• Clinical and Experimental Pediatrics
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• 제45권4호
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• pp.535-539
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• 2002

저자들은 생후 3일째 시작된 경련과 특징적인 피부 병변을 주소로 입원한 환아에서 피부 생검과 뇌 자기 공명 촬영으로 중추 신경계 발달 이상을 동반한 색소 실조증 1례를 경험하였고 중추 신경계 발달 이상은 치명적인 예후 인자로 사료되며 이를 문헌 고찰과 함께 보고하는 바이다.

• Radiation Oncology Journal
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• 제37권4호
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• pp.302-308
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• 2019

The abscopal effect is a term that has been used to describe the phenomenon in which localized radiation therapy treatment of a tumor lesion triggers a spontaneous regression of metastatic lesion(s) at a non-irradiated distant site(s). Radiation therapy induced abscopal effects are believed to be mediated by activation and stimulation of the immune system. However, due to the brain's distinctive immune microenvironment, extracranial abscopal responses following cranial radiation therapy have rarely been reported. In this report, we describe the case of 42-year-old female patient with metastatic melanoma who experienced an abscopal response following her cranial radiation therapy for her brain metastasis. The patient initially presented with a stage III melanoma of the right upper skin of her back. Approximately 5 years after her diagnosis, the patient developed a large metastatic lesion in her upper right pectoral region of her chest wall and axilla. Since the patient's tumor was positive for BRAF and MEK, targeted therapy with dabrafenib and trametinib was initiated. However, the patient experienced central nervous system (CNS) symptoms of headache and disequilibrium and developed brain metastases prior to the start of targeted therapy. The patient received radiation therapy to a dose of 30 Gy delivered in 15 fractions to her brain lesions while the patient was on dabrafenib and trametinib therapy. The patient's CNS metastases improved significantly within weeks of her therapy. The patient's non-irradiated large extracranial chest mass and axilla mass also shrank substantially demonstrating the abscopal effect during her CNS radiation therapy. Following radiation therapy of her residual chest lesions, the patient was disease free clinically and her CNS lesions had regressed. However, when the radiation therapy ended and the patient continued her targeted therapy alone, recurrence outside of her previously treated fields was noted. The disease recurrence could be due to the possibility of developing BRAF resistance clones to the BRAF targeted therapy. The patient died eventually due to wide spread systemic disease recurrence despite targeted therapy.

• Journal of Korean Neurosurgical Society
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• 제61권3호
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• pp.402-406
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• 2018

In contrast to many of the malignant tumors that occur in the central nervous system in adults, the management, responses to therapy, and future perspectives of children with malignant lesions of the brain hold considerable promise. Within the past 5 years, remarkable progress has been made with our understanding of the basic biology of the molecular genetics of several pediatric malignant brain tumors including medulloblastoma, ependymoma, atypical teratoid rhabdoid tumour, and high grade glioma/diffuse intrinsic pontine glioma. The recent literature in pediatric neuro-oncology was reviewed, and a summary of the major findings are presented. Meaningful sub-classifications of these tumors have arisen, placing children into discrete categories of disease with requirements for targeted therapy. While the mainstay of therapy these past 30 years has been a combination of central nervous system irradiation and conventional chemotherapy, now with the advent of high resolution genetic mapping, targeted therapies have emerged, and less emphasis is being placed on craniospinal irradiation. In this article, the present and future perspective of pediatric brain malignancy are reviewed in detail. The progress that has been made offers significant hope for the future for patients with these tumours.

• 대한핵의학회지
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• 제8권1_2호
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• pp.39-47
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• 1974

The purpose of this study is to evalute the diagnostic value of the brain scanning and compare the diagnostic accuracy between the scan and carotid angiography. 109 cases which are proved by specific method to each disease, are analized to evalute the diagnostic value of the brain scanning. The 70 cases among the proven 109 case are performed both the scanning and the arteriography and analized to compare the accuracy between the scanning and the arteriography. The results are as follows; 1. The diagnostic accuracy of the brain scanning in the diseases of the central nervous system is 64.2%. 2. The diagnostic accuracy of the brain scanning in the brain tumor is 88%, especially brain abscess. glioma, glioblastoma multiforme, menirgioma and metastic tumor show high positive rate. 3. The diagnostic accuracy in the disease of the brain vessels is 54 %. 4. The comparison of the diagnostic value between the scanning and the arteriography is as follows; 1) The diagnostic value in all diseases of the central nervous system is nearly equal. 2) The diagnostic accuracy in the intracranial tumor is slightly higher in the brain scanning (90.9%) than in the arteriography (81.8%). 3) The diagnostic accuracy in the disease of the brain vessel is higher in the arteriography (77.3%) than in the scanning (54.5%). 5) The diagnostic value when combining the scanning and the arteriography, is 83% in the all central nervous system-lesions, 97% in the cranial tumor and 81.8% in the disease of the central nervous system-vessel. The brain scanning is simple and safe procedure, and moreover has excellent diagnostic value in the diagnosis of the central nervous system lesion.

• Journal of Korean Neurosurgical Society
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• 제30권7호
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• pp.896-902
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• 2001

Objectives : Aspergillosis of central nervous system(CNS) is a rare pathologic condition and it has been known to be difficult to diagnose and treat. We analyzed seven cases of central nervous system aspergillosis. The clinical characteristics, and the problems in diagnosis and treatment are discussed with review of previous literatures. Material and Methods : We reviewed the clinical records, radiological findings, and pathologic reports of 7 patients with aspergillosis which involved CNS. Results : Five patients were immunocompetent, and infection was related with previous operation in 4 of them. Two patients were immunocompromised and had no history of operation. Five patients had intracranial lesions and two had spinal lesions. Mean duration from the onset of initial symptom to pathologic diagnosis was 2.4 months. Mean duration from the previous operation to the onset of symptom was 9.3 months, and from the onset of symptom to diagnosis was 2.9 months in the patients who had histories of operation. All of them were treated with surgical procedures and intravenous and oral antifungal agents, resulting in cure in 6 cases. Mean duration of the treatment was 4.9 months. Conclusion : Because aspergillosis of CNS is a rare disease and is difficult to be differentiated from the pyogenic abscess or recurrent tumor, the pathologic diagnosis is very important for adequate treatment. Although the prognosis of aspergillosis of CNS has been known to be poor, adequate surgery for both diagnosis and treatment and antifungal chemotherapy resulted in good outcome.

• Journal of Korean Neurosurgical Society
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• 제61권4호
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• pp.485-493
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• 2018

Objective : Cerebral varices (CVs) without an arteriovenous shunt, so called nonfistulous CVs, are very rare, and their etiology and natural course are not well understood. The aim of this study is to evaluate the clinical outcomes of nonfistulous CVs by the analysis of 39 cases. Methods : From 2000 to 2015, 22 patients with 39 nonfistulous CVs (${\geq}5mm$) were found by searching the medical and radiologic records of our institute. Clinical data and radiological data including numbers, sizes and locations of CVs and associated anomalies were retrospectively collected and analyzed. Previously reported cases in literature were reviewed as well. Results : The mean age of the patients was 21 years (range, 0-78 years). On average, $1.8{\pm}1.2CVs$ were found per patient. CVs were categorized as either fusiform or saccular depending on their shapes. Two patients had saccular type CVs, seventeen patients had fusiform types, and three patients had both fusiform and saccular CVs. Eight patients had associated compromise of the vein of Galen and the straight sinus. Four of those patients had sinus pericranii, as well. Five patients had CVs that were distal draining veins of large developmental venous anomalies. One patient had associated migration anomaly, and two patients had Sturge-Weber syndrome. Six patients with an isolated cerebral varix were observed. Of the 39 CVs in 22 patients, 20 lesions in 14 patients were followed up in outpatient clinics with imaging studies. The average follow-up duration was 6.6 years. During this period, no neurological events occurred, and all the lesions were managed conservatively. Conclusion : Nonfistulous CVs seemed to be asymptomatic in most cases and remained clinically silent. Hence, we suggest conservative management.

• Journal of Korean Neurosurgical Society
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• 제48권4호
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• pp.371-374
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• 2010

Cysticercosis is the most common parasitic infection affecting the central nervous system. Spinal neurocysticercosis (NCC) is very rare compared with intracranial NCC arid requires more aggressive management because these lesions are poorly tolerated. The authors report a case of intradural extramedullary cysticercosis of the entire level of spine with review of the literature.

• Journal of Korean Neurosurgical Society
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• 제30권5호
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• pp.622-626
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• 2001

Acute disseminated encephalomyelitis(ADEM) is an uncommon immune-mediated inflammatory demyelinating disorder that typically affects the white matter of the central nervous system. Radiologic findings of acute disseminated encephalomyelitis are not pathognomomic. The differential diagnosis is always difficult. Occasionally, the clinical features, radiological and histopathological findings of patients with acute disseminated encephalomyelitis mimic the brain tumor or other space occupying lesions. The authors report a 6-year-old girl who presented with right hemiparesis two days after nausea and vomiting. Brain MRI of the patient revealed non-enhanced multiple cystic lesions in subcortical white matter of both cerebral hemisphere with prominent edema. One of the cystic lesions was resected to differentiate with metastatic tumor or inflammatory disease such as abscess and confirmed as the acute disseminated encephalomyelitis via various immunohistochemical stains. Pertinent literature is reviewed with discussion on this uncommon ADEM associated with multiple cystic lesions.

• 대한수의학회지
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• 제30권1호
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• pp.93-102
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• 1990

Thirty-day-old piglets were intranasally or subcutaneously inoculated with 2ml of Aujeszky's disease virus, NYJ-1 strain, at the titer of $10^{6.75}$ $TCID_{50}/0.1ml$, that was isolated from the diseased piglets in Korea, and histopathological studies were performed to elucidate the pathognomonic characters of the isolate. Results obtained through the experiments were as follows: 1. Major clinical signs on the 2nd and 3rd days post inoculation (p.i.) were fever, anorexia and dyspnea. On the 6th and 7th days p.i., nervous signs, severe dyspnea and salivation were observed in the group of intranasal inoculation, and one out of 3 piglets in this group died on the 7th day p.i.. General signs were more severe in the group of intranasal inoculation than the group of subcntaneous injection. Between the 8th and l0th days p.i., the signs subsided and the piglets were completely recovered from the illness. 2. Hematologically, most of the inoculated pigs showed a mild lymphocytopenia on the 5th and 6th days p.i.. 3. By necropsy, swelling and hemorrhagic lesions were observed in tonsil, central nervous system and lung. No specific changes were grossly found in other parenchymatous organs. 4. In histopathological study, degeneration and necrosis of nervous cells, non-suppurative meningoencephalitis, diffuse or focal gliosis, perivascular cutting and degeneration of ganglion cells were observed in central nervous system, and swelling and hemorrhagic changes were shown in the tissues of liver, lung and lymph nodes. 5. By indirect immunofluorescence antibody assay using ADV-monoclonal antibody, specific ADV antigens were detected in the tissues of tonsil, brain and spleen of the succumbed piglet. However, in the experimentally slaughtered piglets, the specific reactions were noted only in the tonsils.

• 대한치과의사협회지
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• 제49권6호
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• pp.321-326
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• 2011

Neuropathic pain is caused by functional abnonnalities of structural lesions in the peripheral or central nervous system, and occurs without peripheral nociceptor stimulation. Trigeminal neuropathy always pose differential location difficulties as multiple diseases are capablc of producing them: they can be the result of traumatism, tumors, or diseases of the connective tissue, infectious or demyelinating diseases, or may be of idiopathic origin. There are a number of mechanisms described as causing neuropathy. They can be described as ectopic nerve activity, neuroma, ephatic trasmission, change of sodium channel expression, sympathetic activity, central sensitization, and alteration in central inhibition systems. More than I mechanism may be active to create individual clinical presentations. In order to provide better pain control, the mechanism-based approach in treating neuropathic pain should be familiar to physicians.