• Journal of Korean Neurosurgical Society
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• v.66 no.2
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• pp.183-189
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• 2023

Objective : The facial nerve trace on the ipsilateral side of the vestibular schwannoma was reconstructed by diffusion tensor imaging tractography to identify the adjacent relationship between the facial nerve and the tumor, and to improve the level of intraoperative facial nerve protection. Methods : The clinical data of 30 cases of unilateral vestibular schwannoma who underwent tumor resection via retrosigmoid approach were collected between January 2019 and December 2020. All cases underwent magnetic resonance imaging examination before operation. Diffusion tensor imaging and anatomical images were used to reconstruct the facial nerve track of the affected side, so as to predict the course of the nerve and its adjacent relationship with the tumor, to compare the actual trace of the facial nerve during operation, verify the degree of coincidence, and evaluate the nerve function (House-Brackmann grade) after surgery. Results : The facial nerve of 27 out of 30 cases could be displayed by diffusion tensor imaging tractography, and the tracking rate was 90% (27/30). The intraoperative locations of facial nerve shown in 25 cases were consistent with the preoperative reconstruction results. The coincidence rate was 92.6% (25/27). The facial nerves were located on the anterior middle part of the tumor in 14 cases, anterior upper part in eight cases, anterior lower part in seven cases, and superior polar in one case. Intraoperative facial nerve anatomy was preserved in 30 cases. Among the 30 patients, total resection was performed in 28 cases and subtotal resection in two cases. The facial nerve function was evaluated 2 weeks after operation, and the results showed grade I in 12 cases, grade II in 16 cases and grade III in two cases. Conclusion : Preoperative diffusion tensor imaging tractography can clearly show the trajectory and adjacent position of the facial nerve on the side of vestibular schwannoma, which is beneficial to accurately identify and effectively protect the facial nerve during the operation, and is worthy of clinical application and promotion.

• Investigative Magnetic Resonance Imaging
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• v.5 no.2
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• pp.130-137
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• 2001

Purpose : Our purpose was to compare maximum relative cerebral blood volume (rCBV) with histologic grade of cerebral gliomas. Materials and methods : First-pass perfusion MR imaging was performed preoperatively in 16 patients with pathologically proven cerebral gliomas (7 glioblastoma, 2 anaplastic astrocytoma, 1 anaplastic oligodendroglioma, 5 low-grade astrocytoma, and 1 low-grade oligodendroglioma). Maximum rCBV was compared with histologic diagnosis and grade of the tumor. Results : Maximum rCBVs of glioblastomas were in the range of 433% to-1330% (average, 790 %), as compared with those of contra-lateral normal white matters. Maximum rCBVs of two non-enhancing anaplastic astrocytomas were 66% and 284%, respectively. Maximum rCBV of one well-enhancing anaplastic oligodendroglioma was 702%. Maximum rCBVs of low-grade astrocytomas were in the range of 80%-369% (average, 202%). Maximum rCBV of one low-grade oligodendroglioma was 1450%, even higher than those of glioblastomas. Conclusion : Maximum rCBV was higher in glioblastoma than in low-grade astrocytoma without overlapping. However, there was no difference of maximum rCBV between non-enhancing anaplastic astrocytoma and low-grade astrocrtoma.

• Journal of Korean Neurosurgical Society
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• v.45 no.6
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• pp.381-385
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• 2009

The first case of intracranial metastases of a cervical intramedullary low-grade astrocytoma without malignant transformation in adult is presented in this report. Seven years ago, a 45 year-old male patient underwent biopsy to confirm pathologic characteristics and received craniocervical radiation and chemotherapy for a grade II astrocytoma in the cervical spinal cord. Two years later, posterior fusion was necessary for progressive kyphosis in the cervical spine. He was well for approximately 7 years after the primary surgery. Two months ago, he presented with partial weakness and incoordination with gait difficulty. MRI Scan demonstrated multiple small lesions in the cerebellar vermis and left hemisphere. After suboccipital craniectomy and posterior cervical exposure, the small masses in the cerebellar vermis and hemispheres were excised to a large extent by guidance of an intraoperative navigation system. The tumor at the cervical and brain lesions was classified as an astrocytoma (WHO grade II). When a patient with low-grade astrocytoma in the spinal cord has new cranial symptoms after surgery, radiaton, and chemotherapy, the possibility of its metastasis should be suspected because it can spread to the intracranial cavity even without malignant transformation as shown in this case.

• Journal of Chest Surgery
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• v.27 no.6
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• pp.486-488
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• 1994

The mucoepidermoid cancer is a tumor arising in the bronchial submucosal glands that shows an intimate admixture of glandular element and sheets of cell with or no definite squamous differentiation. This rare tumor is usually located in lobe and bronchi and occasionally in the trachea. This tumor presents with symptoms of bronchial irritation or obstruction, often of several years duration. The treatment is complete resection with use of bronchoplastic techniques.Low grade tumor have a good prognosis with adequate resection. We experienced a case of mucoepidermoid cancer arising from superior segment of left lower lobe, which was treated with Lt.lower lobectomy.

• The Journal of the Korean bone and joint tumor society
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• v.18 no.1
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• pp.20-27
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• 2012

Purpose: The chemokine receptor CXCR4 has been reported to be aberrantly expressed in human cancer and has been shown to participate in cancer metastasis. We compared the expression of CXCR4 in conventional high-grade and low-grade central osteosarcomas, and determined if an association between CXCR4 expression and prognosis could be made. Materials and Methods: We performed the immunohistochemistry for CXCR4 in a total of 63 patients with osteosarcoma and determined the relationships according to the clinicopathologic variables and overall survival rates. Results: CXCR4 was detected in 76.3% of conventional high-grade osteosarcoma patients and in 36% of low-grade central osteosarcomas. Diffuse expression was noted in 47.4% of the high-grade osteosarcomas and all low-grade cases were focal positive. CXCR4 expression was significantly correlated with histologic grade (p<0.0001). While overall survival rate was reduced significantly with increased CXCR4 expression (p=0.0058), higher histologic grade (p<0.0001), and younger age (p=0.0140), survival rate did not correlate with gender, tumor size, or AJCC stage. Conclusion: Our results suggest that CXCR4 expression is associated with higher-grade tumors and with poor prognosis for osteosarcoma patients.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.381-384
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• 2014

Background: Evidence indicates that Dickkopf-1 (DKK-1) levels may be a biomarker for cancer risk. The aim of this study was to assess DKK-1 and its correlation with clinic-pathological features in patients with bladder cancer. Materials and Methods: DKK-1 levels were determined in serum samples from 90 patients with bladder cancer before transurethral tumor resection. The concentrations of DKK-1 were determined by using enzyme linked immune-sorbent assay (ELISA). Results: Elevated preoperative DKK-1 levels were associated with tumor stage (p<0.001), grade (p<0.001) and histological grade (p<0.001). Conclusions: The results of our study demonstrated that the level of serum DKK-1 is correlated with both disease progression and increase in the tumor grade. Preoperative serum DKK-1 elevation may thus represent a novel marker for the determination of bladder cancer and the detection of patients with a likely poor clinical outcome.

• Radiation Oncology Journal
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• v.34 no.3
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• pp.186-192
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• 2016

Purpose: To determine whether large rectal volume on planning computed tomography (CT) results in lower tumor regression grade (TRG) after neoadjuvant concurrent chemoradiotherapy (CCRT) in rectal cancer patients. Materials and Methods: We reviewed medical records of 113 patients treated with surgery following neoadjuvant CCRT for rectal cancer between January and December 2012. Rectal volume was contoured on axial images in which gross tumor volume was included. Average axial rectal area (ARA) was defined as rectal volume divided by longitudinal tumor length. The impact of rectal volume and ARA on TRG was assessed. Results: Average rectal volume and ARA were 11.3 mL and $2.9cm^2$. After completion of neoadjuvant CCRT in 113 patients, pathologic results revealed total regression (TRG 4) in 28 patients (25%), good regression (TRG 3) in 25 patients (22%), moderate regression (TRG 2) in 34 patients (30%), minor regression (TRG 1) in 24 patients (21%), and no regression (TRG0) in 2 patients (2%). No difference of rectal volume and ARA was found between each TRG groups. Linear correlation existed between rectal volume and TRG (p = 0.036) but not between ARA and TRG (p = 0.058). Conclusion: Rectal volume on planning CT has no significance on TRG in patients receiving neoadjuvant CCRT for rectal cancer. These results indicate that maintaining minimal rectal volume before each treatment may not be necessary.

• The Korean Journal of Cytopathology
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• v.17 no.1
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• pp.46-50
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• 2006

A micropapillary variant of urothelial carcinoma (MPC) is a distinct entity with an aggressive clinical course. It has a micropapillary configuration resembling that of ovarian papillary serous carcinoma. Its cytologic features have rarely been reported. We report a case of MPC detected by urine cytology. A woman aged 93 years presented with a chief complaint of macroscopic hematuria. Cytology of her voided urine showed clusters of malignant cells in a micropapillary configuration. Each tumor cell had a vacuolated cytoplasm, a high nuclear:cytoplasmic ratio, and irregular hyperchromatic nuclei. An ureteroscopic examination revealed exophytic sessile papillary masses extending from the left lateral wall to the anterolateral wall of the urinary bladder. A transurethral resection of the tumor was carried out. The tumor was characterized by delicate papillae with a thin, well-developed fibrovascular stromal core and numerous secondary micropapillae lined with small cuboidal cells containing uniform low- to intermediate-grade nuclei and occasional intracytoplasmic mucinous inclusions. These tumor cells infiltrated the muscle layers of the bladder, and lymphatic tumor emboli were frequently seen. Recognizing that the presence of MPC components in urinary cytology is important for distinguishing this lesion from low-grade papillary lesions and high-grade urothelial carcinomas can result in early detection and earlier treatment for an improved treatment outcome.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.273-280
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• 2001

Objectives : The purpose of this study is to assess the long-term outcome and delayed complications of Gamma Knife radiosurgery for low grade glioma(LGG). Methods : Among 31 patients of LGG who had been treated by using Leksell Gamma Knife between March 1992 and December 1996, we could follow up more than 5 years(range 5-9 years) in 17 patients and evaluated their clinical feature, changes of tumor volume and post-radiosurgical complications. Results : During the mean follow-up period of 7.6 years, the tumor was decreased in 5 patients(29.4%), unchanged in 4(23.5%), increased in 4(23.5%) and recurred in 4(23.5%). The tumor control rate was 52.9%(9/17). We have experienced eighteen postradiosurgical complications in 10 patients(58.8%). Early complication was none and delayed complications included radiation necrosis with cyst in ten cases, bleeding in five, radiation-induced edema in one and malignant transformation in one. Two patients ultimately died as a result of tumor progression during the follow-up period. The mortality rate was 11.7%. Conclusion : Gamma Knife radiosurgery may be useful as an adjunctive therapy for small volume, deep-seated LGG. Although radiosurgery can effectively prevent growth of solid tumor, several delayed complications such as radiation necrosis, cyst formation, bleeding or malignant transformation can develop during the long-term followup period. Because of the possible slow growth rate of LGG and development of the delayed complications, the long-term efficacy of radiosurgery requires further analysis.

• Korean Journal of Head & Neck Oncology
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• v.16 no.1
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• pp.46-51
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• 2000

Objectives: Primary malignant tumors in the salivary glands are relatively rare. Because of the rarity and the different histopathologic patterns, it is difficult to establish a uniform treatment strategy. The prime treatment of salivary gland malignancy is the surgery, but the role of radiotherapy has been under debate. Radiation therapy combined with conservative surgical procedures may be as successful and perhaps more rational treatment than radical surgery alone. The aim of this study is to evaluate clinical pattern, incidence, treatment modality and outcome of the salivary gland maligancy. Materials and Methods: The medical records of 32 patients with malignant neoplasm of salivary gland who treated at the Keimyung university Dongsan hospital were analyzed retrospectively. Results: The overall 5 year survival rate was 77.9% stage I : 100%, stage II : 75%, stage III : 66.7%, stage IV : 55.6%). The 5 year survival rate according to tumor grade was 100% in low grade malignancy, 71.8% in high grade malignancy. The 5 year survival rate according to treatment modalities was as follows: Surgery only group was 83.3%, combined treatment group with surgery and posoperative radiation was 74.6%. Conclusion: The factors affecting prognosis is variable, but the stage at the time of diagnosis, site of lesion, tumor grade, histologic subtype were important factors. Surgery was the prime treatment tool and postoperative radiotherapy was also imperative in higher stage patient, high grade tumor, or patients with positive surgical margin.