• Title/Summary/Keyword: 수막종

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Significance of Cerebral Venography in Surgery of Petroclival Meningiomas (추체사대 수막종의 수술과 관련하여 뇌 정맥조영상의 의미)

  • Hwang, Sung-Kyun;Gwak, Ho-Shin;Paek, Sun Ha;Oh, Chang-Wan;Lee, Sang Hyung;Kim, Dong Gyu;Kim, Hyun Jib;Jung, Hee-Won
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1200-1209
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    • 2001
  • Objective : A thorough understanding of the related venous structure is mandatory for successful removal of the petroclival meningiomas. This study was planned to investigate the guideline for safe ligation and incision of transverse or sigmoid sinuses and the importance of drainage pattern of vein of $Labb{\acute{e}}$ in surgical removal of petroclival meningiomas. Patients and Methods : The authors reviewed the venogram of the consecutive 37 cases of petroclival meningiomas and retrospectively analyzed their surgical findings. The drainage pattern of confluence of Herophili was classified as Type A(confluent & equal on both sides), Type B(confluent & non-dominant on tumor side), Type C(confluent & dominant on tumor side) and Type D(unilateral drainage only) as these findings gave the information on safe ligation and resection of the sinus. Usefulness of intraoperative test clamping of sinus for safe ligation was also reviewed. The vein of $Labb{\acute{e}}$ was analyzed with respect to its draining point and its collaterals to other superficial veins. Results : Contraindications of the sinus ligation and resection according to the drainage pattern at the confluence of Herophili were Type C(n=10, 27%)and Type D(n=4, 11%). Patients with Type A(n=12, 32%)and Type B(n=11, 30%) were tolerable to sinus ligation ipsilateral to tumor, if the test clamping proved to be safe. Identification of no brain swelling, after intraoperative test clamping of the sinus for more than 30 minutes performed in 7 out of 11 cases, was a reliable indicator of safe sinus ligation. The drainage pattern of the vein of $Labb{\acute{e}}$, especially low-lying type, could predict the possibility of postoperative hemorrhage and infarction. Its drainage into tentorium or superior petrosal sinus, however, made the transtentorial approach impossible, leading to restricted operative field. Conclusion : For a successful removal of the petroclival meningiomas preoperative venogram should be examined carefully. The extent of exposure in a planned approach can be estimated by analyzing the variation of sinuses and the drainage pattern of vein of $Labb{\acute{e}}$.

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Clinical Considerations of Trigeminal Neuralgia (삼차신경통 진단 및 치료의 중요 고려사항)

  • Jeon, Young-Mi;Tae, Il-Ho;Choi, Jong-Hoon;Ahn, Hyung-Joon;Shim, Woo-Hyun;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.32 no.4
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    • pp.449-453
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    • 2007
  • Trigeminal neuralgia is defined as "a sudden, usually unilateral, brief stabbing recurrent pain in the distribution of one or more branches of the fifth cranial nerve" by the International Association for the Study of Pain(IASP). Trigeminal neuralgia is classified as an idiopathic trigeminal neuralgia with no apparent cause and a symptomatic trigeminal neuralgia which is caused by a structural lesion such as brain tumor. Over 80% of the tumors are meningioma, acoustic neuroma, and epidermoid tumors. Symptomatic trigeminal neuralgia can not be excluded even if old-aged patient does not have abnormal neurologic sign and symptom, and good response to pharmacotherapy. Therefore, initial examinations such as MRI or CT are essential to exclude symptomatic trigeminal neuralgia. When compared with CT, MRI, especially gadolinium enhanced MRI, has an increased sensitivity in the detection of intracranial lesions. The most effective medical treatment of trigeminal neuralgia is carbamazepine. The most common side effects of carbamazepine include drowsiness, dizziness, unsteadiness, nausea, anorexia. Hepatotoxicity, bone marrow depression are the most feared side effect of carbamazepine therapy but occurs rarely. It require periodic complete blood cell counts as well as hepatic and renal function tests. It has been recommended that complete blood cell counts is done every 2 weeks for the first 2months and then quaterly thereafter. Oxcarbazepine can be used if neutropenia occurs.

A Case Report of Recurrent Bacterial Meningitis with a Skull Base Abnormality (두개저 이상을 동반한 재발성 세균성 뇌수막염 증례보고)

  • Oh, Jung-Min;Lee, Ji-Yeon;Lim, Hee-Jeong;Cho, Hyun-Hae;Kim, Kyung-Hyo
    • Pediatric Infection and Vaccine
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    • v.27 no.1
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    • pp.69-76
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    • 2020
  • Recurrent bacterial meningitis is the reappearance of two or more episodes of meningitis caused by a different or same organism after an intervening period of full convalescence. Predisposing factors for recurrent bacterial meningitis include immunodeficiency and developmental and traumatic anatomical defects. Therefore, careful evaluation of children with recurrent meningitis is essential. We report the case of a patient with a skull base abnormality who had suffered from four events of bacterial meningitis between 8 and 17 years of age. He experienced another event of bacterial meningitis at the age of 21, without undergoing correction for the anatomical defect. Streptococcus agalactiae was identified in the patient's blood and cerebrospinal fluid culture. Afterwards, he underwent surgical treatment for a meningioma; this meningioma was strongly suspected as the cause of the recurrence.

Analysis of Proliferative Potentials in Meningiomas by Ki-67, Proliferating Cell Nuclear Antigen, and Flow Cytometry (Ki-67, Proliferating Cell Nuclear Antigen, Flow Cytometry를 이용한 수막종의 증식력 분석)

  • Ahn, Jae Sung;Kim, Jeong Hoon;Kwun, Byung Duk
    • Journal of Korean Neurosurgical Society
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    • v.30 no.7
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    • pp.861-869
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    • 2001
  • Objective : In this study, we investigated the relationship between the histologic grading of meningiomas and proliferative potentials determined by the Ki-67, proliferating cell nuclear antigen(PCNA) and flow cytometry (FCM) with the aim of determining whether these potentials can be used as a parameter to the proliferative activity, in particular of atypical and malignant meningiomas. Methods : This study consisted of 47 meningiomas(6 malignant, 14 atypical, and random sampled 27 benign meningiomas). By immunohistochemical staining of Ki-67 and PCNA on formalin-fixed, paraffin-embedded sections, the anti-human rabbit polyclonal antibody against Ki-67 antigen and anti-PCNA monoclonal antibody(PC10) scores were counted. FCM was also performed on paraffin-embedded tissue using a selective staining technique for DNA. DNA ploidy, S-phase fraction, and proliferative index(PI)) were determined. Results : The results are summarized as follows ; 1) Proliferation rates as assessed by Ki-67 and PCNA closely correlated with the degree of anaplastic histologic features. 2) Proliferative potentials determined by FCM(S-phase fraction and PI) were not able to distinguish between benign and atypical/malignant meningiomas. 3) DNA ploidy was not a useful indicator of histologic grade in these tumors. 4) Proliferative potentials such as Ki-67 staining index(SI) and PCNA SI did not correlate with the ploidy pattern. 5) There was a linear correlation between Ki-67 SI and PCNA SI, but we could not find a correlation between Ki-67 SI and S-phase fraction or PI. Our results also did not show a statistically signficant correlation between PCNA SI and S-phse fraction or PI. Conclusions : We conclude that evaluation of the proliferative potentials with Ki-67 and PCNA is important as an additional factor for the prediction of malignancy in meningiomas. A dual study of Ki-67 and PCNA SIs on the same tissue might improve the accuracy with which the proliferative potential of a tumor can be predicted. We demonstrated that FCM in meningiomas is not valuable in predicting the behavior of these neoplasms, but we did observe a trend toward more malignancy with higher percent S-phase fraction and higher PI. Analysis of the S-phase fraction and PI might therefore be a useful tool to discriminate among histologic grades of meningiomas.

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Stereotactic Radiotherapy by 6MV Linear Accelerator (6MV 선형가속기를 이용한 정위다방향 단일 고선량 조사)

  • Oho, Yoon-Kyeong;Kim, Mi-Hee;Gil, Hak-Jun;Yoon, Sei-Chul;Lee, Jae-Moon;Choi, Kyu-Ho;Shinn, Kyung-Sub;Bahk, Yong-Whee;Kim, Moon-Chan;Kang, Joon-Ki;Song, Jin-Un
    • Radiation Oncology Journal
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    • v.6 no.2
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    • pp.269-276
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    • 1988
  • Eight patients with intracranial tumors or arteriovenous malformation (AVM)s which were less than 3 cm in diameter were treated by a technique of stereotactic radiotherapy during the 4months period from July 1988 through October 1988 at the Division of Radiation Therapy, Kang-Nam St. Mary's Hospital, Catholic University Medical College. The patients were diagnosed as AVMs in 3 cases, acoustic neurinoma, craniopharyngiom (recurrent), hemangioblastoma, pineocytoma, and pituitary microadenoma in each case. There are several important factors in this procedure, such as localization system, portal, field size, radiation dose, and perioperative supportive care. It is suggested that stereotactic radiotherapy may be peformed safely with a radiation dose of 12-30 Gy. So this nonivasive procedure can be used to treat unresectable intracranial tumors or AVMs. Of these, clinical symptoms had been regressed in AVMs in 2 cases at 3 months and 2 months after Stereotactic radiotherapy, one of whom was confirmed slightly regressed on the follow-up angiogram. And also craniopharyngioma and pineocytoma was minimally regressed on 3 month follow-up CT.

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A Comparative Study on Hydrolase Activities in Acanthamoeba culbeytconi and A. roureba (Acanthamoebaculbertsoni와 A. royreba의 가수분해 효소 활성도의 비교 연구)

  • 김용규;김태우
    • Parasites, Hosts and Diseases
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    • v.26 no.2
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    • pp.95-106
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    • 1988
  • Specific or non-specific cytolytic processes of free-living amoebae causing meningoencephalitls have been emphasized and the cytolytic ability related to hydrolases in Entantoeba sp. and Naegleria sp. has also been reported since the latter half of 1970's. However, no information on hydrolase activities in Acanthamoeba sp. is available. Hydrolases in Acanthamoeba culbertsoni, a pathogenic species of free-living amoebae, were assayed and compared with those in a non-pathogenic species, A. royreba. Pathogenicity of these two species was confirmed through experimental infection to BALB/c mice. Hydrolase activities and cytotoxic effects between pathogenic and non.pathogenic species were compared in the trophozoites cultured in CGV media and in CHO cell line, respectively. The results are summarized as follows: 1. The mice infected with A. culbertseni were all dead 15 days after nasal inoculation, and the mean survival time was 8.5 days. Also the mice infected with this pathogenic species manifested typical meningoencephalitis, whereas the mice infected with A. royreba did not. 2. Hydrolases detected both in the cell extracts and culture media were acid phosphatase, ${\beta}-N-acetyl$ galactosaminidase, ${\beta}-N-acetyl$ glucosaminidase, ${\alpha}-mannosidase$, neutral proteinase and acid proteinase, all of which were detected with remarkably higher rate in A. culbertsoni than in A. royreba. 3. A. cuzbertsoni revealed strong cytotoxicity for the target CHO cells, whereas A. royreba did not show any specific cytotoxicity. About 80% of the target cells mixed with A. culbertsoni were dead 48 hours after cultivation, and more than 95% of the target cells were dead 72 hours after cultivation. 4. Hydrolase activities in A. culbertsoni cultured with the target cell line were assayed according to the culture time. The activities of acid phosphatase, ${\beta}-N-acetyl$ galactosaminidase, ${\beta}-N-acetyl$ glucosaminidase, ${\alpha}-mannosidase$ and acid proteinase in this pathogenic amoeba were detected higher in amoeba extracts than in culture media up to 120 hours after cultivation, but after 120 hours of cultivation those activities were detected higher in culture media than in the amoeba Iysates. Neutral proteinase activity in A. culbertsoni increased more in EBSS medium than in the Iysate specimens although the activity in the extracts was generally steady according to the cultivation time. Summarizing the above results, it is concluded that there were differences in hydrolase activities between Pathogenic A. culbertsoni and non-pathogenic A. royreba, and that some hydrolase activities were detected remarkably higher in A. culbertsoni which revealed strong cytotoxicity to the target CHO cell line.

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DEVELOPMENT OF 2ND GENERATION ICE ACCRETION ANALYSIS PROGRAM FOR HANDLING GENERAL 3-D GEOMETRIES (3차원 착빙 형상 예측을 위한 2세대 시뮬레이션 코드 개발)

  • Son, Chankyu;Oh, Sejong;Yee, Kwanjung
    • Journal of computational fluids engineering
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    • v.20 no.2
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    • pp.23-36
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    • 2015
  • The $2^{nd}$ generation ice accretion analysis program has been developed and validated for various icing conditions. The essential feature of the $2^{nd}$ generation code lies in its capability of handling general 3-D geometry and improved accuracy. The entire velocity fields are obtained based on Navier-Stokes equations in order to take the massively separated flow field into account. Unlike $1^{st}$ generation code, the droplet trajectories are calculated using Eulerian approach, which is adopted to yield appropriate collection efficiency even in the shadow region. For improved thermodynamic analysis on the surfaces, water film model and modified Messinger model are newly included in the present analysis. The ice shape for a given time step is obtained by considering the exact amount of ice accreted on the surface. Each module of the icing analysis code has been seamlessly integrated on the OpenFOAM platform. The developed code was validated against available experimental data for 2D airfoils and 3D DLR-F4. Due to the lack of experimental data, the computed results of DLR-F4 were compared with those obtained from FENSAP-ICE, which is state-of-the-art 3D icing analysis code. It was clearly shown that the present code produces comparable results to those of FENSAP-ICE, in terms of prediction accuracy and the capability of handling general 3-D geometries.

Paraganglioma of the Thoracolumbar Spinal Canal -A Case Report- (흉요추부에 발생한 부신경절종 - 증례 보고 -)

  • Jeong, Soon-Taek;Kim, Dong-Hee;Cho, Se-Hyun;Park, Hyung-Bin;Hwang, Sun-Chul;Lee, Jeong-Hee
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.130-134
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    • 2007
  • Paragangliomas arise from a multicentric system of paraganglion cells derived from the neuroectoderm. Although these tumors are the most common in the head and neck region, they may occur in diverse locations including mediastinum, retroperitoneum and visceral organs. Spinal paragangliomas arising in the intradural space of the thoracolumbar spine have been reported rarely, with the majority located in the cauda equina. Only few cases of thoracic paraganglioma have been previously reported. We present an additional case of thoracolumbar paraganglioma and review the clinical MRI and histopathological features of this unusual tumor.

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Application of Fluent Model for Surface Drainage Analysis on Bridge (교면에서 표면배수 해석을 위한 Fluent 모형 적용)

  • Kim, Jung Soo;Lee, Sung Ho;Cho, Hyun Ho;Han, Chung Such
    • Proceedings of the Korea Water Resources Association Conference
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    • 2018.05a
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    • pp.251-251
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    • 2018
  • 도로설계기준(2012)에 따르면 노면 배수시설은 측구, 집수정, 배수관, 배수구(빗물받이, 맨홀) 등으로 구성되며 중앙분리대 배수에서 구조가 방호벽일 경우 원칙적으로 집수정과 종배수관, 횡배수관을 설치하여 노면수를 배수한다. 최근 기후변화에 따른 국지성 집중호우로 교량 배수시설의 배수능력 부족으로 교량의 노후화, 노면의 체수와 수막현상을 야기한다. 교량 설계 시, 교량의 외관은 점배수에 의한 배수불량으로 막힘부에서의 식물생육, 부식, 배수구의 오염 등으로 심미성에 악영향을 미치고 있다. 따라서 국토교통부 도로 배수시설 설계 및 관리지침에서는 기존의 집수정으로 유도하여 배수하는 점배수 형태에서 우수의 지체시간을 저감하기 위해 배수구로 즉시 배수되어 배수 효율을 증가시켜주는 선배수시설을 권장하고 있다. 그러나 선배수 구조의 일반적인 내용만을 기술하고 있으므로 보다 상세한 설계기준이 필요하다. 또한 국내에서는 교면 배수를 위한 횡배수구의 배수능력에 관한 설계 개념은 미국의 빗물받이 설계 개념을 그대로 적용하고 있어서 교량 배수시설의 배수능력 증대를 위한 수치 및 수리실험에 관한 기술적인 자료가 부족한 실정이다. 따라서 도로의 흐름해석 및 선배수를 위한 측구 횡배수관의 흐름개선에 관한 구체적인 연구가 필요한 실정이다. 본 연구에서는 배수로 전반의 유향 분석 및 횡유입관 유입부에서의 상세한 흐름해석과 통수능력을 분석하기 위해서는 수리실험을 통한 연구가 필요한 실정이다. 그러나 최적 횡배수관의 형상 및 간격 설정에 대한 수리실험의 물리적 및 시간적 한계를 극복하기 위해 Fluent 모형(Ansys Workbench 13.0)을 활용한 수치모의를 수행하여 모형의 적용성을 검토하였다. 다상유동 해석을 위해 VOF(Volume of Fluid)방법을 적용하였고, 수치해석 방법으로는 비정상류, 난류 모형으로는 standard ${\kappa}-{\varepsilon}$모형을 적용했다. 도로 형상에 따른 우수유출량을 비교 분석하기 위하여 횡경사는 2%로 고정하고 종경사를 2%로 선정하여 수치모의를 통한 배수능력을 분석하고 설계에 직접적인 적용성을 검토하였다. 횡배수관의 간격변화 및 배수공의 위치 변화 등에 따른 차집량을 분석하였으며, 개략적인 수리실험 결과와 수치모의의 차집율을 비교 및 분석하여 Fluent 모형의 적용성을 확인하였다. 또한, 횡배수관의 유입부에서의 유속 변화 및 유출부에서의 유속이 모의가 가능하므로 배수시설에서 보다 정확한 흐름 해석이 가능하여 보다 적정한 배수능력 분석이 가능할 것으로 판단된다.

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Usefulness of Permeability Map by Perfusion MRI of Brain Tumor the Grade Assessment (뇌종양의 등급분류를 위한 관류 자기공명영상을 이용한 투과성영상(Permeability Map)의 유용성 평가)

  • Bae, Sung-Jin;Lee, Joo-Young;Chang, Hyuk-Won
    • Journal of radiological science and technology
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    • v.32 no.3
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    • pp.325-334
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    • 2009
  • Purpose : This study was conducted to assess how effective the permeability ratio and relative cerebral blood volume ratio are to tumor through perfusion MRI by measuring and reflecting the grade assessment and differential diagnosis and the permeability and relative cerebral blood volume of contrast media plunged from blood vessel into organ due to breakdown of blood-brain barrier in cerebral. Subject and Method : Subject of study was 29 patients whose diagnosis were confirmed by biopsy after surgery and 550 (11 slice$\times$50 image) perfusion MRI were used to make image of relative cerebral blood volume with the program furnished on instrument. The other method was to transmit to private computer and the image analysis was made additionally by making image of relative cerebral blood volume-reformulated singular value decomposition, rCBV-rSVD and permeability using IDL.6.2. In addition, Kruskal-wallis test tonggyein non numerical average by a comparative analysis of brain tumors Results : The rCBV ratio (Functool PF; GE Medical Systems and IDL 6.2 program by analysis) and permeability ratio of tumors were as follows; high grade glioma(n=4), (14.75, 19.25) 13.13. low grade astrocytoma(n=5) (14.80, 15.90) 11.60, glioblastoma(n=5) (10.90, 18.60), 22.00, metastasis(n=6) (11.00, 15.08). 22.33. meningioma(n=6) (18.58, 7.67), 5.58. oliogodendroglioma(n=3) (23.33, 16.33, 15.67. Conclusion : It was not easy to classify the grade with the relative cerebral blood volume ratio measured by using the relative cerebral blood image by type of tumors, however, permeability ratio measured by permeability image revealed that the higher the grade of tumor, the higher the measured permeability ratio, showing the assessment of tumor grade is more effective to differential diagnosis.

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