• 대한핵의학회지
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• 제34권5호
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• pp.371-380
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• 2000

목적: 수술 전에 전향적으로 $^{201}Tl$ 뇌 SPECT를 시행하여 그 소견만으로 뇌 병변이 양성인지 악성인지를 감별하는데 유용한지를 알아보고자 하였다. 대상 및 방법: 본 연구는 CT나 MRI에서 뇌 병변이 확인된 28예(양성: 13, 악성: 15)를 대상으로 하였다. 양성병변에는 비특이적 양성변화가 3예, 뇌수막종 3예, 양성 뇌교종 2예, 결핵종, 중심성 신경세포종, 혈관 모세포종, 방사선괴사, 맥락막총 유두종이 각각 1예씩 이었고 악성병변에는 다형성 교모세포종 6예, 미분화 성상교세포종 5예, 수질아세포종 2예, 전이암과 림프종이 각각 1예였다. $^{201}Tl$ 111 MBq (3 mCi)를 정맥주사자고 $^{201}Tl$ 뇌 SPECT를 얻은 후에 정량화 분석을 위하여 병변의 대부분을 포함하는 합산영상을 만들었고 병변 및 정상뇌부위에 관심영역을 설정하여 평균 $^{201}Tl$-index와 최고 $^{201}Tl$-index를 구하였다. 결과: 양성병변의 평균 $^{201}Tl$-index와 최고 $^{201}Tl$-index는 각각 $3.51{\pm}2.70$과 $4.80{\pm}3.46$으로 악성병변의 평균 $^{201}Tl$-index와 최고 $^{201}Tl$-index인 $2.24{\pm}1.07,\;3.20{\pm}1.46$과 각각 통계적으로 유의한 차이는 없었다(p>0.05). 결론: $^{201}Tl$ 뇌 SPECT만으로 뇌 병변을 악성이나 양성으로 판단하여서는 안된다.

• Journal of Korean Neurosurgical Society
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• 제30권sup2호
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• pp.189-196
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• 2001

목 적 : 교모세포종은 흔한 원발성 뇌종양이며 생물학적 특성상 빠른 성장률을 보이는 것 외에 침습성이 강하여 종양과 인접한 부분을 파괴 시킬 뿐 아니라 직접접촉하지 않는 부분의 파괴도 일어나게 되어 치료 예후가 매우 불량한 것으로 되어 있다. 광역학치료는 광감각제를 이용하며 광감각제는 적절한 파장의 광원에 노출되면 세포 내에서 산소독성 물질을 생성하여 세포괴사를 유도하는 것이 주 살해작용의 기전이다. 본 실험에서는 사람의 신경교종 세포주인 U87 세포를 이용하여 실험관 내에서 광감각제 photofrin을 이용한 광역학치료가 종양의 침습성에 미치는 영향을 알아보고 동시에 이를 뇌종양치료의 새로운 방법으로 사용될 수 있는지의 여부를 알아보고자 하였다. 재료 및 방법 : 교모세포종 세포주인 U87 세포를 여러 농도의 photofrin으로 처리한 후 632nm $100mJ/cm^2$의 고정된 광선조건에서 본 실험을 시행 하였으며 Microculture tetrazolium(MTT) assay를 이용하여 세포 살해능력을 측정하고 침습성은 matrigel artificial basement membrane assay 및 tumor spheroid fetal rat brain aggregate(FRBA) confrontation assay를 이용하여 측정하였다. 결 과 : MTT assay를 이용하여 측정한 광역학 치료의 세포살해능력은 $100mJ/cm^2$의 광선 세기에서 광감각제인 photofrin의 농도에 비례하여 세포 살해 능력을 보였다. Matrigel artificial basement membrane assay 를 이용한 종양 침습성 검사에서 광역학치료가 종양침습의 억제효과를 나타냄을 알 수 있었으며 특히 세포 살해능력을 별로 보이지 않았던 photofrin 농도 2.5ug/ml에서 뚜렷한 침습억제효과를 나타내고 있었다(p<0.05). tumor spheroid fetal rat brain aggregate(FRBA) confrontation assay에서는 brain aggregate의 파괴와 종양의 침습을 관찰할 수 있었는데 파괴의 모양은 생체내에서 보이는 것과 비슷 하였다. 또한 그 정도와 범위는 처리된 Photofrin의 농도에 비례하여 종양침습이 억제됨을 알 수 있었다. 결 론 : 이러한 결과를 종합해 보았을 때 PDT는 종양세포의 침습성에 중요한 역할을 함을 알 수 있었으며 PDT 는 세포 살해능력뿐 아니라 침습성에도 영향을 미침으로써 종양 치료에 유용한 방법으로 사용될 수 있을 것으로 사료된다.

• 대한의용생체공학회:의공학회지
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• 제41권2호
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• pp.67-74
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• 2020

Brain tumors or gliomas are fatal cancer species with high recurrence rates due to their strong invasiveness. Therefore, the goal of surgery is complete tumor resection. However, the surgery is difficult to distinguish the border because tumors and blood vessels have the same color tone and shape. The fluorescein sodium is used as a fluorescence contrast agent for boundary separation. When the external light source is irradiated, yellow fluorescence is expressed in the tumor, which helps distinguish between blood vessels and tumor boundaries. But, the fluorescence expression of fluorescence sodium depends on the concentration of fluorescein sodium and such analytical data is insufficient. The unclear fluorescence can obscure the boundaries between blood vessels and tumors. In addition, reduce the efficiency of fluorescence sodium use. This paper proposes a protocol of concentration range for fluorescence expression conditions. Fluorescent expression was observed using a near-infrared (NIR) color camera with corresponding dilution using normal saline in 1 ml microtube. The flunoresence emission density range is 1.00 mM to 0.15 mM. The fluorescence emission begin to 1.00 mM and the 0.15 mM discolor. The discolor is difficult to fluorescence emission condition obserbation. Thus, the maximum density range of the bright fluoresecein is 0.15 mM to 0.30 mM. When the concentration range of fluorescein sodium is analyzed based on the gradient of fluorescence expression and the power measurement, the brightest fluorescence is expected to facilitate the complete resection of the tumor. For the concentration range protocol, setting concentration ranges and analyzing fluorescence expression image according to saturation and brightness to find optimal fluorescence concentration are important. Concentration range protocols for fluorescence expression conditions can be used to find optimal concentrations of substances whose expression pattern varies with concentration ranges. This study is expected to be helpful in the boundary classification and resection of brain tumors and glioma.

• Radiation Oncology Journal
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• 제10권1호
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• pp.15-20
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• 1992

1980년부터 1990년까지 연세의료원 암쎈터 치료방사선과에서 방사선 치료를 받은 20예 (남자 : 여자=10:10, 성인 소아=8:12)의 뇌간종양 환자의 치료결과를 분석하여 보았다. 총 20예의 환자 중 13예에서는 보통 분할 방사선치료(분할 당 180%200 cGy, 주 5회, 총 4680\~5400 cGy)를 시행하였고 나머지 7예에서는 과분할 방사선치료(분할 당 100 cGy, 1일 2회, 주 10회 총 7200 cGy)를 시행하였다. 중앙 추적 기간은 보통 분할 방사선 치료군과 과분할 방사선 치료군에서 각각 36개월과 10개월이었다. 20예의 환자중 4예에서는 치료전 병리학적 진단을 얻을 수 있었다. 이중 3예는 저분화 성상 세포종양 이었고 1예는 미분화 성상 세포종양이었다. 전체 대상환자의 실제 2년 생존율은 30%이었다. 예후인자로 나이, 증상 발현기간, 종양 형태 등을 분석해 보았는데, 증상 발현기간이 긴 환자에서 짧은 환자보다 예후가 좋았고, 성인에서 소아보다 예후가 좋았다. 종양 형태간에는 차이가 없었다. 보통 분할 방사선 치료군보다 과분할 방사선 치료군에서 초기 임상적 치료 반응이 좋았다. 보통 분할 방사선 치료군과 과분할 방사선치료군을 비교하는 것은 환자의 숫자가 적고, 과분할 방사선치료군의 추적 기간이 짧아 어려웠다.

• 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 the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권5호
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• pp.509-517
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• 2008

DNA 손상 치유 유전자 연구를 기초로 한 임상적 접근이 새로운 치료방법으로 떠오르고 있다. 많은 연구들이 중요한 DNA 수복유전자의 다형성을 찾아내어 각각의 단백질의 활동성에 대한 영향을 알아내고 특정한 치료법을 찾아내고 임상적 적용을 시도하고 결과를 평가하였다. 그 결과 암 치료에서 정상 세포와 암세포에서 DNA 수복 유전자의 발현 분석은 화학요법이나 방사선 치료에서 개인맞춤형 치료법을 가능하게 하고 있다. 예를 들어, NER이 결핍된 종양은 cisplatin 치료에 민감성을 나타내고, MMR 결핍세포는 알킬화 화학요법 약제에 높은 내성을 나타낸다. 선천성 비폴립성 결장암과 같은 MMR 결손종양 또한 알킬화 화학요법 약제에 의한 치료에 내성을 가진다. 신경교종(glioma)에서 MGMT 유전자 프로모터가 흔히 메틸화되는데 이것은 유전자 발현이 억제되고 알킬화 화학요법제에 대한 반응성을 증가시킨다. 향후 구강악안면외과 영역에서도 구강암의 발생의 위험성을 증가시킬 수 있는 더 많은 DNA 수복 유전자의 다형성을 발굴하고 임상적으로 개인맞춤형 치료법을 개발하고 적용할 수 있는 많은 연구가 필요할 것으로 사료된다.

• Journal of Korean Neurosurgical Society
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• 제30권5호
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• pp.575-580
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• 2001

Purpose : In general, pineal region tumors are managed by using microsurgical approach or stereoctactic biopsy. However, in selected cases endoscopic approach to pineal lesions might prove to be as effective as microsurgery and less invasive. We report an alternative surgical strategy for managing certain patients with pineal neoplasms that allows treatment of the symptomatic hydrocephalus as well as tumor biopsy under direct vision in the same sitting. Materials and Methods : Twenty-two patients with pineal region tumors with associated hydrocephalus were treated in one session by endoscopic third ventriculostomy and endoscopic tumor biopsy at our institution from October 1996 to January 2000. All patients were retrospectively evaluated. Results : There was no operative mortality. There was one cause of significant bleeding during biopsy, but was controlled endoscopically, and the patient recovered completely without neurologic deficit resulting from intra-operative bleeding. The symptoms related to increased intracranial pressure(ICP) have resolved in all patients, and the need for a shunt is completely eliminated. Histological diagnosis was achieved in 21 of the 22 patients by this procedure. A biopsy was not obtained in one patient. Although this pineal region tumor was seen endoscopically, this could not be biopsied because of technical difficulties in working around an enlarged massa intermedia. The lesions included fourteen germinomas, three mixed germ cell tumors, and one each of the followings: pineocytoma, pineoblastoma, pineocytoma/pineoblastoma(intermediate type), meningioma, and low grade glioma. Five of the 22 patients subsequently underwent formal microsurgical tumor removal. Additional chemotherapy or radiotherapy could then be initiated according to the histological diagnosis. Conclusion : We consider that endoscopy affords a minimally invasive way of reaching three objectives by one-step surgery in the management of pineal region tumors with associated hydrocephalus : 1) cerebrospinal fluid(CSF) sample for analysis of tumour markers and cytology, 2) treatment of hydrocephalus by third ventriculostomy, and 3) several biopsy specimens can be obtained identifying tumors which will require further open surgery or adjuvant radiation and/or chemotherapy. However, complications and morbidities should be emphasized so as to be avoided with further technical experience.

• Journal of Korean Neurosurgical Society
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• 제30권4호
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• pp.430-436
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• 2001

Objective : The proliferative potential of intracranial glioma affects the histological malignancy and prognosis of patients with these tumors. In this study, we present the relationship between MIB-1 labeling index(LI) and clinical variables which might play the major role in determining the prognosis of patient with astrocytic tumors. Patients and Methods : Excised tumor specimens from a total of 52 patients were stained to detect monoclonal MIB-1-Ki-67 antibody by avidin-biotin complex immunohistochemistry. The MIB-1 LI was evaluated with histological grades, demograpghic data, and survival time. The statistical significance of their correlation was analyzed by Pearson correlation test. Results : The 52 patients included 30 male patients and 22 female patients. The tumors according to the criteria of the World Health Organization(WHO) classification were verified as pleomorphic xanthoastrocytoma in one, pilocytic astrocytomas 4, astrocytomas 1, anaplastic astrocytomas 3, and glioblastomas 31. MIB-1 LI in astrocytic ttumors showed no correlation with age and gender. However, the patients under 10 years had the longest survival time, whereas short survival time was observed in the older patients. The mean MIB-1 LI of different tumor grades were as follows : pleomorphic xanthoastrocytoma, $4.40{\pm}0.00$ ; pilocytic astrocytoma, $4.53{\pm}3.09$ ; astrocytoma, $5.50{\pm}6.03$ ; anaplastic astrocytoma, $12.68{\pm}12.50$ ; Glioblastoma, $21.31{\pm}19.63$. Although the levels of MIB-1 LI were varied in individual tumors, the MIB-1 LI was increased in parallel with the histological grades. Glioblstomas showed significantly higher MIB-1 LI compared with that of anaplastic astrocytomas and low grade astrocytomas (p = 0.001). The mean survival time of entire group of patients was also well correlated with MIB-1 LI in astrocytic tumors(p = 0.015). Moreover, the mean survival time of the entire group of patients with Lis < 10 was $125.33{\pm}113.57weeks$, and the mean survival of those with $Lis{\geq}10$ was $60.71{\pm}62.58weeks$. This difference was also statistically significant(p = 0.004). Conclusion : The results of this study suggest that MIB-1 LI correlates with histological grades and might play a significant role in predicting the survival of patients with astrocytic tumors.

• 대한한방내과학회지
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• 제28권4호
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• pp.694-708
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• 2007

Objectives : Jageum-Jung is used as an anti-cancer agent in oriental medicine, but the mechanism by which it induces cell death in cancer cells is still unclear. The purpose of this study was to investigate the effects of Jageum-Jung on apoptosis and cell cycle arrest in HepG2 hepatoma cells. Methods : Various cancer cell lines including HepG2, C6 glioma, SH-SY5Y, PANC-1, and MCF-7 cells, were used. Apoptosis was determined by DAPI nuclei staining and flow cytometry in HepG2 cells treated with various concentrations (from 25 to 200 ${\mu}g/ml$) of $H_2O$ extract of Jageum-Jung (JGJ) for 48 hrs. Expression of cell cycle arrest mediators including Rb, p53, p21, cyclin B1, cdk4, and cyclin E proteins were measured by Western blot analysis. To estimate intracellular hydrogen peroxide levels and intracellular nitric oxide levels, HepG2 cells were stained with DCFH-DA dye and DAF dye, subjected on flow cytometric analysis. Results : 1. Jageum-Jung decreased the viability of HepG2 cells in a dose-dependent manner. 2. Jageum-Jung induced the catalytic activation of caspase-3 in HepG2 cells. 3. Jageum-Jung increased the intracellular hydrogen peroxide and NO in HepG2 cells. 4. Jageum-Jung increased the expression of Rb, p53 and p21 in HepG2 cells. 5. Jageum-Jung induced the expression of cyclin B1, cdk4, and cyclin E in HepG2 cells. Conclusions : Taken together, we suggest that Jageum-Jung exhibits cytotoxic effects on HepG2 cells, causing apoptosis and cell cycle arrest. The results showed that Jageum-Jung may do so by regulating the expression of specific target molecules that promote efficient apoptotic cell death following $G_2$/M phase arrest in a dose-dependent manner.

• Journal of Korean Neurosurgical Society
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• 제42권1호
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• pp.27-34
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• 2007

Objective : On the magnetic resonance image (MRI) of the infiltrating brain tumor, enhancement is usually higher in malignant tumor than in benign tumor, and tumor cells can invade into the peritumoral area without definite enhancement. In various pathological conditions, the blood brain barrier (BBB) becomes changed to pathological condition, allowing various materials extravasating into the interstitial space, and degree of enhancement is depend on the pathology. Authors performed dynamic MRI on enhancing and surrounding edematous area in order to evaluate the degrees of opening of BBB, to differentiate tumor from non-tumorous condition, and to determine its relationship with the recurrence of the tumor. Methods : Dynamic MRI was performed in 25 patients. Dynamic scans were done every 15 seconds after administration of Gd-DTPA on the enhancing and surrounding area for maximum 300 seconds, and the patterns of enhancement were ana lysed. The enhancement curve with initial steep increase followed by slow decrease was defined as "N pattern", those with initial steep increase followed by additional slow increase as "T pattern", and those with initial steep increase followed by plateau as "E pattern". Histopathological findings were compared with the dynamic scan. Results : The graphs taken from enhancing area showed "T pattern" regardless of pathology. In the surrounding area, "T pattern" was noticed in the malignant tumors, but "E pattern" or "N pattern" was noted in low-grade or benign tumors and non-tumorous condition. "T pattern" in the surrounding area was related to the malignant with tumor cell infiltration and recurrence. Conclusion : The results suggest that the malignant tumor infiltration changes the condition of BBB enough to extravasate the Gd-DTPA. Enhancement pattern in the surrounding edematous area may be a useful information to differentiate the malignant glioma with the low-grade and benign tumors or other non-tumorous conditions.