• Journal of Korean Neurosurgical Society
• /
• v.48 no.2
• /
• pp.145-152
• /
• 2010

Objective : The aim of this report is to provide accurate nationwide epidemiologic data on primary central nervous system (CNS) tumors in Korea. Despite its importance, there are no accurate statistics on primary CNS tumors in Korea. We analyzed primary CNS tumors diagnosed in 2005 from the nationwide registry. Methods : Data on primary CNS tumors diagnosed in 2005 were collected from the Korean Central Cancer Registry and the Korean Brain Tumor Society. Crude and age-standardized rates were calculated in terms of gender, age, and histological type. Tumors of uncertain histology were investigated individually at the corresponding hospitals and had their diagnoses confirmed. Results : A total of 5,692 patients diagnosed with primary CNS tumors in 2005 were included in this study. CNS tumors occurred in females more often than in males (female to male, 1.43 : 1). The most common tumor was meningioma (31.2%). Glioblastoma accounted for 30.7% of all gliomas, and 19.3% of all malignant primary CNS tumors. In children under 19 years of age, both germ cell tumor and embryonal/primitive/medulloblastoma were the most common tumors. Conclusion : This article is the first nationwide primary CNS tumor epidemiology report in Korea. Data from this study should provide valuable information regarding the understanding of primary CNS tumors epidemiology in Korea.

• PNF and Movement
• /
• v.6 no.2
• /
• pp.39-50
• /
• 2008

Purpose : This article reviewed the advances in the understanding of the effect of motor rehabilitation and brain plasticity on functional recovery after CNS damage. Methods : This is literature study with Pubmed, Medline and Science journal. Results : The inability of CNS neurons to regenerate is largely associated with nonneuronal aspects of the CNS environment. Especially, this neuronal growth inhibition is mediated by myelin associated glycoprotein, olygodendrocyte-myelin glycoprotein, and NOGO. Enriched environment, motor learning, forced limb use have been utilized in scientific studies to promote functional reorganization and brain plasticity. Especially, enriched environment and motor enrichment may prime the brain to respond more adaptively to injury, in part by expressed neurotrophic factors. Conclusions : These reviews suggest that activity-induced neural plasticity occur in damaged brain areas in order to functional reorganization, where it could contribute to motor recovery, and represent a target for stroke rehabilitation.

• Proceedings of the Korean Society of Toxicology Conference
• /
• 2006.11a
• /
• pp.55-64
• /
• 2006

The fetal central nervous system (CNS) is sensitive to diverse environmental factors, such as alcohol, heavy metals, irradiation, mycotoxins, neurotransmitters, and DNA damage, because a large number of processes occur during an extended period of development. Fetal neural damage is an important issue affecting the completion of normal CNS development. As many concepts about the brain development have been recently revealed, it is necessary to compare the mechanism of developmental abnormalities induced by extrinsic factors with the normal brain development. To clarify the mechanism of fetal CNS damage, we used one experimental model in which 5-azacytidine (5AZC), a DNA damaging and demethylating agent, was injected to the dams of rodents to damage the fetal brain. 5AzC induced cell death (apoptosis)and cell cycle arrest in the fetal brain, and it lead to microencephaly in the neonatal brain. We investigated the mechanism of apoptosis and cell cycle arrest in the neural progenitor cells in detail, and demonstrated that various cell cycle regulators were changed in response to DNA damage. p53, the guardian of genome, played a main role in these processes. Further, using DNA microarray analysis, tile signal cascades of cell cycle regulation were clearly shown. Our results indicate that neural progenitor cells have the potential to repair the DNA damages via cell cyclearrest and to exclude highly affected cells through the apoptotic process. If the stimulus and subsequent DNA damage are high, brain development proceeds abnormally and results in malformation in the neonatal brain. Although the mechanisms of fetal brain injury and features of brain malformation afterbirth have been well studied, the process between those stages is largely unknown. We hypothesized that the fetal CNS has the ability to repair itself post-injuring, and investigated the repair process after 5AZC-induced damage. Wefound that the damages were repaired by 60 h after the treatment and developmental processes continued. During the repair process, amoeboid microglial cells infiltrated in the brain tissue, some of which ingested apoptotic cells. The expressions of genes categorized to glial cells, inflammation, extracellular matrix, glycolysis, and neurogenesis were upregulated in the DNA microarray analysis. We show here that the developing brain has a capacity to repair the damage induced by the extrinsic stresses, including changing the expression of numerous genes and the induction of microglia to aid the repair process.

• Brain Tumor Research and Treatment
• /
• v.6 no.2
• /
• pp.73-77
• /
• 2018

Germinoma is the most common type of intracranial germ cell tumors (GCTs). Pineal gland and suprasellar region are the most frequent sites of central nervous system (CNS) involvement. Intracranial masses caused by Langerhans cell histiocytosis (LCH) mimics features of CNS GCTs. LCH frequently involve spine and is the most common cause of vertebra plana in children. A 15-year-old boy presented with progressing symptoms of polydipsia, polyuria, general headache, nausea and severe back pain. Brain MRI showed brain tumor with simultaneous involvement of suprasellar region and pineal gland. An excisional biopsy of suprasellar mass was done. The pathologic assessment confirmed the diagnosis of germinoma. Patient's treatment continued accordingly. A spine MRI, done due to persistent backache, showed a vertebra plana. We reevaluated the primary diagnosis suspecting LCH. Germinoma of CNS was confirmed and a biopsy of vertebral lesion resulted in hemangioma. Thus we report a case of CNS germinoma with co-occurrence of vertebra plana. We emphasized the importance of histopathologic diagnosis of pineal/suprasellar masses and primary investigation of other CNS regions including spine for possible metastasis or comorbidities.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.2
• /
• pp.637-640
• /
• 2012

The Delhi Population Based Cancer Registry data during the period 2003-2007 were used to describe the epidemiology of primary malignant brain and central nervous system tumors in Delhi. A total of 1989 brain and CNS tumors cases in 1291 males and 698 females were registered during the period 1st January 2003 to 31st December 2007. The age adjusted (world population) incidence rates were 3.9 per 100,000 for males and 2.4 per 100,000 for females. Gliomas were the most frequently reported histology both in males (26.6%) and females (23.2%). A male predominance in incidence was observed for all histological classifications. The rates in Delhi are low compared to the incidences reported from developed countries.

• Radiation Oncology Journal
• /
• v.37 no.4
• /
• pp.302-308
• /
• 2019

The abscopal effect is a term that has been used to describe the phenomenon in which localized radiation therapy treatment of a tumor lesion triggers a spontaneous regression of metastatic lesion(s) at a non-irradiated distant site(s). Radiation therapy induced abscopal effects are believed to be mediated by activation and stimulation of the immune system. However, due to the brain's distinctive immune microenvironment, extracranial abscopal responses following cranial radiation therapy have rarely been reported. In this report, we describe the case of 42-year-old female patient with metastatic melanoma who experienced an abscopal response following her cranial radiation therapy for her brain metastasis. The patient initially presented with a stage III melanoma of the right upper skin of her back. Approximately 5 years after her diagnosis, the patient developed a large metastatic lesion in her upper right pectoral region of her chest wall and axilla. Since the patient's tumor was positive for BRAF and MEK, targeted therapy with dabrafenib and trametinib was initiated. However, the patient experienced central nervous system (CNS) symptoms of headache and disequilibrium and developed brain metastases prior to the start of targeted therapy. The patient received radiation therapy to a dose of 30 Gy delivered in 15 fractions to her brain lesions while the patient was on dabrafenib and trametinib therapy. The patient's CNS metastases improved significantly within weeks of her therapy. The patient's non-irradiated large extracranial chest mass and axilla mass also shrank substantially demonstrating the abscopal effect during her CNS radiation therapy. Following radiation therapy of her residual chest lesions, the patient was disease free clinically and her CNS lesions had regressed. However, when the radiation therapy ended and the patient continued her targeted therapy alone, recurrence outside of her previously treated fields was noted. The disease recurrence could be due to the possibility of developing BRAF resistance clones to the BRAF targeted therapy. The patient died eventually due to wide spread systemic disease recurrence despite targeted therapy.

• Genomics & Informatics
• /
• v.11 no.4
• /
• pp.254-262
• /
• 2013

The multidrug resistance protein 2 (MRP2, ABCC2) gene may determine individual susceptibility to adverse drug reactions (ADRs) in the central nervous system (CNS) by limiting brain access of antiepileptic drugs, especially valproic acid (VPA). Our objective was to investigate the effect of ABCC2 polymorphisms on ADRs caused by VPA in Korean epileptic patients. We examined the association of ABCC2 single-nucleotide polymorphisms and haplotype frequencies with VPA related to adverse reactions. In addition, the association of the polymorphisms with the risk of VPA related to adverse reactions was estimated by logistic regression analysis. A total of 41 (24.4%) patients had shown VPA-related adverse reactions in CNS, and the most frequent symptom was tremor (78.0%). The patients with CNS ADRs were more likely to have the G allele (79.3% vs. 62.7%, p=0.0057) and the GG genotype (61.0% vs. 39.7%, p=0.019) at the g.-1774delG locus. The frequency of the haplotype containing g.-1774Gdel was significantly lower in the patients with CNS ADRs than without CNS ADRs (15.8% vs. 32.3%, p=0.0039). Lastly, in the multivariate logistic regression analysis, the presence of the GG genotype at the g.-1774delG locus was identified as a stronger risk factor for VPA related to ADRs (odds ratio, 8.53; 95% confidence interval, 1.04 to 70.17). We demonstrated that ABCC2 polymorphisms may influence VPA-related ADRs. The results above suggest the possible usefulness of ABCC2 gene polymorphisms as a marker for predicting response to VPA-related ADRs.

• Journal of Acupuncture Research
• /
• v.20 no.6
• /
• pp.168-181
• /
• 2003

Objective: The neuroanatomical studies on the acupoints(Waiguan(SJ5), Neiguan(Pe6), Sanyinjiao(SP6) and Xuanzhong(GB39)) projecting to the brain area related to dimentia using the pseudorabies virus (PRV-Ba strain) in the mouse was described. Methods: The common locations of the brain projecting to the Waiguan, Neiguan, Sanyinjiao and Xuanzhong following injection of PRV-Ba were histochemically observed. The results were as follows Results : 1. PRV-Ba labeled areas in medulla oblongata, pons and midbrain were similar to 4 acupoints, theses areas were related to autonomic center. 2. PRV-Ba labeled areas in diencephalon and cebrebrum were differently labeled according to the acupoints. 3. CNS labeled areas in Waiguan were dense labeled in CA1-3 area of hippocampus, amygdaloid nucleus, insular cortex, parietal cortex, entorhinal cortex, perirhinal cortex, dorsal endopiriform cortex, piriform cortex, amygdalopiriform transition and bed n. of stria terminalis. 4. CNS labeled areas in Neiguan were dense labeled in insular cortex, amygdaloid nucleus, parietal cortex, entorhinal cortex, perirhinal cortex, dorsal endopiriform cortex, piriform cortex, amygdalopiriform transition and bed n. of stria terminalis. 5. CNS labeled areas in Sanyinjiao were dense labeled in CA1-3 of hippocampus, suprachiasmatic n., dorsal endopiriform cortex, piriform cortex and bed n. of stria terminalis. 6. CNS labeled areas in Xuanzhong were dense labeled in suprachiasmatic n., dorsal endopiriform cortex and piriform cortex. Conclusions : Following these results, labeled acupoints in brain areas related to dimentia are Waiguan and Neiguan. Common labeled areas are amygdaloid n., entorhinal cortex, amygdaopiriform transition, bed n. stria terminalis and perirhinal cortex.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.6
• /
• pp.3979-3985
• /
• 2013

Background: Although primary malignant CNS tumors are registered in the national cancer registry (NCR) of Iran, there are no available data on the incidence of the primary malignant or benign CNS tumors and their common histopathologies in the country. This study analyzed the 10-year data of the Iranian NCR from March 21, 2000 to March 20, 2010, including a systematic review. Materials and Methods: The international and national scientific databases were searched using the search keywords CNS, tumor, malignancy, brain, spine, neoplasm and Iran. Results: Of the 1,086 primary results, 9 papers were selected and reviewed, along with analysis of 10-year NCR data. The results showed that primary malignant brain tumors have an overall incidence of 2.74 per 100,000 person-years. The analysis of the papers revealed a benign to malignant ratio of 1.07. The most common histopathologies are meningioma, astrocytoma, glioblastoma and ependymoma. These tumors are more common in men (M/F=1.48). Primary malignant spinal cord tumors constitute 7.1% of the primary malignant CNS tumors with incidence of 0.21/100,000. Conclusions: This study shows that CNS tumors in Iran are in compliance with the pattern of CNS tumors in developing countries. The NCR must include benign lesions to understand the definitive epidemiology of primary CNS tumors in Iran.

• Journal of Korean Neurosurgical Society
• /
• v.63 no.1
• /
• pp.119-135
• /
• 2020

Objective : To investigate the epidemiology of newly-diagnosed, histologically-confirmed (NDHC) central nervous system (CNS) tumours and its changes over a 21-year period in a regional hospital in Hong Kong. Methods : This is a single-institute retrospective descriptive study of patients undergoing surgery for CNS tumours in a regional hospital of Hong Kong in the period from January 1996 to December 2016. The histological definition of CNS tumours was according to the World Health Organization classification, while the site definition for case ascertainment of CNS tumours was as set out by the Central Brain Tumour Registry of the United States. Patients of any age, who had NDHC CNS tumours, either primary or secondary, were included. The following parameters of the patients were retrieved : age at diagnosis, gender, tumour location, and histological diagnosis. Population data were obtained from sources provided by the Government of Hong Kong. The incident rate, estimated by the annual number of cases per 100000 population, for each histology grouping was calculated. Statistical analyses, both including and excluding brain metastases, were performed. Statistical analysis was performed with Microsoft Excel, 2016 (Microsoft, Redmond, WA, USA). Results : Among the 2134 cases of NDHC CNS tumours, there were 1936 cases of intracranial tumours and 198 cases of spinal tumours. The annual number of cases per 100000 population of combined primary intracranial and spinal CNS tumours was 3.6 in 1996, and 11.1 in 2016. Comparing the 5-year average annual number of cases per 100000 population of primary CNS tumours from the period 1996-2000 to 2011-2015, there was an 88% increase, which represent an increase in the absolute number of cases by 4.52 cases/100000 population. This increase was mainly contributed by benign histologies. In the aforementioned periods, meningiomas increased by 1.45 cases/100000 population; schwannomas by 1.05 cases/100000 population, and pituitary adenomas by 0.91 cases/100000 population. While gliomas had a fluctuating 5-year average annual number of cases per 100000 population, it only had an absolute increase of 0.51 cases/100000 population between the 2 periods, which was mainly accounted for by the change in glioblastomas. Conclusion : This retrospective study of CNS tumour epidemiology revealed increasing trends in the incidences of several common CNS tumour histologies in Hong Kong, which agrees with the findings in large-scale studies in Korea and the United States. It is important for different geographic locations to establish their own CNS tumour registry with well-defined and structured data collection and analysis system to meet the international standards.