• 종양간호연구
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• 제12권2호
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• pp.186-193
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• 2012

Purpose: The purpose of this narrative study was to understand how family caregivers interpreted themselves life during caring for dying patients with gliobalstoma, and how they integrated these experiences into their personal biographies. Methods: Three family caregivers were recruited for the study. Data were collected through a series of audio-taped unstructured interviews and conversations with participants. The interviews and observation were conducted between October and November, 2011. Data were analyzed using psychosocial analytical methods that combined case based, in-depth staged analysis of narratives. Results: The life experiences of the family caregivers with a dying family member were summarized as, in their own voices, 'the repetition of gliobalstoma,' 'a smart patient,' 'being obsessed with rehabilitation treatment,' 'the frustration from nothing but just looking at the suffering of the patient,' and 'a stubborn son'. Conclusion: Caregiving was characterised by various roles and life changes from the moment of diagnosis. Family caregivers of brain tumor reported experiences similar to those described by caregivers of people with other cancers. What differed for this group was the rapidity of change and the need for immediate information and support to assist with caring for a person with high-grade glioma.

• The Korean Journal of Physiology and Pharmacology
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• 제15권4호
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• pp.211-216
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• 2011

Glioblastoma multiforme is one of the most common and aggressive tumors in central nervous system. It often possesses characteristic necrotic lesions with hemorrhages, which increase the chances of exposure to thrombin. Thrombin has been known as a regulator of MMP-9 expression and cancer cell migration. However, the effects of thrombin on glioma cells have not been clearly understood. In the present study, influences of thrombin on glioma cell migration were examined using Boyden chamber migration assay and thrombin-induced changes in MMP-9 expression were measured using zymography, semi-quantitative RT-PCR, and Western blotting. Furthermore, underlying signaling pathways by which thrombin induces MMP-9 expression were examined. Thrombin-induced migration and MMP-9 expression were significantly potentiated in the presence of wortmannin, a PI3K inhibitor, whereas MAPK inhibitors suppressed thrombin-induced migration and MMP-9 expression in C6 glioma cells. The present data strongly demonstrate that MAPK and PI3K pathways evidently regulate thrombin-induced migration and MMP-9 expression of C6 glioma cells. Therefore, the control of these pathways might be a beneficial therapeutic strategy for treatment of invasive glioblastoma multiforme.

• 생명과학회지
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• 제17권8호통권88호
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• pp.1039-1045
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• 2007

다형성 교모세포종은 뇌종양 가운데 가장 빈번하게 발병하는 악성종양이다. 다형성 교모세포종에 종양 줄기세포가 존재한다는 보고가 있음에도 불구하고, 항암제 내성과 종양 줄기세포 사이의 상호 연관성에 관한 연구는 아직 미비한 실정이다. 본 연구에서 다형성 교모세포종 세포주 A172 및 뇌종양 환자로부터 확립한 GBM2에 1,3-bis(2 -chloroethyl)-1-nitrosourea (BiCNU)를 처리시 극소량의 세포군만이 생존하며, 이들 생존 세포군은 BiCNU 재처리에 내성을 나타내는 것으로 조사되었다. 또한 이 다형성 교모세포종 유래 BiCNU-내성세포군의 Erk 및 Akt 인산화 활성이 증가되었으며, CD133 줄기세포 표지인자를 발현하는 세포가 다량 존재하였다. 이와 아울러, 다형성 교모세포종 유래 BiCNU-내성세포를 severe combined immuno-deficient (SCID) mouse brain에 이식하였을 때 암이 형성되는 것을 관찰할 수 있었다. 이와 같은 결과는 다형성 교모세포종 유래 BiCNU-내성세포가 종양줄기세포의 능력을 가지는 것으로 생각된다. 따라서 이상의 결과는 다형성 교모세포종에 존재하는 종양줄기세포가 항암제 내성에 관여 한다는 중요한 단서를 제공해줄 수 있을 것으로 사료된다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.971-977
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• 2015

Malignant glioblastoma multiforme (GBM) is the most malignant brain tumor and despite recent advances in diagnostics and treatment prognosis remains poor. In this retrospective study, we assessed the clinical and radiological parameters, as well as fluorescence in situ hybridization (FISH) of 1p19q deletion, in a series of cases. A total of 816 patients with GBM who received surgery and radiation between January 2010 and May 2014 were included in this study. Kaplan-Meier survival analysis and Cox regression analysis were used to find the factors independently influencing patient progression free survival (PFS) and overall survival (OS). Age at diagnosis, preoperative Karnofsky Performance Scale (KPS) score, KPS score change at 2 weeks after operation, neurological deficit symptoms, tumor resection extent, maximal tumor diameter, involvement of eloquent cortex or deep structure, involvement of brain lobe, Ki-67 and MMP9 expression level and adjuvant chemotherapy were statistically significant factors (p<0.05) for both PFS and OS in the univariate analysis. Cox proportional hazards modeling revealed that age ${\leq}50$ years, preoperative KPS score ${\geq}80$, KPS score change after operation ${\geq}0$, involvement of single frontal lobe, deep structure involvement, low Ki-67 and MMP9 expression and adjuvant chemotherapy were independent favorable factors (p<0.05) for patient clinical outcomes.

• Korean Journal of Radiology
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• 제22권8호
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• pp.1369-1378
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• 2021

Objective: Few attempts have been made to investigate the prognostic value of dynamic contrast-enhanced (DCE) MRI or dynamic susceptibility contrast (DSC) MRI of non-enhancing, T2-high-signal-intensity (T2-HSI) lesions of glioblastoma multiforme (GBM) in newly diagnosed patients. This study aimed to investigate the prognostic values of DCE MRI and DSC MRI parameters from non-enhancing, T2-HSI lesions of GBM. Materials and Methods: A total of 76 patients with GBM who underwent preoperative DCE MRI and DSC MRI and standard treatment were retrospectively included. Six months after surgery, the patients were categorized into early progression (n = 15) and non-early progression (n = 61) groups. We extracted and analyzed the permeability and perfusion parameters of both modalities for the non-enhancing, T2-HSI lesions of the tumors. The optimal percentiles of the respective parameters obtained from cumulative histograms were determined using receiver operating characteristic (ROC) curve and univariable Cox regression analyses. The results were compared using multivariable Cox proportional hazards regression analysis of progression-free survival. Results: The 95th percentile value (PV) of Ktrans, mean Ktrans, and median Ve were significant predictors of early progression as identified by the ROC curve analysis (area under the ROC curve [AUC] = 0.704, p = 0.005; AUC = 0.684, p = 0.021; and AUC = 0.670, p = 0.0325, respectively). Univariable Cox regression analysis of the above three parametric values showed that the 95th PV of Ktrans and the mean Ktrans were significant predictors of early progression (hazard ratio [HR] = 1.06, p = 0.009; HR = 1.25, p = 0.017, respectively). Multivariable Cox regression analysis, which also incorporated clinical parameters, revealed that the 95th PV of Ktrans was the sole significant independent predictor of early progression (HR = 1.062, p < 0.009). Conclusion: The 95th PV of Ktrans from the non-enhancing, T2-HSI lesions of GBM is a potential prognostic marker for disease progression.

• Journal of Korean Neurosurgical Society
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• 제58권5호
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• pp.426-431
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• 2015

Objective : The purpose of this study was to evaluate the clinical efficacy of continuous low-dose temozolomide (TMZ) chemotherapy for recurrent and TMZ-refractory glioblastoma multiforme (GBM) and to study the relationship between its efficacy and microvessel density within the tumor. Methods : Thirty patients who had recurrent GBM following Stupp's regimen received TMZ daily at $50mg/m^2/day$ until tumor progression between 2007 and 2013. The median duration of continuous low-dose TMZ administration was 8 weeks (range, 2-64). Results : The median progression-free survival (PFS) of continuous low-dose TMZ therapy was 2 months (range, 0.5-16). At 6 months, PFS was 20%. The median overall survival (OS) from the start of this therapy to death was 6 months (95% CI : 5.1-6.9). Microvessel density of recurrent tumor tissues obtained by reoperation of 17 patients was $22.7{\pm}24.1/mm^2$ (mean${\pm}$standard deviation), and this was lower than that of the initial tumor ($61.4{\pm}32.7/mm^2$) (p-value=0.001). It suggests that standard TMZ-chemoradiotherapy reduces the microvessel density within GBM and that recurrences develop in tumor cells with low metabolic burden. The efficacy of continuous low-dose TMZ could not be expected in recurrent GBM cells in poor angiogenic environments. Conclusion : The efficacy of continuous low-dose TMZ chemotherapy is marginal. This study suggests the need to develop further treatment strategies for recurrent and TMZ-refractory GBM.

• 대한핵의학회지
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• 제26권2호
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• pp.360-364
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• 1992

Treatment for the brain tumors consist of surgery, chemotherapy, and a variety of methods of irradiation. Therapy is aimed to destroy the tumor, but necrosis and edema occur concurrently. Conventional structural imaging techniques such as CT or MRI are unable to reliably distinguish persistent and recurrent tumor from necrosis or edema. T1-201 has been shown to be useful in the evaluation of the myocardial viability by comparing the early uptake and redistribution image. The aim of this study is to evaluate the clinical usefulness of the early uptake and delayed washout images of the T1-201 brain SPECT in the brain tumors. In the pathologically diagnosed various brain tumor patients, brain SPECT was done with rotating gamma camera 15 minutes and 3 hours after T1-201 injection, and the T1-201 uptake in the tumor was compared with the skull and scalp activity. In the glioblastoma multiforme, meningioma and metastatic tumor, the T1-201 uptake was higher than low grade glioma in both 15 minute and 3 hour images (p<0.02). In the low grade glioma,3 hour T1-201 uptake was significantly lower than 15 minute uptake (p<0.05) but in the glioblastoma, meningioma and metastatic tumor there was no significant difference. There was no significant difference in the T1-201 uptake among the glioblastoma, meningioma and metastatic tumors. In one matastatic tumor, T1-201 uptake was decreased after radiation therapy. T1-201 brain SPECT could distinguish the benign and malignancy, and seems to be useful in the follow-up after treatment. But one of the early or delayed SPECT seems not to be necessary for these purposes.

• Molecules and Cells
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• 제43권6호
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• pp.539-550
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• 2020

Glioblastoma multiforme (GBM) is a fatal malignant tumor that is characterized by diffusive growth of tumor cells into the surrounding brain parenchyma. However, the diffusive nature of GBM and its relationship with the tumor microenvironment (TME) is still unknown. Here, we investigated the interactions of GBM with the surrounding microenvironment in orthotopic xenograft animal models using two human glioma cell lines, U87 and LN229. The GBM cells in our model showed different features on the aspects of cell growth rate during their development, dispersive nature of glioma tumor cells along blood vessels, and invasion into the brain parenchyma. Our results indicated that these differences in the two models are in part due to differences in the expression of CXCR4 and STAT3, both of which play an important role in tumor progression. In addition, the GBM shows considerable accumulation of resident microglia and peripheral macrophages, but polarizes differently into tumor-supporting cells. These results suggest that the intrinsic factors of GBM and their interaction with the TME determine the diffusive nature and probably the responsiveness to non-cancer cells in the TME.

• Journal of Korean Neurosurgical Society
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• 제37권4호
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• pp.296-299
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• 2005

We report a case of primary central nervous system(CNS) lymphoma in an organ recipient. A 33-years-old man who underwent a renal transplantation 3years previously presented with headache and vomiting. In Brain computed tomography scans and magnetic resonance images showed multiple periventricular cystic rim enhancing masses. Pathologic diagnosis by stereotactic biopsy revealed malignant non-Hodgkins B-cell lymphoma. After pathologic confirmation, methotrexate chemotherapy and whole brain radiation therapy were done. Having experienced such a case, the authors strongly recommend to add primary CNS lymphoma as one of the differential diagnoses to brain abscess, metastatic brain tumor and glioblastoma multiforme in cases of multiple ring enhancing periventricular lesions of immunocompromised patient or organ recipient.

• 대한자기공명의과학회:학술대회논문집
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• 대한자기공명의과학회 2003년도 제8차 학술대회 초록집
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• pp.21-21
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• 2003

목적： 악성뇌종양 주변부위의 역동자기공명영상에서의 시간신호강도곡선 양상으로 종양의 성장 양상이나 예후를 판단할 수 있는지를 알고자 한다. 대상 및 방법： Anaplastic oligodendroglioma 3예, Anaplastic astrocytoma 1예, Glioblastoma multiforme 1예, Malignant ependymoma 2예, Medulloblastorna 1예로서, 총 8예의 종양절제전, 혹은 후의 잔류 종양을 대상으로 하였다. Routine MRI에 추가하여 종양부위에서 Turbo spin echo T1 강조 역동자기공명영상을 하였으며, Gd-DTPA 0.1 mmol/kg를 급속 주사 한 후, TR/TE, 350/15, slice thickness 6 mm, slice number 3, NEX 2회, scan time은 15 초로 하여 5 분 동안 20회 영상을 얻었다. 가시적으로 조영증강이 없는 종양의 주변부위나 수술경계부위에 관심영역을 그려서 시간신호강도곡선을 얻었으며, 첫 회 조영제 통과시의 peak 이후에 신호가 감소하는 경우를 Normal pattern으로, peak 이후에 신호가 계속 유지되거나 증가하는 경우를 Tumor pattern으로 하였으며, Normal pattern과 Tumor pattern을 보인 예들을 구분하여 종양의 재성장 상태와 환자의 생존 기간을 비교 관찰하였다.