Purpose : Brain tumors are the most common solid tumor in children. We retrospectively investigated the clinical characteristics of pediatric brain tumors, such as age, sex, tumor site and survival, as seen in a single institution over the last 15 years. We tried to evaluate the role of chemotherapy on the survival of some brain tumors. Methods : Three hundred fifty four children with primary brain tumor who were treated at Severance Hospital from Jan. 1985 to Sep. 2001 were enrolled. Results : Pediatric brain tumors were found most frequently in 10-15 years of age group(35.3%) and the ratio of male to female was 1.3 : 1. Supratentorial tumors(52%) were more frequent than infratentorial tumors(48%). Medulloblastoma/primitive neuroectodermal tumor(PNET) was the most common type(24.6%), followed by cerebellar astrocytoma(14.1%). Ten year survival rate of medulloblastoma, cerebellar astrocytoma and cerebral astrocytoma were 59.4%, 79.3% and 71%, respectively. The prognosis for brain stem glioma and glioblastoma multiforme were still grim with a 10 year survival rate of 12.7% and 13.3%, respectively. The addition of chemotherapy for high grade medulloblastoma led to an improved 10 year survival rate of 54.5%, compared with 40% without chemotherapy. Conclusion : The combined use of chemotherapy and radiation and surgery improved survival rate of pediatric brain tumors in our study. Chemotherapy for high grade medulloblastoma improved the 10 year survival rate. Further data analysis of the treatment modalities will lead to better comparisons.
Neural stem cells (NSCs) of the central nervous system (CNS) have raised a great interest not only for their importance in basic neural development but also for their therapeutic potentials in neurologically degenerative diseases such as Parkinson's, Alzheimer and stroke. During the CNS development, two molecular cascades determine specification of midbrain dopamine system. In one pathway, FGF-8, sonic hedgehog and transcription factor Nurr1 specify dopamine neurotransmitter phenotype. In the other, transcription factors $Lm{\times}lb\;and\;Pt{\times}3$ are required for induction of dopaminergic neurons. In Nurr1 knockout mouse, tyrosine hydroxylase (TH) positive cells fail to appear in substantia nigra, indicating that Nurr1 is essential in specification of dopaminergic cell phenotype. In this study, we used the immortalized human NSCs retrovirally transduced with Nurr1 gene to probe the Nurr1 mediated mechanism to induce dopamine phenotype. While Nurr1 over-expression alone did not generate dopamine phenotype in NSCs, applications of retinoid and forskolin induced expression of TH and AADC mRNAs. In addition, co-cultures of Nurr1 expressing NSCs with human astrocytes induced a marked increase of TH expression. In this co-culture system, the addition of retinoid and forskolin dramatically increased expression of TH. These results indicate that the immortalized human NSCs with Nurr1 gene could have a clinical utility for cell replacement for the Parkinson patients.
Lee, Sang Koo;Park, Kwan;Park, Ik Seong;Seo, Dae Won;Uhm, Dong Ok;Nam, Do-Hyun;Lee, Jung-Il;Kim, Jong Soo;Hong, Seung Chyul;Shin, Hyung Jin;Eoh, Whan;Kim, Jong Hyun
Journal of Korean Neurosurgical Society
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v.29
no.6
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pp.778-785
/
2000
Objectives : Intraoperative neurophysiologic monitoring(INM) is a well known useful method to reduce intraoperative neurological complications during neurosurgical procedures. Furthermore, INM is required in most cerebellopontine angle(CPA) surgery because cranial nerves or brain stem injuries can result in serious complications. Object of this study is to the correlation between the changes of intraoperative monitoring modalities during cerebellopontine angle tumor surgery and post-operative functional outcomes in auditory and facial functions. Material and Methods : Fifty-seven patients who underwent intraoperative neurophysiologic monitoring during CPA tumor surgery were retrospectively reviewed. Their lesions were as follows ; vestibular schwannomas in 42, other cranial nerve schwannomas in seven, meningiomas in five and cysts in three cases. Pre- and postoperative audiologic examinations and facial nerve function tests were performed in all patients. Intraoperative neurophysiologic monitoring modalities includes brainstem auditory evoked potentials(BAEP) and facial electromyographies(EMG). We compared the events of INM during CPA tumor surgeries with the outcomes of auditory and facial nerve functions. Results : The subjects who had abnormal changes during CPA tumor surgery were twenty cases with BAEP changes and facial EMG changes in twenty one cases. The changes of intraoperative neurophysiologic monitoring did not always result in poor functional outcomes. However, most predictable intraoperative monitoring changes were wave III-V complex losses in BAEP and continuous neurotonic activities in facial EMG. Conclusion : These results indicate that intraoperative neurophysiologic monitoring in CPA tumor surgery usually provide predictive value for postoperative functional outcomes.
Early onset of Batten disease (EBD), one of the most lethal neurodegenerative storage disorders of childhood, is caused by inactivating mutations in the Ceroid Lipofuscinosis, Neuronal (CLN1) gene. Neurogranin, a calmodulin-binding protein, is expressed in the brain and participates in the protein kinase C (PKC) signaling pathway. While oxidative stress is the suggested cause of neurodegeneration in EBD, its molecular mechanism(s) remains obscure. In this research, we examined the levels of neurogranin in the brain mRNA of wild-type (WT) mice and EBD knockout (KO) mice, as well as the proteins. We also performed neuronal cultures to measure the expression levels of neurgranin and phosphorylated-neurogranin with or without oxidative stress inducers and anti-oxidants. Results showed that neurogranin in both EBD KO mice brain mRNA and protein extracts decreased in an age dependent manner. However, high amounts of phosphorylated-neurogranin were detected in the 6-month brain. This pattern was also confirmed by cultured neurospheres samples. Moreover, neurospheres treated with $H_2O_2$, an oxidative stress inducer, showed increased phosphorylated-neurogranin patterns. Interestingly, this pattern returned to normal status when treated with N-acetyl-L-cystein, an anti-oxidant, after $H_2O_2$ treatment was performed. Our results suggest that the phosphorylation of neurogranin is affected by oxidative stress status in EBD, and appropriate anti-oxidant treatment will relieve hyper-phosphorylation of neurogranin.
The aim of the present study was to investigate whether Bovine Spongiform Encephalopathy (BSE) is present in this country and to analyze the Global BSE Risk (GBR) status in Bangladesh. A total of 2,000 brain samples were collected from cattle older than 30 months of age, slaughtered for human consumption in the district slaughter houses from 2005 to 2006. The brainstem (obex), Pyriform lobe, cerebrum and cerebellum were subjected to histopathological study. Samples that showed some nonspecific lesions were subjected to immunohistochemistry and only brain stem to ELISA for the detection of abnormal prion protein $PrP^{sc}$. In passive surveillance, annual overall diseases of cattle, buffalo, sheep and goats in Bangladesh were collected from Department of Livestock Services (DLS), Dhaka to investigate the occurrences of neurological diseases. Import related data were collected from "National Export Promotion Bureau" Kawran Bazar, Bangladesh Bank and DLS to analyze the importing products of animal origin (cattle, buffalo, sheep and goats) from different countries to find whether or not the imported products posed any risk for the BSE. In an actire surveillance conducted in slaughter house, histopathologically BSE specific lesions were not detected in any of the brain samples, but other nonspecific lesions were observed. No $PrP^{sc}$ was detected from the samples by immunohistochemistry and ELISA. DLS report also supported the absence of BSE in cattle and buffalo and scrapie in sheep and goats in Bangladesh. It was also clearly recorded that Bangladesh imported livestock products from countries in GBR level I and II but not from countries in GBR level III and IV. From this study it apparently seems that BSE is not currently present in the indigenous animals in Bangladesh and poses no or negligible risk to human and animal health.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.8
no.1
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pp.113-122
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1997
The purpose of this study was to examine brain structural abnormalities in autistic children. Magnetic resonance imaging(MRI) findings in 22 male children with a DSM-Ⅲ-R diagnosis of autistic disorder and 17 non-autistic male control children were investigated. The ratio measures by lineometry was used to examine the cerebrum, midbrain, cerebellum, brain stem and ventricular system. The left to right ratio of the lateral ventricle was larger in autistic children than in controls. The pons was significantly larger in autistic children than in controls, and the cerebellum was smaller in autistic children. There were no significant differences between autistic children and controls in the symmetricity of the fontral lobe, parietal lobe, occipital lobe and temporal lobe, and in the size of the midbrain and 4th ventricle. These findings suggest that autistic disorder may be related to structural impairment of the brain.
The Sasang constitutional Medicine is the original medicine that is created from the deep studies on former Eastern medical theories by Lee Jae-Ma in the late 19th century. This medicine deals with the interaction between mind and body in great depth. The temperament (the distinct nature and character of an individual, 性情) concept is the theoretical basis which divides man's constitution into four(Taeyangin, Taeumin, Soyangin and Soumin). This concept is derived from The old oriental Sung-Myung concept which has philosophical meaning. These terms of Sung and Jung also have metaphysical meaning and can not be explained easily. but roughly, The temperament is divided two concept. the distinct nature(性) means human's nature and the distinct nature(情) means human's desire. Besides, In Sasang constitution medicine, terms that traditionally represent emotions in asia are used as terminology of temperament. Altough too many aspects about Human's mind remains unknown yet, According to Neurological evidences, the brain is regarded as the main organ that produces rationality and emotion. Especially the way that brain produces an emotion provides some clues that can tell us how can mind affect body. Emotion is considered as evolutionary adaptation to response correctly against unexpected chaotic external changes. It is something that humans are born with, and causes physical responses simultaneously. Moreover, It can be come out with or without consciousness. The temperament(性情) concept and Emotion have similarity that both play an important role in mind-body correlation. Therefore Neurological researches on emotion were able to help reinterpret temperament(性情) concept. the distinct nature(性) seems to be the emotion that is come out directly from the brain stem, and the distinct nature(情) seems to be the emotion that is produced after neocortex involved thinking process. And the reason why Sung and Jung affect organs differently is explained from the manner that brain expresses emotion.
Neuroblastoma is the most common extracranial solid tumor in children. We retrospectively analyzed the results of neuroblastoma treatment of 191 patients (116 males and 75 females) treated between January 1986 and December 2005 at the Department of Pediatric Surgery and the Department of Pediatrics, Seoul National University Children's Hospital. The mean age at diagnosis was 3.1 years (0.1 yrs - 13.5 yrs). Forty-seven patients were under 1 year of age. The mean follow-up period was 57.3 months (24 days - 19.1 yrs). Patients were classified into two groups according to the completeness of resection of the primary tumor; (1) gross total resection (GTR) and (2) incomplete resection (IR). The number of patients in stages I, II, III, IV, IV-S were 17 (8.9 %), 12 (6.3 %), 43 (22.5 %), 114 (59.7 %), 4 (2.1 %), respectively. GTR was achieved in 120 patients and IR in 71 (22 stage III, 47 stage IV, 1 stage IV-S, 1 brain). Overall survival (OS) was 65.2 % and event-free survival (EFS) was 48.6 %. EFS were 100 %, 75 %, 66.8 %, 31.3 %, 75 % at stage I, II, III, IV, IV-S, respectively. There was no significant difference in EFS according to the completeness of resection. EFS was improved in GTR group (p=ns) of stage III, but by contrast, stage IV patients showed worse EFS in GTR group. EFS was improved significantly after the introduction of autologous stem cell transplantation (ASCT) (58.1% vs. 40.6%, p=.029). The EFS improved significantly after the introduction of ASCT in IR group (p=.009) rather than GTR group (p=ns). The EFS of the patients under 1 year of age (N=47) was better than the patients over 1 year of age (N=144) significantly (75.5 % vs. 39.4 %, p=.0034). The prognosis of neuroblastoma was related to the INSS stage and age at diagnosis. The survival of IR group significantly improved after ASCT.
Kim, Myung Jin;Ko, Sung Ae;Jang, Hyo Jin;Jeong, Da Eun;Park, Jeung Min;Lee, Kyoung Hee;Kim, Min Kyoung;Bae, Young Kyung;Hyun, Myung Soo
Journal of Yeungnam Medical Science
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v.29
no.2
/
pp.96-101
/
2012
Allogeneic hematopoietic stem cell transplantation (HSCT) is considered the optimal curative treatment for acute myeloid leukemia (AML), but some patients develop bone marrow relapse due to remnant leukemia, and few patients develop extramedullary relapse without bone marrow relapse. Isolated extramedullary relapse (IMER) is defined as extramedullary relapse without bone marrow relapse. IMER has been reported in various sites, including the skin, soft tissue, and central nervous system(CNS). Isolated CNS relapse is relatively rare and is associated with poor prognosis due to the absence of an optimal treatment for it. Reported herein is a case involving an adult AML woman who suffered from isolated extramedullary relapse in the CNS after allogeneic HSCT. She was treated with intrathecal chemotherapy and whole-brain and spine radiotherapy, followed by systemic chemotherapy. She is currently well, with no evidence of leukemia recurrence for over six years.
Lee, Woo Sang;Kwon, Junhye;Yun, Dong Ho;Lee, Young Nam;Woo, Eun Young;Park, Myung-Jin;Lee, Jae-Seon;Han, Young-Hoon;Bae, In Hwa
Molecules and Cells
/
v.37
no.1
/
pp.17-23
/
2014
We already had reported that Bcl-w promotes invasion or migration in gastric cancer cells and glioblastoma multiforme (GBM) by activating matrix metalloproteinase-2 (MMP-2) via specificity protein 1 (Sp1) or ${\beta}$-cateinin, respectively. High expression of Bcl-w also has been reported in GBM which is the most common malignant brain tumor and exhibits aggressive and invasive behavior. These reports propose that Bcl-w-induced signaling is strongly associated with aggressive characteristic of GBM. We demonstrated that Sp1 protein or mRNA expression is induced by Bcl-w using Western blotting or RT-PCR, respectively, and markedly elevated in high-grade glioma specimens compared with low-grade glioma tissues using tissue array. However, relationship between Bcl-w-related signaling and aggressive characteristic of GBM is poorly characterized. This study suggested that Bcl-w-induced Sp1 activation promoted expression of glioma stem-like cell markers, such as Musashi, Nanog, Oct4 and sox-2, as well as neurosphere formation and invasiveness, using western blotting, neurosphere formation assay, or invasion assay, culminating in their aggressive behavior. Therefore, Bcl-w-induced Sp1 activation is proposed as a putative marker for aggressiveness of GBM.
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