우에 대한 성능 측정이 가능하도록 한다. 또한 제안된 메트릭을 통하여 EJB 어플리케이션의 성능 향상을 도모할 수 있도록 한다.로 표면 위로 자라났고, 부종은 창상 밑 조직까지 감소하였으며, 육아조직은 교원질 섬유로 대체되었다. 창상 유발 21일 후, 다른 창상에 비해, HG 처치창은 유의적으로 창상 표면이 거의 재생성 상피로 덮였으며, 육아조직은 창상 유발 14일 후와 비교해서 유의적으로 교원질 섬유로 대체되었다. 위의 모든 결과에서 보듯이, 개에서 전층피부 창상의 처치 시 HG의 사용은 HC와 생리 식염수에 비해 창상치유 복구기의 치유 속도를 촉진하는 것으로 사료된다.시범학교의 자녀를 들 부모들은 환경관련문제에 대한 의식 및 환경관련 제품에 대한 구매행동의 변화가 두드러지게 나타났다.EX>$d^{2+}$ + SA처리구는 두 화합물의 이중 효과에 의해 전반적인 생리 활성을 억제하여, 결국에는 식물의 고사를 유도하는 것으로 사료된다.목에 대한 보안'이 가장 중요한 것으로 나타났다. 본 연구에서는 솔루션 선정요인에 관한 중요도를 e-마켓플레이스의 유형과 산업 별로 평가해보았는데, 여기에서 밝혀진 중요도를 통해 e 마켓플레이스를 구축하고 자 하는 기업은 솔루션을 자체 개발하거나 구입할 때 올바른 의사결정을 할 수 있다. 그리고 솔루션을 제공하려는 기업측면에서는 e-마켓플레이스를 구축하고자 하는 기업에게 유형과 산업별로 적절한 솔루션을 제공할 수 있다.순환이 뇌대사 및 수술 후 신경학적 결과에 보다 유익한 효과를 제공해 줄 수 있음

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Interictal rCBF SPECT, MRI and Surgical Outcome of Intractable Temporal Lobe Epilepsy (난치성 측두엽간질의 발작간 뇌혈류 SPECT, MRI와 수술성과 비교)

  • Zeon, Seok-Kil;Joo, Yang-Goo;Lee, Sang-Doe;Son, Eun-Ik;Lee, Young-Hwan
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.307-312
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    • 1994
  • Interictal single photon emission computed tomography of regional cerebral blood flow (rCBF SPECT) in 18 intractable temporal lobe epilepsy patients(8 male and 10 female patients: average 23.5 years old) were compared with 2.0 T magnetic resonance imaging (MRI). And surgical outcome was analysed with the findings, symptom duration and lateralization of temporal lobe. Preoperatively rCBF SPECT was done in all 18 patients with intravenous injection of 740 MBq 99mTc-HMPAO. MRI was also done preoperatively in 13 patients. Surgical outcome was classified by Engel's outcome classification(four-part classification recommended at the first Palm Desert conference). rCBF SPECT detected correctly lateralising abnormality of temporal lobe hypoperfusion in 13/18(72.2%), contralateral temporal lobe hypoperfusion in 2/18(11.1%) and showed no def-inite abnormality in 3/18(16.7%). The positive predictive value of unilateral temporal lobe hypoperfusion was 87%. MRI detected correct localising abnormality in 8/13(61.5%), such as hippocampal atrophy(7/13), asymmetric temporal horn(6/13), anterior temporal lobe atrophy(1/13), increased signal intensity from hippocampus(1/13) and calcific density(1/13), and no abnormal finding was noted in 5/13(38.5%). There was no false positive findings and the positive predictive value of MRI was 100%. Only 2 cases showed same lateralization findings in rCBF SPECT and MRI. There was no significant correlation between symptom duration and no abnormal findings on SPECT or MRI. Surgical outcome showed class I in 15/18(83.3%), and class II in 2/18(11.1%). One case of no abnormal finding in both SPECT and MRI showed class III surgical outcome. No class IV surgical outcome was noted. Surgical outcome, lateralization of epileptic focus in temporal lobe and abnormal findings in rCBR SPECT or MRI were not significantly correlated.

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Acrodysostosis Associated with Symptomatic Cervical Spine Stenosis

  • Ko, Jung-Min;Kwack, Kyu-Sung;Kim, Sang-Hyun;Kim, Hyon-Ju
    • Journal of Genetic Medicine
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    • v.7 no.2
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    • pp.145-150
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    • 2010
  • Acrodysostosis is an extremely rare disorder characterized by short fingers and toes with peripheral dysostosis, nasal hypoplasia, and mental retardation. We report a 16-year-old Korean boy with acrodysostosis who had characteristic clinical features and cervical spine stenosis manifested by neurologic symptoms. On presentation, he complained of difficulty in raising his arms, and suffered from intermittent pain and weakness in both upper extremities. He had short stature and dysmorphic facial features, including a broad, depressed nasal bridge, small, upturned nose, bilateral epicanthal folds, and mild hypertelorism. Moderate mental retardation and sensorineural hearing loss in both ears were also present. Radiological findings included broad, short metacarpals and phalanges with cone-shaped epiphyses, bilateral Madelung deformities, hypertrophied first metatarsals, and thickening of the calvarium. Magnetic resonance imaging findings included stenosis of the cervical spine, platybasia with compression into the cervicomedullary junction, and downward displacement of the cerebellar tonsils. Here, we report a case of acrodysostosis with symptoms and signs of cervical spinal stenosis first in Korea. If it is diagnosed in the early stages, possible life-threatening complications, including spinal canal stenosis, can be managed properly and permanent neurologic sequelae might be avoided. Therefore, it is important to consider acrodysostosis in the differential diagnosis of peripheral dysostosis.

Stereotactic LINAC Radiosurgery of Meningiomas (선형가속기를 이용한 뇌수막종의 뇌정위적 방사선수술)

  • Ryu, Kyung-Sik;Son, Byung-Chul;Kim, Moon-Chan;Suh, Tae-Suk;Kay, Chul-Seung;Yoon, Sei-Chul;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.317-323
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    • 2000
  • Objective : To evaluate the role of stereotactic LINAC radiosurgery in treatment of meningiomas, the authors retrospectively analyzed the result of radiosurgery in our institute. Method: During last ten years, twenty patients underwent stereotactic LINAC radiosurgery(LINAC SRS) for meningiomas. The mean age of the patients was 51 years(22-78 years). The most common tumor location for radiosurgery was parasagittal, sphenoid wing and tentorial area. With regards to indications of radiosurgery for meningiomas, LINAC radiosurgery was done for primary treatment in six patients, for postoperative residual tumors in eleven patients, for postoperative regrowth in three patients. Mean tumor volume was $5.14cm^3$($0.28-15.1cm^3$), mean field diameter was 2.01cm(1.2-3cm). The mean marginal dose was 20.55Gy(13-30Gy). The follow-up evaluation was done annually with radiologic findings and clinical status. The mean follow-up period was 46.8(24-120) months. Result : In the radiologic response, the tumor volume was reduced in five(25%) of twenty patients, fourteen showed arrested growth(70%), but one patient showed increased growth(5%). In the clinical response, nine patients improved clinically(45%), ten patients was stable(50%) and one patient worsened during follow-up period. With regards to correlation with radiologic and clinical response, in nineteen patients who showed radiologic response to radiosurgery(decreased and arrested growth after radiosurgery), nine patients(47.4%) improved and ten patients (52.6%) showed no change, one patient(5%) had symptomatic radiation necrosis at four years after SRS, which needed craniotomy. Conclusion : The overall control rate of meningiomas with LINAC radiosurgery was 95% in radiologic follow up and 95% clinically. The radiation complication rate was 5%. These results indicate that LINAC radiosurgery can be considered as safe and effective method for meningiomas.

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Clinical course and prognosis of hemodynamically significant congenital heart defects in very low birth weight infants (혈역학적으로 의미있는 선천성 심기형을 가진 극소 저체중 출생아의 임상경과 및 예후)

  • Yoo, Hye Soo;Kim, Ji Eun;Park, Soo Kyoung;Seo, Hyun Ju;Jeong, Yoo Jin;Chio, Seo Heui;Jeong, Soo In;Kim, Sung Hoon;Yang, Ji Hyuk;Huh, June;Chang, Yun Sil;Jun, Tae Gook;Kang, I Seok;Park, Won Soon;Park, Pyo Won;Lee, Heung Jae
    • Clinical and Experimental Pediatrics
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    • v.52 no.4
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    • pp.481-487
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    • 2009
  • Purpose : This study investigated the clinical course and prognostic factor of very low birth weight infants (VLBWI) with hemodynamically significant congenital heart defects (CHDs). Methods : Medical records of 1,098 VLBWI with birth weight <1,500 g who had been admitted to the neonatal intensive care unit of Samsung Medical Center from October 1994 to December 2007 were reviewed retrospectively. The data for these patients with hemodynamically significant CHD (n=33) were compared with those without CHD (n=1,065). Results : The incidence of CHD was 3.0% (33 patients) 7 patients (21%) had CHD combined with the congenital abnormalities or chromosomal disorders. The most common CHD was a ventricular septal defect. The incidence of intrauterine growth retardation was higher in patients with CHD than in patients without CHD (34% vs. 20%), but there were no significant differences in gestational age, birth weight, respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, severe intraventricular hemorrhage (${\geq}$Gr III), and periventricular leukomalacia. Cardiac surgery was performed on 13 patients (39%). Nine patients received staged operations, and 10 patients received early intervention. The overall mortality in patients who had CHD was higher than in the patients who did not have CHD (27% vs. 16%). In patients with CHD, congenital abnormalities or chromosomal disorders were more important factors for increased mortality (86% vs. 11%) than the degree of complexity of CHD (19% vs. 42%). Conclusion : The most important prognostic factors of VLBWI with CHD are the associated congenital abnormalities or chromosomal disorders.

Effect of Ischemic Preconditioning for Preventing Ischemic Injury of the Spinal Cord (척추 신경의 허혈성 손상 예방을 위한 허혈성 전처치의 효과)

  • 홍종면;차성일;송우익;홍장수;임승운;임승운;임승평
    • Journal of Chest Surgery
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    • v.34 no.11
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    • pp.823-830
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    • 2001
  • Background: Paraplegia is a serious complication of thoracic or thoracoabdominal aortic operations, which is related to ischemic injury of the spinal cord induced by low perfusion pressure during cross clamping of the aorta. Ischemic preconditioning of heart or brain with reversible sublethal ischemic injury induces resistance to subsequent lethal ischemia. The aim of this study is to investigate whether ischemic tolerance could be induced by the preconditioning of the spinal cord using swine model. Material and Method: The animals were randomly assigned to three groups: sham group(n=3), control group(n=6) and pre-conditioning group(n=8). In the sham group, we performed the left thoracotomy only without any ischemic injury. In the preconditioning group, the swine received reversible spinal cord ischemic injury by aortic clamping for 20 minutes, whereas control group had no previous aortic cross- clamping. Forty-eight hours later, the aorta was clamped for 30 minutes in both groups. Neurological examination was done 24 hours later, then the animals were euthanized for histopathology and malonedialdehyde(MDA) spectrophotometry assay of the spinal cord. Result: Statistically significant difference in neurological outcome was observed between the control and preconditioning groups at 24 hours after ischemic injury. The incidence of paraplegia and severe paresis was 100% in the control group, and 62.5% in the preconditing group(p=0.028). There was no statistically significant difference in histopathology and MDA assay of the ischemic spinal cord between these two groups with borderline statistical difference in MDA assay(p=0.0745). Conclusion: In the present swine study, ischemic preconditioning could induce tolerance against 30 minute ischemic insult of the spinal cord, although the animals did not completely recover(stand-up or walk). We expect that combining this preconditioning with other currently existing protection methods might lead to a synergistic effect, which warrants further investigation.

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The Results of Radiation Therapy in Locally Advanced Non-Small Cell Lung Cancer (국소적으로 진행된 비소세포폐암의 방사선치료 성적)

  • Kim Mi Sook;Yoo Seoung Yul;Cho Chul Koo;Yoo Hyung Joon;Kim Jae Young;Shim Jae Won;Lee Choon Taek;Kang Yoon Koo;Kim Tae You
    • Radiation Oncology Journal
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    • v.15 no.3
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    • pp.233-241
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    • 1997
  • Purpose : This study was done to evaluate the survival rate and Prognostic factors of patients with inoperable non-small cell lung cancer(NSCLC) treated with radiation therapy. Materials and Methods A retrospective analysis was undertaken of 62 Patients who had inoperable NSCLC treated with radiation therapy from January 1991 through December 1993. According to AJCC slaging, stage IIIA was 14 patients and stage IIIB was 48 patients. Forty Gy to 70.2Gy to the primary tumor site was delivered with daily fractions of 1.8Gy or 2Gy, 5days per week. Thirty-seven patients received neoadjuvant chemotherapy. Results : Complete, partial and no response to radiation therapy were 3 patients, 34 Patients and 25 patients, respectively The median survival period of all patients was 11 month. One rear survival rate, 2 year survival rateand 5 rear survival rate for all patients were 45.0%, 14.3%, and 6.0% respectively The median survival period was 6.5 months in stage IIIA and 13 months in stage IIIB. One year survival rates were 28.6% in stage IIIA and 50.3% in stage IIIB In univariaite analysis, prognostic factors affecting survival were T-s1aging, AJCC staging, and response after radiation therapy (P<0.05) . Pretreatment peformance status affected survival but was not statistically significant (0.050.1). In multivariate analysis, Pathology and response to radiation therapy are independently significant prognostic factor. T stage was marginally significant (P=0.0809). During follow-up duration, distant metastasis developed in 20 patients-bone metastasis in 10 patients, brain metastasis in 3 patients, liver mentastasis in 3 patients, contralateral lung metastasis in 1 patients and multiple metastases in 3 patients. Conclusion : Conventional radiotherapy alone or combined chemoradiotherapy are unlikely to achieve long term survival in patients with NSCLC. Surgery after concurrent chemoradiotherapy is Ivied to improve the local control in our hospital

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