• Asian Pacific Journal of Cancer Prevention
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• 제15권17호
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• pp.7201-7205
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• 2014

Chemokine and chemokine receptor expression by tumor cells contributes to tumor growth and angiogenesis and thus these factors may be considered as tumor markers. Here we aimed to characterize cells directly extracted from glioma, meningioma, and secondary brain tumors as well as non-tumoral cells in vitro. Cells were isolated from brain tissues using 0.2% collagenase and characterized by flow cytometry. Expression of SDF-1, CXCR4, CXCR7, RANTES, CCR5, MCP-1 and IP-10 was defined using flow cytometry and qRT-PCR methods. Brain tissue isolated cells were observed as spindle-shaped cell populations. No significant differences were observed for expression of SDF-1, CXCR4, CXCR7, RANTES, CCR5, and IP-10 transcripts. However, the expression of CXCR4 was approximately 13-fold and 110-fold higher than its counterpart, CXCR7, in meningioma and glioma cells, respectively. CXCR7 was not detectable in secondary tumors but CXCR4 was expressed. In non tumoral cells, CXCR7 had 1.3-fold higher mRNA expression than CXCR4. Flow cytometry analyses of RANTES, MCP-1, IP-10, CCR5 and CXCR4 expression showed no significant difference between low and high grade gliomas. Differential expression of CXCR4 and CXCR7 in brain tumors derived cells compared to non-tumoral samples may have crucial impacts on therapeutic interventions targeting the SDF-1/CXCR4/CXCR7 axis.

• Journal of Korean Neurosurgical Society
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• 제30권3호
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• pp.263-271
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• 2001

교모세포종은 비교적 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 그 결과 치료 예후가 매우 불량한 것으로 되어 있다. 이러한 불량한 예후를 개선 시키기 위해서는 이들 종양의 침습에 대한 기전의 정확한 이해가 필요하며 이를 이용한 새로운 치료방법이 요구된다할 것이다. Protein kinase C(PKC)는 세포내 신호전달체제 과정에서 매우 중요한 역할을 하는 효소로 세포막 수용체 신호를 핵으로 전달하는 역할을 하며 세포내 여러 생물학적 작용이 알려져 있다. 본 실험은 종양침습과 연관하여 세포내 PKC가 어떠한 작용을 하는지에 대해서 악성교종 세포를 대상으로 하여 알아보고자 하였다. 따라서 PKC가 종양침습에 중요한 역할을 할 것이라는 가설을 세웠고 이 가설을 증명하기 위해 세포내 PKC농도를 길항제 및 촉진제를 이용하며 높고 낮게 조절함으로써 그에 따른 침습성의 변화를 살펴보았다. 방법으로는 교모세포종 세포주인 U-87 세포를 약제로 처리한 후 인위적으로 조절된 세포내의 PKC에 대해 효소의 활성도를 측정하였고 침습성은 matrigel artificial basement membrane assay 및 tumor spheroid fetal rat brain aggregate(FRBA) confrontation assay를 이용하여 측정하였다. 결과로 PKC의 길항제인 tamoxifen과 hypericin으로 처치한 세포는 PKC의 활성과 침습도가 모두 감소하였으며 이는 약제농도에 비례하여 나타났다. 반면 PKC 자극제인 TPA로 처치된 세포는 증가된 PKC 활성도나 침습도을 보이지 않았다. 이러한 결과를 종합해 보았을 때 PKC는 종양세포의 침습성에 중요한 역할을 함을 알 수 있었으며 PKC의 길항제는 종양 치료에 유용한 화학 요법 제가 될 수 있을 것으로 사료된다.

• Journal of Korean Neurosurgical Society
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• 제44권4호
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• pp.222-227
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• 2008

Objective : Malignant gliomas are the most common primary cerebral neoplasms in adults. Despite multimodality treatments, the prognosis for patients with malignant glioma remains poor. However, recently, the effectiveness of concomitant chemoradiotherapy (CCRT) with temozolomide (TMZ) has been reported. We report for the first time preliminary results of the treatment with CCRT of newly diagnosed malignant gliomas in Korean people. Methods : Thirty-two patients over the age of 17 years with newly diagnosed and histologically confirmed high-grade gliomas (HGG), from June 2004 to August 2007 were the subjects of this study. There were 17 men and 15 women, with a median age of 53.5 years (range, 17-74). Pathologically, glioblastoma, anaplastic astrocytoma, anaplastic oligodendroglioma, and gliomatosis cerebri had been diagnosed in eighteen, eight, four, and two patients, respectively. These 32 patients were treated with CCRT with TMZ. Results : The median follow-up period was 12.5 months (range 3-48). At the time of this analysis, 13 patients died and three patients had been lost to follow-up. There was no mortality caused by drug toxicity. The median progression-free survival (PFS) of these patients was 9.0 months, and the six-month PFS rate was 72.4%. The median overall survival (OS) was 26 months, and the one-year OS rate was 83.6%. The 18 patients with glioblastoma were analyzed separately from the other patients with HGG, and the median OS was 18 months, and the one-year OS rates were 81.8%. The median PFS was seven months, and the six-month PFS rate was 75.0%. Conclusion : Our results are consistent with many other reports, confirming that CCRT with TMZ achieves good clinical outcomes in the treatment of HGG. Therefore, we suggest that CCRT with TMZ as adjuvant chemotherapy be considered as a standard therapy for patients with HGG.

• 대한핵의학회지
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• 제38권3호
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• pp.268-271
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• 2004

A 43-year-old man was presented with persistent headache for two weeks. 72 weighted MR imaging showed high signal intensity with surrounding edema in the left frontal lobe. These findings were considered with intracranial tumor such as glioma or metastasis. Tc-99m tetrofosmin SPECT showed focal radiotracer accumulation in the left frontal lobe. The operative specimen contained cerebral infarction with organizing leptomeningeal hematoma by pathologist. Another 73-year-old man was hospitalized for chronic headache. Initial CT showed ill-defined hypodensity with mass effect in the right parietal lobe. Tc-99m tetrofosmin SPECT showed focal radiotracer uptake in the right parietal lobe. These findings were considered with low-grade glioma or infarction. Follow-up CT after 5 months showed slightly decreased in size of low density in the right parietal lobe, and cerebral infarction is more likely than others. Tc-99m tetrofosmin has been proposed as a cardiotracer of myocardial perfusion imaging and an oncotropic radiotracer. Tc-99m tetrofosmin SPECT image provides a better attractive alternative agent than T1-201 as a tumor-imaging agent, with characteristics such as high-energy flux, short half-life, favorable biodistribution, dosimetry and lower background radioactivity. We have keep in mind on the analysis of Tc-99m tetrofomin imaging when cerebral infarction is being differentiated from brain tumor.

• Journal of Korean Neurosurgical Society
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• 제42권2호
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• pp.132-134
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• 2007

The authors describe an anaplastic oligodendroglioma of the cerebellum which is distinctly uncommon. The patient presented with sudden onset of decreased consciousness associated with hemorrhage in the cerebellum, which appeared to origin from a vascular malformation or a tumor on a initial computed tomography (CT) scan. Subsequent magnetic resonance (MR) imaging suggested a high grade glioma with abundant vascularity in the right cerebellum. The histological examination revealed the findings compatible with those of an anaplastic oligodendroglioma. A complicated clinical course had led him to a poor outcome.

• Parasites, Hosts and Diseases
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• 제47권1호
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• pp.53-56
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• 2009

The authors report here a rare case of cerebellar schistosomiasis identified by pathological diagnosis, lacking extracranial involvement. The clinical symptoms included headache, dizziness, and nausea. Studies in blood were normal and no parasite eggs were detected in stool. Computed tomography of brains showed hypodense signal, and magnetic resonance imaging showed isointense signal on T1-weighted images, hyperintense signal on T2-weighted images, and intensely enhancing nodules in the right cerebellum after intravenous administration of gadolinium. A high-grade glioma was suspected, and an operation was performed. The pathologic examination of the biopsy specimen revealed schistosomal granulomas scattered within the parenchyma of the cerebellum. The definitive diagnosis was cerebellar schistosomiasis japonica. A standard use of praziquantel and corticosteroid drugs was applied, and the prognosis was good. When the pattern of imaging examinations is present as mentioned above, a diagnosis of brain schistosomiasis should be considered.

• Journal of Korean Neurosurgical Society
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• 제46권4호
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• pp.385-388
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• 2009

Objective : We analyzed the methylation status of the O6-methylguanine-DNA methyltransferase (MGMT) gene promoter in World Health Organization (WHO) grade III gliomas in association with other molecular markers to evaluate their prevalence. Methods : The samples of a total of 36 newly WHO grade III glioma patients including 19 anaplastic oligodendrogliomas (AO), 7 anaplastic oligoastrocytomas (AOA), and 10 anaplastic astrocytomas (AA) were analyzed. The methylation status of the MGMT gene promoter was confirmed by methylation-specific polymerase chain reaction. The 1p/19q chromosomal deletion status and EGFR amplification were assessed by Fluorescence In-Situ Hybridization. MGMT, EGFR, EGFRvlll, and p53 expression were analyzed by immunohistochemical staining. Results : The MGMT gene promoter was methylated in 32 (88.9%) and unmethylated in 4 (11.2%) Among them, all of the AO and AOA had methylated MGMT gene promoter without exception. Significant associations between MGMT gene promoter hypermethylation and 1p/19q deletion was observed (p=0.003). Other molecular markers failed to show significant associations between MGMT gene promoter statuses. Conclusion : There was extensive epigenetic silencing of MGMT gene in high grade gliomas with oligodendroglial component. Together with frequent 1p/19q co-deletion in oligodendroglial tumors, this may add plausible explanations supporting the relative favorable prognosis in oligodendroglial tumors compared with pure astrocytic tumors.

• Journal of Korean Neurosurgical Society
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• 제50권1호
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• pp.68-71
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• 2011

We present a case of Neuro-Behçet's disease with an unpredictable clinical course. A 47-year-old man was admitted to the neurosurgery department of our hospital with a mild headache. Three days after admission, his consciousness suddenly decreased and respiratory distress progressed rapidly. A brain MRI revealed that the previously observed abnormal signal had extended markedly to both the thalamic areas and the entire brain stem, and the surrounding brain parenchyma were compressed by cerebral edema. Based on the patient's symptoms of recurrent oral and genital ulcers, skin lesions, and uveitis, a rheumatologist made a diagnosis of Behçet's disease with CNS involvement. The patient was treated with high-dose methylprednisolone with respiratory assistance in the intensive care unit for 9 days and his neurologic symptoms improved remarkably. Neuro-Behçet's disease must be considered in the differential diagnosis in rapidly deteriorated young neurological patients along with a stroke, low-grade glioma, multiple sclerosis, and occlusive venous disease.

• Radiation Oncology Journal
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• 제10권2호
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• pp.171-180
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• 1992

저분화 성상세포종에 대한 방사선 치료의 역할이나 적정 방사선량, 치료시기등은 논란의 여지가 많다. 후향적 분석결과로 얻은 정보는 방사선량이나 외과적 또는 방사선 치료에 의한 시술시기 등의 관점에서 전향적인 연구계획을 세우는데 도움이 된다. 저자들은 1979년부터 1989년까지 경희대학병원에서 수술로 확진된 저분화 성상세포종 환자중 천막하부를 제외한 총 56(남 : 여 =29:27)명에 대한 치료결과를 후향적으로 분석하였다. 수술절제범위는 38명 ($68\%$)에서 근치수술하였고, 18예 ($32\%$)는 부분절제 또는 조직생검만 시행하였다. 총 56예중 수술후 방사선치료를 받은 환자는 36명 ($64\%$)이었고, 방사선량은 최저 5000 cGy를 국소조사하였다. 총 56예의 5년 및 10년 생존율은 각각 $44\%$와 $32\%$였으며, 중간 생존기간은 4.1년이었다. 조직소견에 따른 5년 및 10년 생존율은 grade I(23명)이 각각 $52\%$와 $35\%$이고, grade II(23명)는 $20\%$와 $10\%$였다. Oligodendroglioma 환자는 성상세포종보다 생존율이 높았으며(5년 생존율=$65\%$ vs $36\%$)장기간 생존율은 각각 $54\%$와 $23\%$로 현저한 차이가 있었다. 다량의 방사선치료를 받은 (<54 Gy)환자는 소량의 방사선 (<54 Gy)이나 수술만 받은 환자보다 5-년 및 10-년 생존율이 높았다(P<0.05). 수술범위에 따른 5년 생존율은 $46\%$와 $41\%$로 비슷하였으나, 10년 생존율은 근치수술한 경우가 $41\%$, 부분절제 또는 조직생검한 경우는 $12\%$로 현저한 차이가 있었다(p<0.01). 과거 여러 저자들의 연구에 의하면 환자나이, 수술범위, 방사선치료유무, 악성도, 증상 발현기간, 수행능력 상태등이 성상세포종의 중요 예후인자라고보고하였으나, 본 저자들의 예에서는 grade I조직소견 (p<0.025)과 환자나이 (p<0.001)가 가장 중요한 예후일자였으며 향후 무작위화한 전향적인 연구가 필요할 것으로 생각된다.

• 대한방사선기술학회지:방사선기술과학
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• 제32권4호
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• pp.461-469
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• 2009

최근 신경계 질환의 진단에 많이 이용되는 관류자기공명영상기법 중 상대적 뇌 혈류량(relative cerebral blood volume)의 분석에 의한 뇌교종의 악성도 구분(고등급과 저등급 종양의 구분)에 있어 자기공명영상의 뇌 혈류량 검사의 유용성에 대하여 알아보고자 하였다. 뇌교종 환자 17명(평균연령 57.5세, 남자 11명, 여자 6명)을 대상으로 모든 환자에게 수술 전 관류자기공명 영상과 고식적 뇌 자기공명영상을 시행하고, 조직의 병리학적 검사를 시행하였다. 국소적 뇌 혈류량과 상대적 뇌 혈류량의 분석은 지멘스사의 소프트웨어(PAT)와 자체 개발한 영상 후 처리 소프트웨어 Xmap 2.0을 이용하여 비교, 분석하였다. 대상자 17명 중 뇌교종이 저등급인 6명과 고등급인 11명의 관류자기공명영상의 분석 결과는 저등급 뇌교종의 상대적 뇌 혈류량의 백질에 대한 종양부위의 평균 뇌 혈류량(rCBVw)의 평균은 1.62, 피질에 대한 종양부위의 평균 뇌 혈류량(rCBVc)의 평균은 0.12이었다. 고등급 뇌교종의 상대적 뇌 혈류량의 rCBVw의 평균은 33.53, rCBVc의 평균은 0.96이었다. 뇌교종과 반대측 뇌 백질과의 통계적인 상관성은 0.01(p-value)이었고. 뇌교종과 반대측 피질과의 통계적인 상관성은 0.02(p-value)로 나타났다. 결과 중 뇌교종과 뇌 백질의 통계분석수치가 뇌교종과 피질과의 통계분석 결과보다 더 유의한 결과를 나타내었다. 결국 두 가지 모두에서 유의한 결과를 나타냄을 알 수 있었다(p<0.05). 임상적으로 기존의 자기공명영상과 병리학적 결과와 함께 관류자기공명영상은 뇌교종의 등급을 판단하는데 있어 유용할 것으로 사료된다.