• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.343-349
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• 1986

Histopathological diagnosis of brain stem glioma should be performed for the purpose of the determination of its management and clinical course, but its surgical biopsy has been followed by high mortality and morbidity. We performed the tissue sampling for histological examination with BRW stereotaxic system under local anesthesia successfully.

• Investigative Magnetic Resonance Imaging
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• v.19 no.2
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• pp.117-121
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• 2015

Chordoid glioma is a rare, low-grade brain neoplasm typically located in the third ventricle. Herein, we report an unusual case of histologically confirmed chordoid glioma located in the pituitary fossa and suprasellar region, not attached to the third ventricle. A 57-year-old woman presented with a 2-month history of headache and visual disturbance. Magnetic resonance imaging revealed an ovoid mass in the pituitary fossa and suprasellar region, compressing the optic chiasm without involvement of the third ventricle. The tumor showed low signal intensity on T1-weighted images and iso- to high signal intensity on T2-weighted images, with strong and homogenous contrast enhancement. Subtotal resection was performed via the transcranial approach, and the patient subsequently received adjuvant gamma knife radiosurgery. However, the residual mass showed disease progression 5 months after the initial surgery.

• Investigative Magnetic Resonance Imaging
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• v.1 no.1
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• pp.86-93
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• 1997

Purpose: To assess the ability of in vivo H-1 MRS to determine the degree of malignancy and to characterize the histopathologic type of intracranial solid tumors. Materials and Methods: In vivo H-1 MR spectra of the pathologically-proven 81 intracranial soild tumors (low-grade glioma 17 cases, high-grade glioma 31 cases, lymphoma 9 cases, meningioma 8 cases, central neurocytoma 4 cases, medulloblastoma 3 cases, PNET 3 cases, metastasis 2 cases, others 4 cases) were analyzed. H-1 MR spectroscopy was performed on a 1.5T MR unit using PRESS sequence with a TR of 2000ms, a TE of 270 or 135ms and a voxel size of $2{\times}2{\times}2cm^3$ for all spectra. N-acetyl aspartate (NAA)/Creatine complex(Cr), Choline complex (Cho)/Cr, and lactate (Lac)/Cr ratios were measured on the peak heights of each resonance and compared among the different tumors. Results: All intracranial solid tumors demonstrated decreased NAA, elevated Cho and lactate, and variable Cr levels. All tumors showed increased Cho/Cr and Lac/Cr, whereas NAA/Cr level was decreased. Mean Cho/Cr and Lac/Cr ratios were significantly higher in high-grade gliomas than in low-grade gliomas. However, NAA/Cr ratio showed no significant difference between low-grade and high-grade gliomas. Very high Cho peaks were seen in lymphomas, meningiomas, medulloblastomas, and neurocytomas in addition to high-grade gliomas. Conclusion: H-1 MRS may be useful in differentiating between low-grade and high-grade gliomas, however cannot characterize the histologic types or subtypes of tumors.

• Journal of Korean Neurosurgical Society
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• v.61 no.3
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• pp.319-332
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• 2018

Germline mutations in cancer causing genes result in high risk of developing cancer throughout life. These cancer predisposition syndromes (CPS) are especially prevalent in childhood brain tumors and impact both the patient's and other family members' survival. Knowledge of specific CPS may alter the management of the cancer, offer novel targeted therapies which may improve survival for these patients, and enables early detection of other malignancies. This review focuses on the role of CPS in pediatric high grade gliomas (PHGG), the deadliest group of childhood brain tumors. Genetic aspects and clinical features are depicted, allowing clinicians to identify and diagnose these syndromes. Challenges in the management of PHGG in the context of each CPS and the promise of innovative options of treatment and surveillance guidelines are discussed with the hope of improving outcome for individuals with these devastating syndromes.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10621-10625
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• 2015

Background: Increasing evidence has indicated that high Forkhead box protein C2 (FOXC2) level is closely associated with the development, progression, and poor prognosis of a variety of tumors. However, the relationship between FOXC2 and the progression of human gliomas remains to be clarified. The aim of present study was to assess FOXC2 expression and to explore its contribution in human gliomas. Materials and Methods: Realtime quantitative PCR was performed to examine FOXC2 expression in 85 pairs of fresh frozen glioma tissues and corresponding non-neoplastic brain tissues. Associations of FOXC2 expression with clinicopathological factors and prognosis of glioma patients were statistically analyzed. Results: The relative mRNA expression of FOXC2 was significantly higher in glioma tissues than the corresponding non-neoplastic brain tissues (p<0.001). In addition, high FOXC2 expression was significantly associated with advanced pathological grade (P=0.005) and the low Karnofsky performance score (KPS) (p=0.003), correlating with poor survival (p<0.001). Furthermore, multivariate Cox regression analysis showed that high FOXC2 expression was an independent predictor of overall survival (p=0.006). Conclusions: FOXC2 may act as an oncogenic gene and represent a potential regulator of aggressive development and a candidate prognostic marker in human gliomas.

• The Korean Journal of Nuclear Medicine Technology
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• v.27 no.1
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• pp.62-65
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• 2023

Purpose The purpose of this study is to determine whether the glucose loading method (GLM) is useful in the differentiation of cerebral gliomas by comparing it with fasting images. Materials and Methods The patients were 70 people diagnosed with cerebral gliomas, and the equipment was Discovery 710 (GE Healthcare, MI, USA). All patients fasted for more than 6 hours, and fasting images and GLM were performed under the same imaging conditions, and the examination interval was 1 to 14 days. GLM administered 250 ㎖ of 10% glucose solution prior to radiopharmaceutical injection. SUVmax of cerebral glioma and SUVmean of cerebral cortex were measured and then compared and analyzed by tumor-to-normal brain cortex ratio (TNR). Statistical analysis confirmed the difference between the two images with an independent-sample t-test. Results The averages of GLM and fasting TNR were 1.26 and 1.09, respectively, which were 15.6% higher in GLM. In low-grade, the difference in TNR was insignificant at 4%, but in high-grade, 23%, GLM was high. There was a statistically significant difference between the two images (P=0.008), but there was no statistically significant difference in TNR in the low grade (P=0.473), and there was a very significant difference in the high grade (P=0.005). Conclusion GLM increased TNR for cerebral gliomas. In particular, it was found that the TNR increased more in the high grade. Therefore, GLM is considered to be useful for the differentiation of high-grade gliomas.

• Journal of Korean Neurosurgical Society
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• v.38 no.1
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• pp.12-15
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• 2005

Objective : Cerebral edema develops in the brain tumors by loosening of the endothelial tight junction. Tight junction[TJ] proteins, such as occludin and claudin bind adjacent cells tightly. Authors examine the expression rate of occludin in human brain tumors to evaluate the effect of altered expression of occludin on cerebral edema. Methods : Seventy surgical specimens stored at $-70^{\circ}C$ were used. It included 14 astrocytic tumors, 27 meningiomas, 12 scwannomas, 7 pituitary adenomas, 6 hemangioblastomas. and 4 craniopharyngiomas. After protein extraction, expression of occludin was investigated by Western blot analysis. The tumors were classified according to World Health Organization[WHO] classification. Results : The expression rates of occludin in brain tumors were : glioma [8/14=57.1%]. meningioma [16/27=59.3%], schwannoma [10/12=83.3%], pituitary adenoma [6/7=85.7%], hemangioblastoma [6/6=100%], and craniopharyngioma [3/4=75.0%]. The expression rate in glioma and meningioma was lower than other brain tumors. In gliomas, high grade tumor [1/4=25.0%] exhibited lower expression rate of occludin than low grade one [7/10=70.0%]. Conclusion : These results suggest that the expression of occludin is different among the various kinds of brain tumors. In gliomas, its expression is correlated with the histological grade. It may indicate that occludin plays a role in the development of edema in the brain tumors.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.9
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• pp.4079-4083
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• 2014

Background: Previous studies have showed that argonaute 2 is a potential factor related to genesis of several cancers, however, there have been no reports concerning gliomas. Methods: Paraffin specimens of 129 brain glioma cases were collected from a hospital affiliated to Binzhou Medical University from January 2008 to July 2013. We examined both argonaute 2 mRNA and protein expression by real-time quantitative PCR (qRT-PCR), Western blot analysis, and immunohistochemistry (IHC). The survival curves of the patients were determined using the Kaplan-Meier method and Cox regression, and the log-rank test was used for statistical evaluations. Results: Both argonaute 2 mRNA and protein were upregulated in high-grade when compared to low-grade tumor tissues. Multivariate analysis revealed that argonaute 2 protein expression was independently associated with the overall survival (HR=4.587, 95% CI: 3.001-6.993; P=0.002), and that argonaute 2 protein expression and WHO grading were independent prognostic factors for progression-free survival (HR=4.792, 95% CI: 3.993-5.672; P<0.001, and HR=2.109, 95% CI: 1.278-8.229; P=0.039, respectively). Kaplan-Meier analysis with the log-rank test indicated that high argonaute 2 protein expression had a significant impact on overall survival (P=0.0169) and progression-free survival (P=0.0324). Conclusions: The present study showed that argonaute 2 expression is up-regulated in gliomas. Argonaute 2 might also serve as a novel prognostic marker.

• Radiation Oncology Journal
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• v.28 no.3
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• pp.117-124
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• 2010

Purpose: To analyze the postoperative radiotherapy results and prognostic factors in patients with WHO grade 3 and 4 gliomas. Materials and Methods: A total of 99 patients with malignant gliomas who underwent postoperative radiotherapy between 1988 and 2007 were enrolled in this study. Total resections, subtotal resections ($\geq$50%), partial resections (<50%), and biopsies were performed in 16, 38, 22, and 23 patients, respectively. In total there were 32, 63 and 4 WHO grade 3, 4, and unspecified high grade gliomas, respectively. The biologically equivalent dose was in the range of 18.6 to $83.3\;Gy_{10}$ (median dose, $72.2\;Gy_{10}$). We retrospectively analyzed survival rate, patterns of failure, prognostic factors, and adverse effects. Results: The median follow-up time was 11 months and there were 54 patients (54.5%) with local failure. The one and 2-year survival rates were 56.6% and 29.3%, respectively, and the median survival duration was 13 months. The one and 2-year progression-free survival rates (PFS) were 31.3% and 18.2%, respectively, and the median PFS was 7 months. The prognostic factors for overall survival were age (p=0.0001), surgical extents (subtotal resection, p=0.023; partial resection, p=0.009; biopsy only, p=0.002), and enhancement of tumor in postoperative imaging study (p=0.049). The factors affecting PFS were age (p=0.036), tumor enhancement of the postoperative imaging study (p=0.006). There were 3 patients with grade 3 and 4 side effects during and after radiotherapy. Conclusions: In addition to age and surgical extents, tumor enhancement of the postoperative imaging study was included in the prognostic factors. The most common relapse patterns were local failures and hence, additional studies are needed to improve local control rates.

• Journal of Korean Neurosurgical Society
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• v.54 no.2
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• pp.125-127
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• 2013

Here, we report a rare case of an anaplastic astrocytoma masquerading as a hypertensive basal ganglia hemorrhage. A 69-year-old woman who had been under medical management for hypertension during the past 3 years suddenly developed right hemiparesis with dysarthria. Brain computed tomography (CT) scans with contrast and CT angiograms revealed an intracerebral hemorrhage (ICH) in the left basal ganglia, without an underlying lesion. She was treated conservatively, but underwent a ventriculoperitoneal shunt operation 3 months after the initial attack due to deteriorated mental status and chronic hydrocephalus. Three months later, her mental status deteriorated further. Magnetic resonance imaging (MRI) with gadolinium demonstrated an irregular enhanced mass in which the previous hemorrhage occurred. The final histological diagnosis which made by stereotactic biopsy was an anaplastic astrocytoma. In the present case, the diagnosis of a high grade glioma was delayed due to tumor bleeding mimicking hypertensive ICH. Thus, a careful review of neuroradiological images including MRI with a suspicion of tumor bleeding is needed even in the patients with past medical history of hypertension.