• Annual Conference of KIPS
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• 2023.05a
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• pp.574-575
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• 2023

뇌종양은 인체에 발생하는 여러 종양 중 세 번째로 많이 나타난다. 뇌종양 환자 수는 지속해서 증가하고 있으며, 별도의 예방법이 존재하지 않아 빠른 진단 및 종양 종류에 따른 치료가 매우 중요하다. 현재 뇌종양 진료는 전문의가 전용 소프트웨어로 뇌 Magnetic Resonance Imaging(MRI) 이미지를 확대, 축소하여 자세히 살펴보면서 종양의 크기, 위치, 양성/악성 여부 등을 판단한다. 이 방식은 의사의 숙련도에 따라 진료 시간과 판독의 차이가 크고 오진 가능성이 있다. 본 논문은 뇌종양 종류별 MRI 이미지가 학습된 CNN 모델을 사용한 의사의 뇌종양 진단 시간 단축, 진단 정확도 향상을 통해 환자 치료의 효율성을 높이는 방안으로 Brain Tumor X를 제안한다.

• Proceedings of the KSMRM Conference
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• 2003.10a
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• pp.21-21
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• 2003

목적： 악성뇌종양 주변부위의 역동자기공명영상에서의 시간신호강도곡선 양상으로 종양의 성장 양상이나 예후를 판단할 수 있는지를 알고자 한다. 대상 및 방법： Anaplastic oligodendroglioma 3예, Anaplastic astrocytoma 1예, Glioblastoma multiforme 1예, Malignant ependymoma 2예, Medulloblastorna 1예로서, 총 8예의 종양절제전, 혹은 후의 잔류 종양을 대상으로 하였다. Routine MRI에 추가하여 종양부위에서 Turbo spin echo T1 강조 역동자기공명영상을 하였으며, Gd-DTPA 0.1 mmol/kg를 급속 주사 한 후, TR/TE, 350/15, slice thickness 6 mm, slice number 3, NEX 2회, scan time은 15 초로 하여 5 분 동안 20회 영상을 얻었다. 가시적으로 조영증강이 없는 종양의 주변부위나 수술경계부위에 관심영역을 그려서 시간신호강도곡선을 얻었으며, 첫 회 조영제 통과시의 peak 이후에 신호가 감소하는 경우를 Normal pattern으로, peak 이후에 신호가 계속 유지되거나 증가하는 경우를 Tumor pattern으로 하였으며, Normal pattern과 Tumor pattern을 보인 예들을 구분하여 종양의 재성장 상태와 환자의 생존 기간을 비교 관찰하였다.

• Journal of Korean Biological Nursing Science
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• v.19 no.2
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• pp.107-112
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• 2017

Purpose: The purpose of this study was to identify the lipid profile ratios as factors affecting disease progress in patients with high-grade primary brain cancers undergoing concurrent chemoradiotherapy (CCRT) and adjuvant chemotherapy. Methods: The levels of lipid profile ratios were evaluated by looking at the total cholesterol (TC) to high-density lipoprotein (HDL)-cholesterol (TC/HDL-c), low-density lipoprotein (LDL)-cholesterol to HDL-cholesterol (LDL-c/HDL-c), and triglycerides to HDL-cholesterol (TG/HDL-c). This descriptive research was conducted 7 months after the initiation of CCRT and adjuvant chemotherapy. Results: A total of 36 patients with newly diagnosed primary malignant brain cancer were included in the study. The levels of lipid profile ratios such as TC/HDL-c, LDL-c/HDL-c, TG/HDL-c were significantly different between the patients with and without disease progress at 7 months after initiation of CCRT and adjuvant chemotherapy. Conclusion: The lipid profile ratios were indicators affecting disease prognosis with tumor-related factors at 7 months after initiation of CCRT and adjuvant chemotherapy. Therefore, lipid profile ratios indicating hyperlipidemia in patients with high-grade brain cancers should be carefully monitored during and after cancer-related therapy.

• Journal of Korean Neurosurgical Society
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• v.30 no.11
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• pp.1340-1344
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• 2001

This is a rare case of cerebral metastasis from malignant fibrous histiocytoma(MFH) of the soft tissue. A 62-year-old man underwent craniotomy for resection of multiple intracerebral masses under the impression of metastatic brain tumor with unknown primary site. Preoperative investigation failed to detect any extracranial lesion. At six months after the operation and whole brain radiotherapy, right shoulder mass was detected to grow and excised. Specimen from the brain and shoulder lesions revealed identical pathological findings of malignant fibrous histiocytoma except existence of glial fibrillary acidic protein(GFAP)-positive cells only in brain lesions. Palliative radiotherapy was performed for subsequently developing metastatic lesions in skeletal system. At twelve months after initial diagnosis recurrent lesion at right shoulder was detected and chemotherapy is given. This case is unique because metastatic brain lesion from MFH is rare and also cerebral metastasis as an initial manifestaion of MFH has not been reported before. Another important finding is that there was expression of GFAP only in brain lesions but not in extracranial primary site lesion. Although the presence of GFAP-positive cells is thought as one of characteristic histological findings of primary intracrainal MFH, our observation supports the hypothesis that GFAP-positive cells in primary intracranial MFH may be nonneoplastic astrocytes secondarily involved by MFH.

• Journal of Life Science
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• v.29 no.5
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• pp.530-536
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• 2019

Glioblastoma (GBM) is the most incurable brain cancer derived from the transformed glial cells. Standard anti-GBM treatment, including surgery and chemoradiotherapy, does not ensure good prognosis for the patients with GBM, because successful therapy is often impeded by presence of glioma stem cells (GSCs). GSCs, which is generally divided into proneural (PN) and mesenchymal (MES) subtype, are understood as subpopulation of cancer cells responsible for GBM initiation, progression and recurrence after standard treatments. In the present study, we demonstrate that PN subtype GSCs differentially transit to MES subtype GSCs by specific cytokines. The expression of CD44, a marker of MES subtype GSCs, was observed when GSC11 PN subtype GSCs were exposed to tumor necrosis factor alpha ($TNF-{\alpha}$) cytokine and GSC23 PN subtype GSCs were treated to transforming growth factor beta 1 ($TGF-{\beta}1$) cytokine. Ivy glioblastoma atlas project (Ivy GAP) bioinformatics database showed that $TNF-{\alpha}$ and $TGF-{\beta}1$ were highly expressed in necrotic region and perivascular region, respectively. In addition, $TNF-{\alpha}$ signaling was relatively upregulated in necrotic region, while $TGF-{\beta}$ signaling was increased in perivascular region. Taken together, our observations suggest that MES subtype GSCs can be derived from various PN subtype GSCs by multimodal cytokine stimuli provided by neighboring tumor microenvironment.

• The Journal of Korean Physical Therapy
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• v.2 no.1
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• pp.123-125
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• 1990

문헌에 의하면 대상포진의 원인은 바이러스에 대한 세포성 면역이 저하될 때, 또는 악성종양 등으로 면역억제제 치료를 받아서 2차적으로 면역이 저하될 때 체내에 잠재해 있던 바이러스가 재활되어 발병하는 것으로 추정하고 있다. 본 저자도 이에 대하여 의견을 같이하고 있는데 노령층의 $60\~70$대 여자환자수가 압도적으로 많았다는 점과, $20\~39$세 사이의 청${\cdot}$장년층에서는 단1명의 대상자가 없다는 점뿐 아니라, 본 대상자중 11세의 소녀는 7세때 뇌종양 수술을 2차례에 걸쳐 실시한 후 면역제제를 계속적으로 사용하는 있는 점 등은 문헌의 발병원인과 상당히 일치하였다. <전파 양식> 비말 감염 (droplet infection)으로 전파되며, 수두와 달리 전염성이 높지 않다. <잠복기> 잠복해 있던 바이러스가 언제 재활할지 알 수 없으므로 불명이다. 그러나 본조사에서는 대상포진에 대한 병력을 가진 사람이 없었고, 발생 원인을 본인 자신도 모르고 있었다. <합병증> Ramsay Hunt의 증후에 의하면 합병증은 외이도의 수포, 안면신경마비, 혀의 2/3부분의 미각상실, 간혹 청각 및 평행장애를 일으킨다고 한다. <치료> 대상포진의 대증요법으로 calamine lotion Burrow solution의 wet dressing 진통제 및 cytosine arabinoside나 adenosine arabinoside와 같은 항히스타인제, 최근에는 Acyclovir가 많이 사용되고 있는 것으로 알려졌다.

• Journal of Life Science
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• v.17 no.8 s.88
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• pp.1039-1045
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• 2007

Glioblastoma multiforme (GBM) is the most frequently occurring brain cancer. Although the existence of cancer stem cells (CSCs) in GBM has been established, there is little evidence to explain the link between CSCs and chemoresistance. In this study, we investigated that only a few cells of A172 and established GBM2 survived after 1,3-bis(2chloroethyl)-1-nitrosourea (BiCNU) exposures and these sur-vived cells resist the subsequent BiCNU treatment. In addition, these BiCNU-resistant small pop-ulations derived from GBM cells increased the phosphorylations of Erk and Akt and highly expressed CD133 stem cell surface marker. Furthermore, we observed that the BiCNU-resistant cancer cells de-rived from GBM have grown tumors when transplanted into severe combined immuno-deficient (SCID) mouse brain. These results demonstrate that BiCNU-resistant subpopulation cells derived from GBM have cancer stem-like cell properties. Therefore, it may provide provide further evidence that CSCs in GBM have chemotherapeutic drug resistance.

• Journal of Korean Neurosurgical Society
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• v.29 no.6
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• pp.731-737
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• 2000

Objective : Growth factor receptors on the tumor cells are known to be expressed highly allowing the tumor cells to bind growth factors to stimulate cellular division. Immunotoxin therapy is one of the novel approaches to the primary malignant brain tumor, and expression of cell-surface receptor is essential for the immunotoxin to have specific anti-tumor activity. Despite promising cytotoxic activity of immunotoxin, tumor responses are not curative on clinical trials, and additional studies are needed regarding various factors influencing the efficacy of the immunotoxin. The purpose of this study is to detect the expression of various growth factor receptors on brain tumor cell lines which are going to be used in these studies. Materials and Methods : The authors detected transferrin receptor(TR), insulin-like growth factor-1 receptor(IGF-1R), and interleukin-4 receptor(IL-4R) on medulloblastoma cell line(Daoy) and glioblastoma cell lines(U373 MG and T98 G) by flow cytometric analysis. Results : TR was expressed on Daoy, U373 MG, and T98 G. IGF-1R was expressed on Daoy and U373 MG, but not on T98 G. IL-4R was expressed on all cell lines tested. Conclusion : The transferrin and interleukin-4 receptors might be good targets for immunotoxin therapy. The results should be considered in additional in vitro and in vivo studies regarding immunotoxin and in establishing the proper treatment model of the immunotoxin therapy including selection of the adequate immunotoxin.

• Radiation Oncology Journal
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• v.12 no.2
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• pp.151-158
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• 1994

Since Jan. 1992, authors have conducted a pilot study to treat malignant glioma with multiple daily fractionated(MDF) radiation therapy and this paper presents the outcome compared MDF to conventional factionated(CF) radiation therapy Between Sep. 1989 and Jan. 1993, forty three patients with high grade glioma of brain except brain stem glioma were treated: nineteen patients were treated with CF radiation therapy and 24 patients were treated with MDF radiation therapy. In CF radiation therapy, total dose was 6300cGy/35fx in 7 weeks, which 5040cGy was delivered to the initial target volume and 1260cGy to reduced target volume. And in MDF radiation therapy, total dose was 6400cGy/40fx in 4 weeks, which 3200cGy was delivered to the initial target volume as 160cGy 2 times daily 6hr apart. All patients had histologically confirmed anaplastic astrocytoma(AA) of glioblastoma multiforme (GBM) with stereotactic biopsy or craniotomy for subtotal or gross tumor resection. The range of follow-up was 7 months to 4 years with a median follow-up of 9 months. The Median survival from surgery was 9 months for all patients. The median survival was 9 months and 10 months for MDF group and CF group and 10 months and 9.5 months for glioblastoma multiforme and anaplastic astrocytoma, respectively. In 36 patients with follow-up CT scan or MRI scan, disease status was evaluated according to treatment groups, Four patients(GBM:3, AA:1) of 21 patients in MDF group, were alive with no evidence of disease, while none of patient was alive with no evidence of disease in CF group. The progression of disease had occurred in 20 patients, 11 patients and 9 patients in MDF group and CF group, respectively All of these patients showed in-field progression of disease, Four of 11 patients($27\%$) in MDF group showed the new leasion outside of the treatment field, while 5 of 9 patients($56\%$) in CF group. In our study the prognosis was not influenced by age, KPS, grade, extent of surgery and different fractional scheduled radiation therapy. Authors concluded that MDF regimen was well tolerated and shortened the treatment period from 7 weeks to 4 weeks without compromising results. We believe that further follow-up is needed to assess the role of MDF.

• The Korean Journal of Nuclear Medicine
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• v.30 no.4
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• pp.476-483
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• 1996

Following radiation therapy for brain tumors, patients often have clinical deterioration due to either radiation necrosis or recurrent tumor progression in the treatment field. The distinction between these entities is important but difficult clinically or even with CT or MRI. T1-201 has been known to accumulate in various tumors and be useful to grade, predict prognosis or detect recurrence of glioma. The aim of this study was to evaluate the usefulness of T1-201 SPECT in the differentiation of recurrent tumor from radiation necrosis. Of 67 patients who did T1-201 brain SPECT imaging with clinically suspected recurrent tumor or radiation necrosis, 20 patients underwent histopathological examination and constituted the study population. T1-201 uptake indices on T1-201 brain SPECT imaging rrere calculated and correlated with histopathological diagnosis. Of 20 patients, 15 were histopathologically confirmed as recurrent original tumor or malignant transformation of benign tumor and 5 were diagnosed as radiation necrosis. On T1-201 SPECT, 18 of 20 had T1-201 index above 2.5 which was regarded as positive indicator for the presence of tumor. Seventeen cases showed concordance, which consisted of 15 true positive and 2 true negative. Discordant 3 cases were all false positive. There was no case of false negative. The sensitivity, specificity, positive and negative predictive value of T1-201 SPECT were 100%, 40%, 83% and 100%. In conclusion, T1-201 brain SPECT is a sensitive diagnostic test in the detection of recurrent tumor following radiation therapy and is useful in the differentiation of recurrent tumor from radiation necrosis. Relatively low specificity should be evaluated further in larger number of patients in consideration of sampling error and referral bias for pathologic examination.