• Clinical Pain
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• 제19권1호
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• pp.54-58
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• 2020

Skeletal muscle metastasis of gastric cancer is extremely rare and is associated with various symptoms. Here, we report on a 60-year-old woman with right hip pain after excessive walking. Two years earlier, the patient had been treated for advanced gastric cancer (surgery, adjuvant chemotherapy). Upon magnetic resonance imaging, diffuse muscle swelling and high signal intensity were observed in T2-weighted images of the right hip muscle. However, the FDG uptake in the right gluteal muscles was not obviously increased. Pathological examination of muscle biopsy revealed metastatic adenocarcinoma of stomach origin. The patient was treated with chemotherapy, and the swelling and pain in the right hip are progressively improving.

• Journal of Korean Neurosurgical Society
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• 제66권1호
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• pp.82-89
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• 2023

Objective : Rathke's cleft cysts (RCCs) are nonneoplastic cysts. Most of them are asymptomatic and stable; when symptomatic, RCCs are surgically fenestrated and drained. However, the outcomes remain unclear. The authors evaluated the outcomes of RCC decompression. Methods : Between 2004 and 2019, 32 RCCs were decompressed in a single tertiary institution. The clinical characteristics, intraoperative findings, postoperative complications, and endocrinological and surgical outcomes were retrospectively reviewed. Patients who underwent sequential imaging at least twice and at least 12 months after surgery were included in the analysis. Results : Patients' mean age was 40.8±14.9 years, and 62.5% were women. The mean follow-up duration was 62.3±48.6 months. In 21 patients (65.6%), no residual cysts were identified on postoperative magnetic resonance imaging. Of the 18 patients with preoperative visual field defects, 17 (94.4%) experienced postoperative visual improvement. Postoperative complications included endocrinological deterioration in 11 patients (34.4%), permanent diabetes insipidus in 11 (34.4%), infection in four (12.5%), intrasellar hemorrhage in three (9.4%), and cerebrospinal fluid leak in two (6.3%). Follow-up images revealed cyst recurrence in nine patients (28.1%), an average of 20.4 months after surgery; in three patients, the cysts were symptomatic, and resection was repeated. Multivariable analysis revealed that postoperative endocrinological deterioration was the only independent factor associated with cyst recurrence (p=0.028; hazard ratio, 6.800). Conclusion : Our findings showed that although only cyst fenestration for decompression was performed to preserve pituitary function, more pituitary dysfunction occurred than expected. Besides, the postoperative hormonal deterioration itself acted as a risk factor for cyst recurrence. In conclusion, surgery for RCC should be more careful.

• Journal of Korean Neurosurgical Society
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• 제66권2호
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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.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2022년도 추계학술대회
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• pp.297-299
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• 2022

악성 뇌교종은 예후가 매우 나쁜 질병으로 평균 생존 기간은 6개월에서 14개월 사이로 보고되어 있다. 따라서 악성 뇌교종을 가진 환자들에게는 정확한 예후 예측이 요구된다. 본 논문에서는 악성 뇌교종을 가진 환자의 예후와 연령을 동시에 예측하는 합성곱 신경망 모델을 제안한다. 악성 뇌교종의 영상 특성을 효과적으로 파악할 수 있는 네 가지 자기공명영상인 T1, T1-contrast enhanced, T2, fluid-attenuated inversion recovery 영상을 입력 데이터로 이용하였다. 예후 예측에 가장 중요한 환자의 연령을 고려함으로써 신경망 모델의 예후 예측 성능이 높아질 것으로 기대된다. 학습된 모델을 검증 데이터에 적용한 결과 환자의 예후와 연령의 피어슨 상관계수가 각각 0.1748, 0.3056으로 나타난 것을 확인하였다.

• Journal of Digestive Cancer Research
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• 제3권2호
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• pp.105-107
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• 2015

췌장암은 예후가 매우 불량한 암으로 수술적 절제술을 시행하여도 대부분의 경우 재발을 한다고 알려져 있다. 재발을 하는 경우 대개 항암화학요법을 시행하게 되나, 그 반응 또한 좋지 않은 것으로 알려져 있다. 간에 국소적으로 재발을 했을 경우 종양절제술을 시행하는 것에 대해서는 몇몇 보고가 있는 정도이며, 생존율을 향상시킬 수 있는지에 대해서는 연구가 거의 없는 상태이다. 본 증례는 유문보존 췌십이지장 절제술 시행 후 간에 국소적으로 재발한 췌장암에 대하여 gemcitabine 및 capecitabine과 oxaliplatin 병합 항암화학요법을 시행하였으나 크기가 증가하였고, 이에 종양절제술을 시행하였으며, 이후 장기생존을 보였던 경우로 매우 드문 증례를 경험하였기에 보고하는 바이다.

• Journal of Digestive Cancer Research
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• 제3권2호
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• pp.113-115
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• 2015

본 증례는 전이성 췌장암에서 연수막전이로 발현된 국내 첫 사례이다. 또한 급성뇌졸중 양상이 첫 증상으로 발현된 경우도 이전에 보고된 바가 없다. 향후 전이성 췌장암의 뇌전이 양상에 대해 좀 더 많은 증례를 통한 연구가 필요하며, 췌장암의 빈번한 연수막전이 기전에 대해서도 추가 연구가 필요하다.

• Clinical Pain
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• 제18권1호
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• pp.8-15
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• 2019

Objective: To determine the relationship between cervical sagittal parameters and the degree of the cervical disc degeneration at each cervical level by using cervical plain radiographs and disc degeneration grading. Method: This study analyzed 110 patients with posterior neck pain. Cervical radiographic measurements included the occipito-cervical (O~C2) angle; sagittal Cobb angles of C1~C2, C2~C7; and sagittal vertical axis (SVA) of C1~C7 and C2~C7. The degenerations of cervical discs at each level were evaluated through Pfirrmann grading system by magnetic resonance images of the cervical spine. The correlations between the cervical sagittal measurements and the disc degeneration at each level were analyzed by Spearman's correlation. Results: A significant correlation was found for the C2~C7 angle with disc degenerations at C2~C6 levels. O~C2 angle was correlated significantly with disc degenerations at C2~C4 and C5~C7 levels. There was significant correlation between C1~C2 angle and disc degeneration at C6~C7 level. No significant relationship was found between the cervical SVA and the cervical disc degeneration at all cervical levels. Conclusion: Cervical sagittal parameters representing cervical angles (C2~C7, O~C2, and C1~C2 angles) were significantly correlated with the degree of the cervical disc degeneration. These findings suggest that the loss of the natural cervical lordosis rather than loss of natural SVA could be correlated with progression of the cervical disc degeneration.

• 대한의생명과학회지
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• 제29권4호
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• pp.211-219
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• 2023

Caffeic acid phenethyl ester (CAPE) is an active component of propolis obtained from honeybee hives. CAPE possesses anti-mitogenic, anti-carcinogenic, anti-inflammatory, and immunomodulatory activities in diverse systems, which know as displays antioxidant activity and inhibits lipoxygenase activities, protein tyrosine kinase, and nuclear factor kappa B (NF-κB) activation. This study aimed to investigate the effect of CAPE on lipopolysaccharide (LPS)-induced human neutrophil phagocytosis. Human neutrophils were cultured with various concentrations of CAPE (1, 10, and 100 µM) with or without LPS. The pro-inflammatory proteins (tumor necrosis factor-alpha [TNF-α], interleukin [IL]-6 and IL-8) levels were measured after 4 h incubation. To investigate the intracellular signaling pathway, we measured the levels of mitogen-activated protein kinases (MAPK), including phosphorylation of p38, extracellular signal-regulated protein kinases 1 and 2 (ERK1/2) and c-Jun N-terminal kinase (JNK). Next, to evaluate the potential phagocytosis, neutrophils were labeled with iron particles of superparamagnetic iron oxide nanoparticles (SPIONs, 40 nm) for 1 h in culture medium containing 5 mg/mL of iron. The labeling efficiency was determined by Prussian blue staining for intracellular iron and 3T-wighted magnetic resonance imaging. CAPE decreased the activation of intracellular signaling pathways, including ERK1/2 and c-Jun, and expression of pro-inflammatory cytokines, including TNF-α and IL-6, but had no effect on the signaling pathways of p38 and cytokine IL-8. Furthermore, images obtained after mannan-coated SPION treatment suggested that CAPE induced significantly higher signal intensities than the control or LPS group. Together, these results suggest that CAPE regulates LPS-mediated activation of human neutrophils to reduce phagocytosis.

• 대한의용생체공학회:의공학회지
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• 제44권6호
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• pp.377-383
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• 2023

Purpose: There is increasing attention to the application of transcranial direct current stimulation (tDCS) for enhancing cognitive functions in subjects to aging, mild cognitive impairment (MCI), and Alzheimer's disease (AD). Despite varying treatment outcomes in tDCS which depend on the amount of current reaching the brain, there is no general information on the impacts of anatomical features associated with AD on tDCS-induced electric field. Objective: The objective of this study is to examine how AD-related anatomical variation affects the tDCS-induced electric field using computational modeling. Methods: We collected 180 magnetic resonance images (MRI) of AD patients and healthy controls from a publicly available database (Alzheimer's Disease Neuroimaging Initiative; ADNI), and MRIs were divided into female-AD, male-AD, female-normal, and male-normal groups. For each group, segmented brain volumes (cerebrospinal fluid, gray matter, ventricle, rostral middle frontal (RMF), and hippocampus/amygdala complex) using MRI were measured, and tDCS-induced electric fields were simulated, targeting RMF. Results: For segmented brain volumes, significant sex differences were observed in the gray matter and RMF, and considerable disease differences were found in cerebrospinal fluid, ventricle, and hippocampus/amygdala complex. There were no differences in the tDCS-induced electric field among AD and normal groups; however, higher peak values of electric field were observed in the female group than the male group. Conclusions: Our findings demonstrated the presence of sex and disease differences in segmented brain volumes; however, this pattern differed in tDCS-induced electric field, resulting in significant sex differences only. Further studies, we will adjust the brain stimulation conditions to target the deep brain and examine the effects, because of significant differences in the ventricles and deep brain regions between AD and normal groups.

• 대한영상의학회지
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• 제83권2호
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• pp.439-443
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• 2022

갈색지방종은 갈색지방조직의 드문 양성 종양이다. 저자들은 53세 여자 환자에서 액와부 갈색지방종의 다양한 영상 소견을 보고하고자 한다. 초음파에서 오른쪽 액와부에 4.5 cm의 경계가 분명한 타원형의 비균질한 고에코의 종괴였으며, 액와부 혈관들을 앞쪽으로 전위시키고 있었다. 조영 전 흉부 단층촬영에서 5 cm의 경계가 분명한 타원형의 저감쇠의 종괴로 보였다. 자기공명영상에서는 T1과 T2 강조영상에서 비균질한 중간 및 고신호강도의 5.5 cm 종괴였으며, 변연부에서 불규칙한 조영증강을 보였다. 환자는 초음파유도중심부바늘생검을 받아 최종적으로 갈색지방종으로 진단되었다.