• Journal of Korean Neurosurgical Society
• /
• v.57 no.1
• /
• pp.50-53
• /
• 2015

Usually fungal infections caused by opportunistic and pathogenic fungi had been an important cause of morbidity and mortality among immunocompromised patients. However clinical data and investigations for immunocompetent pathogenic fungal infections had been rare and neglected into clinical studies. Especially Cryptococcal brainstem abscess cases mimicking brain tumors were also much more rare. So we report this unusual case. This 47-year-old man presented with a history of progressively worsening headache and nausea for 1 month and several days of vomituritions before admission. Neurological and laboratory examinations performed demonstrated no abnormal findings. Previously he was healthy and did not have any significant medical illnesses. A CT and MRI scan revealed enhancing $1.8{\times}1.7{\times}2.0$ cm mass lesion in the left pons having central necrosis and peripheral edema compressing the fourth ventricle. And also positron emission tomogram scan demonstrated a hot uptake of fluoro-deoxy-glucose on the brainstem lesion without any evidences of systemic metastasis. Gross total mass resection was achieved with lateral suboccipital approach with neuronavigation system. Postoperatively he recovered without any neurological deficits. Pathologic report confirmed Cryptococcus neoformans and he was successively treated with antifungal medications. This is a previously unreported rare case of brainstem Cryptococcal abscess mimicking brain tumors in immunocompetent host without having any apparent typical meningeal symptoms and signs with resultant good neurosurgical recovery.

• Journal of Korean Neurosurgical Society
• /
• v.41 no.6
• /
• pp.387-390
• /
• 2007

Objective : To determine the presentation, incidence, and risk factors of seizures in patients treated for brain tumors. Methods : One hundred patients who consecutively underwent a craniotomy for the treatment of supratentorial brain tumors were assessed. The pathologies of the patients enrolled in the study included glioma [n=56], meningioma [n=31], metastatic brain tumor [n=7], primary central nervous system lymphoma [n=4], and central neurocytoma [n=2]. Anti-epileptic drugs [AEDs] were administered to all patients for up to six months after the surgery. Pre-defined variables for outcome analysis included tumor grade and location, extent of tumor resection, number of seizures, age at tumor diagnosis, adjuvant therapy, medication and radiological abnormalities. Results : Thirty patients [30%] presented at least a single episode of seizure at the time of admission. Five of these patients [16.7%] developed the seizure during the follow-up period. Newly developed seizure was noticed in six out of seventy patients [8.6%] without prior seizure. Histopathology was malignant gliomas in 10 and supratentorial meningioma in one. Early seizure developed only in two patients. Conclusion : Compared with patients without seizure, patients with seizure at the time of admission showed younger age [p=0.003], a higher portion of low-grade glioma [p=0.001], tumor location in the frontal and temporal lobes [p=0.003] and cortical involvement [p=0.017]. Our study suggestes that tumor progression is considered a significant risk factor for seizure development in glioma patients.

• The Korean Journal of Cytopathology
• /
• v.5 no.2
• /
• pp.90-98
• /
• 1994

There has been a marked increase in the utility of aspiration cytology for pathologic diagnosis. It may be applied to any kinds of organs and substitutes surgical biopsy. Be cause of the high risk of complication and difficulties In localization, aspiration cytology in the central nervous system (CNS) has been used with less frequency compared to other sites. However, with the advent of sophisticated imaging instruments, aspiration cytology of lesions in the CNS is being used increasingly. We present cytologic features of brain tumors as well as corresponding histologic findings. Eight types of tumors were aspirated intraoperatively and stained with the Papanicolaou method; 1 anaplastic astrocytoma, 1 glioblastoma multiforme, 1 ependymoma, 1 malignant ependymoma, 1 central neurocytoma, 1 primitive neuroectodermal tumor, 1 benign neurogenic tumor and 1 germinoma. Cytologic features of the CNS neoplasms were quite similar to those of histology except one spindle cell tumor. Reviewing various CNS neoplasms, it appears that cytology may be a useful diagnostic method.

• The Korean Journal of Cytopathology
• /
• v.9 no.1
• /
• pp.21-28
• /
• 1998

Cytologic evaluation of cerebrospinal fluid(CSF) is an effective tool in diagnosing many disorders involving the central nervous system(CNS). CSF examination has been found to be of particular value in the diagnosis of metastatic carcinoma, lymphomatous or leukemic involvement of CNS and certain primary CNS tumors. As a survey of metastatic tumors to CSF and an evaluation of the preparation techniques increasing cellular yield in our laboratory, 713 CSF specimens examined between July 1995 and April 1997(1 year 10 months), were reviewed. There were 75 positive and 5 suspicious cases, the latter have had no evidence of tumors clinically. Primary tumors of 75 positive cases were classified as follows; 4(5.3%) as primary brain tumors, 40(53.3%) as secondary carcinomas, 13(17.3%) as leukemias, and 18 (24.0%) as lymphomas. The most common primary site of metastatic carcinomas was the lung in 17 cases(42.5%) followed by the stomach in 13(32.5%), breast in 8 (20.0%), and unknown primary in 2(5.0%). Four primary brain tumors were 3 cerebellar medulloblastomas and a supratentorial primitive neuroectodermal tumor (PNET). All 40 metastatic carcinomas were adenocarcinoma presented as single cells or cell clusters. Although signet ring cells were frequent in the cases of gastric primary cancers, no significant cytologic differences according to the primary site were observed. The cytologic features of leukemia and lymphoma were characterized by hypercellular smears presenting as individual atypical cells with increased N/C ratio, presence of nucleoli, and nuclear protrusions. In medulloblastomas and PNET, the principal cytologic findings were small undifferentiated cells arranged singly or in loose clusters with occasional rosettoid features. This study suggests that the CSF cytology is useful in the diagnosis of malignancy, especially metastatic extracranial tumors and the diagnostic accuracy can be improved by increasing cellular yield using cytocentrifuge.

• Journal of Korean Neurosurgical Society
• /
• v.66 no.6
• /
• pp.632-641
• /
• 2023

Central nervous system tumors are identified as tumors of the brain and spinal cord. The associated morbidity and mortality of cerebrospinal tumors are disproportionately high compared to other malignancies. While minimally invasive techniques have initiated a revolution in neurosurgery, artificial intelligence (AI) is expediting it. Our study aims to analyze AI's role in the neurosurgical management of cerebrospinal tumors. We conducted a scoping review using the Arksey and O'Malley framework. Upon screening, data extraction and analysis were focused on exploring all potential implications of AI, classification of these implications in the management of cerebrospinal tumors. AI has enhanced the precision of diagnosis of these tumors, enables surgeons to excise the tumor margins completely, thereby reducing the risk of recurrence, and helps to make a more accurate prediction of the patient's prognosis than the conventional methods. AI also offers real-time training to neurosurgeons using virtual and 3D simulation, thereby increasing their confidence and skills during procedures. In addition, robotics is integrated into neurosurgery and identified to increase patient outcomes by making surgery less invasive. AI, including machine learning, is rigorously considered for its applications in the neurosurgical management of cerebrospinal tumors. This field requires further research focused on areas clinically essential in improving the outcome that is also economically feasible for clinical use. The authors suggest that data analysts and neurosurgeons collaborate to explore the full potential of AI.

• Journal of Korean Biological Nursing Science
• /
• v.7 no.1
• /
• pp.47-56
• /
• 2005

nm23-H1 gene expression has been inversely correlated with tumor metastatic potential in certain tumors including melanomas, breast carcinomas, and hepatocellular carcinomas. However, its role with respect to the invasive behavior of central nervous system tumors has scarcely been addressed Because cell motility and invasion plays an essential role in metastatic dissemination, we have studied whether motile human glioma cell(U87MG) transfected with nm23-H1 complementary DNA have any alterations in their ability to migrate and invade. There was no significant changes in the shape and size of the cells following nm23-H1 transfection. The role of nm23-H1 in glioma migration and invasion have been evaluated by in vitro simple scratch technique and brain slice invasion model Basal migration ability of nm23-H1 transfectants cell(U87MG-pEGFP-nm23) were lesser than U87MG. Accordingly, U87MG-pEGFP-nm23 didn't migrate away apparently from the tumors implanted site comparing U87MG in brain slice invasion model. These results suggest that nm23-H1 may play an important role in suppressing the human glioma migration and invasion.

• BMB Reports
• /
• v.55 no.8
• /
• pp.380-388
• /
• 2022

The B cell translocation gene 1 (BTG1) and BTG2 play a key role in a wide range of cellular activities including proliferation, apoptosis, and cell growth via modulating a variety of central biological steps such as transcription, post-transcriptional, and translation. BTG1 and BTG2 have been identified by genomic profiling of B-cell leukemia and diverse lymphoma types where both genes are commonly mutated, implying that they serve as tumor suppressors. Furthermore, a low expression level of BTG1 or BTG2 in solid tumors is frequently associated with malignant progression and poor treatment outcomes. As physiological aspects, BTG1 and BTG2 have been discovered to play a critical function in regulating quiescence in hematopoietic lineage such as Hematopoietic stem cells (HSCs) and naive and memory T cells, highlighting their novel role in maintaining the quiescent state. Taken together, emerging evidence from the recent studies suggests that BTG1 and BTG2 play a central anti-proliferative role in various tissues and cells, indicating their potential as targets for innovative therapeutics.

• Radiation Oncology Journal
• /
• v.2 no.2
• /
• pp.287-297
• /
• 1984

The normal intracranial structures are relatively resistant to therapeutic radiation, but may react adversely in a variety of ways, and the damage to nerve tissue may be slow in making its appearance, and once damage has occured the patient recovers slowly and incompletly. Therefore, it is important to consider the possibility of either recurrent tumor or late adverse effect in any patient who has had radiotherapy. The determination o( rnorphological/pathological correlation is very important to the therapeutic radiologist who uses CT scans to define a treatment volume, as well as to the clinician who wishes to explain the patient's clinical state in terms of regress, progression, persistence, or recurrence of tumor or radiation-induced edema or necrosis, The authors are obtained as following results ; 1. The field size(whole CNS, large, intermediate, small field) was variable according to the location and extension of tumor and histopathologic diagnosis, and the tatal tumor dose was 4,000 to 6,000 rads except one of recurred case of 9,100 rads. The duration of follow up CT scan was from 3 months to 5 year 10 months. 2, The histopathologic diagnosis of 9cases were glioblastoma multiforme(3 cases), pineal tumor (3), oligodendroglioma (1), cystic astrocytoma (1), pituitary adenoma (1) and their adverse effects after radiation therapy were brain atrophy (4 cases) , radiation necrosis(2), tumor recurrence with or without calcification (2), radiation·induced infarction (1). 3. The recurrent symptoms after radiation therapy of brain tumor were not always the results of regrowth of neoplasm, but may represent late change of irradiated brain. 4. It must be need that we always consider the accurate treatment planning and proper treatment method to reduce undesirable late adverse effects in treatment of brain tumors.

• Clinical and Experimental Pediatrics
• /
• v.57 no.7
• /
• pp.333-336
• /
• 2014

Reports of constitutional ring chromosome 22, r(22) are rare. Individuals with r(22) present similar features as those with the 22q13 deletion syndrome. The instability in the ring chromosome contributes to the development of variable phenotypes. Central nervous system (CNS) atypical teratoid rhabdoid tumors (ATRTs) are rare, highly malignant tumors, primarily occurring in young children below 3 years of age. The majority of ATRT cases display genetic alterations of SMARCB1 (INI1/hSNF5 ), a tumor suppressor gene located on 22q11.2. The coexistence of a CNS ATRT in a child with a r(22) is rare. We present a case of a 4-month-old boy with 46,XY,r(22)(p13q13.3), generalized hypotonia and delayed development. High-resolution microarray analysis revealed a 3.5-Mb deletion at 22q13.31q13.33. At 11 months, the patient had an ATRT ($5.6cm{\times}5.0cm{\times}7.6cm$) in the cerebellar vermis, which was detected in the brain via magnetic resonance imaging.

• Journal of Korean Neurosurgical Society
• /
• v.49 no.6
• /
• pp.367-369
• /
• 2011

Angiocentric glioma was recently recognized as a distinct clinicopathological entity in the 2007 World Health Organization classification of tumors of the central nervous system. Typically, it presents with seizure in children and young adults. However, our patient did not have a history of seizure. Seizure did not occur up to 6 months after operation. Although it usually does not have calcification brain magnetic resonance imaging in our patient showed T1-hyperintense and T2-hypointense signals with calcification.