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기초 : 악성신경교종의 세포고사체로 감작시킨 수지상세포에 의해 유도된 종양특이적 T 림프구의 HLA Type에 따른 세포독성
박익성 ( Ik Seong Park ),정동섭 ( Dong Sup Chung ),한영민 ( Young Min Han ),장경술 ( Kyung Sool Jang ),김종태 ( Jong Tae Kim ),박영섭 ( Young Sup Park ) 대한뇌종양학회 2008 대한뇌종양학회지 Vol.7 No.2
Objective:The purpose of this study is to determine whether human dendritic cells(DCs) pulsed with glioma apoptotic bodies(GABs) can induce tumor-specific T lymphocytes having cytotoxicities to allogeneic glioma cells matched or mismatched at class I human leukocyte antigen(HLA) loci. Methods:DCs were generated from peripheral blood mononuclear cells(PBMCs) of HLA-A2 positive healthy donors cultured in the presence of granulocyte macrophage-colony stimulating factor and interleukin(IL)-4. GABs from HLAA2 positive T98G glioblastoma cells following actinomycin D treatment were pulsed to DCs. CD8+ T lymphocytes isolated from PBMCs of the same donors were cultured in media containing IL-2 and were stimulated by GAB-pulsed DCs three times at weekly interval. Then cytolytic activities of these cytotoxic CD8+ T cells against HLA-A2 positive T98G and U87 glioblastoma cells, and HLA-A2 negative A172 glioblastoma cells were determined by a standard 4hr [51Cr]-release assay. Results:The average percentages of T98G , U87 and A172 cell lysis were 43.7%, 45.6% and 5.1% compared with 3.6% of controls at an effector to target cell ratio of 40:1 respectively. The cytotoxic T lymphocytes(CTLs) primed with HLAA2 positive T98G GAB-pulsed DCs had cytotoxicity to HLA-A2 positive T98G and U87 glioma cells but not to HLAA2 negative A172 cells(p<0.01). Conclusion:This study showed that tumor-specific CTLs generated by stimulations with GAB-pulsed DCs had cytotoxicity to the glioma cells in a HLA-restricted manner. This result suggests the feasibility of the use of HLA-matched allogeneic glioma cells as a source of antigens for patients not eligible for surgery in the DC-based immunotherapy.
소뇌-교각종양 수술시 수술 중 전기생리학적 신경감시에 따른 수술 후 기능적 결과
이상구,박관,박익성,서대원,엄동옥,남도현,이정일,김종수,홍승철,신형진,어환,김종현,Lee, Sang Koo,Park, Kwan,Park, Ik Seong,Seo, Dae Won,Uhm, Dong Ok,Nam, Do-Hyun,Lee, Jung-Il,Kim, Jong Soo,Hong, Seung Chyul,Shin, Hyung Jin,Eoh, Whan,Kim, 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.6
Objectives : Intraoperative neurophysiologic monitoring(INM) is a well known useful method to reduce intraoperative neurological complications during neurosurgical procedures. Furthermore, INM is required in most cerebellopontine angle(CPA) surgery because cranial nerves or brain stem injuries can result in serious complications. Object of this study is to the correlation between the changes of intraoperative monitoring modalities during cerebellopontine angle tumor surgery and post-operative functional outcomes in auditory and facial functions. Material and Methods : Fifty-seven patients who underwent intraoperative neurophysiologic monitoring during CPA tumor surgery were retrospectively reviewed. Their lesions were as follows ; vestibular schwannomas in 42, other cranial nerve schwannomas in seven, meningiomas in five and cysts in three cases. Pre- and postoperative audiologic examinations and facial nerve function tests were performed in all patients. Intraoperative neurophysiologic monitoring modalities includes brainstem auditory evoked potentials(BAEP) and facial electromyographies(EMG). We compared the events of INM during CPA tumor surgeries with the outcomes of auditory and facial nerve functions. Results : The subjects who had abnormal changes during CPA tumor surgery were twenty cases with BAEP changes and facial EMG changes in twenty one cases. The changes of intraoperative neurophysiologic monitoring did not always result in poor functional outcomes. However, most predictable intraoperative monitoring changes were wave III-V complex losses in BAEP and continuous neurotonic activities in facial EMG. Conclusion : These results indicate that intraoperative neurophysiologic monitoring in CPA tumor surgery usually provide predictive value for postoperative functional outcomes.
례부재성 안장증후군 양상의 터어키안 내부 지주막 낭종으로 인한 범뇌하수체 기능저하증의 수술적 치료 -증례보고-
박준상 ( Jun Sang Park ),박익성 ( Ik Seong Park ),조광욱 ( Kwang Wook Jo ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2012 대한뇌종양학회지 Vol.11 No.1
Differentiating between empty sella syndrome (ESS) and isolated intrasellar arachnoid cysts (ISAC) in cases of panhypopituitarism is critical for determining appropriate treatment strategies. However, the radiological properties of these lesions are quite similar on computed tomography (CT) and magnetic resonance imaging (MRI). CT cisternography using radiopaque dye is a useful modality for identifying symptomatic ISAC without para- or suprasellar extension. We present a successful case of surgically treated symptomatic ISAC, which had been previously diagnosed and treated medically without improvement.
누액선에 발생한 Adenoid Cytic Carcinoma - 증 례 보 고 -
서대희,백정환,김윤덕,하범준,박익성,남도현,박관,김종현,Seo, Dae Hee,Baek, Chung-Hwan,Kim, Yoon-Duck,Ha, Bom Joon,Park, Ik-Seong,Nam, Do-Hyun,Park, Kwan,Kim, Jong-Hyun 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.8
Adenoid cystic carcinoma(ACC) is a rare malignant tumor that occurs in exocrine glands such as major and minor salivary glands, lacrimal glands, ceruminal glands. It has a tendency for delayed distant metastasis and long clinical course. ACC of the lacrimal gland is generally found in adults and is usually managed by radical orbitectomy and supplemental external beam irradiation. The authors present two cases of recurrent lacrimal gland ACC with review of the literature.
뇌기저부 종양제거 수술후 발생한 척추동맥의 거대가성동맥류 -증례보고-
홍현진 ( Hyun Jin Hong ),박익성 ( Ik Seong Park ),백민우 ( Min Woo Baik ),조광욱 ( Kwang Wook Jo ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2011 대한뇌종양학회지 Vol.10 No.2
A 33-year-old man initially presented with posterior neck swelling. He subsequently underwent removal of a brain stem tumor via a far lateral transcondylar approach four weeks prior to representation due to complications. A giant aneurysm originating from the extracranial vertebral artery was identified via digital subtraction angiography (DSA). Due to subsequent surgical exploration on the high cervical area, a pseudoaneurysm was found in it. In this paper, we describe the clinical presentation and treatment of this post-operative complication of a posterior fossa skull base approach.
김종현,조태구,박관,박익성,남도현,이정일,조양선,홍성화,홍승철,신형진,어환,Kim, Jong Hyun,Cho, Tae Goo,Park, Kwan,Park, Ik Seong,Nam, Do-Hyun,Lee, Jung-Il,Cho, Yang-Sun,Hong, Sung Hwa,Hong, Seung-Chyul,Shin, Hyung-Jin,Eoh, Whan 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.6
Objective : To determine the feasibility of translabyrinthine approach in the vestibular schwannoma patients, the authors reviewed eighteen consecutive cases, focusing at their functional outcome and operative complications. Materials and Method : To evaluate the functional outcome, we reviewed preoperative radiological findings such as size of tumors and location of jugular bulb as well as the preoperative neurological status including audiometric analysis and cranial nerve function in 18 patients, diagnosed as vestibular schwannoma. Also the surgical outcome was evaluated according to the functional preservation of facial nerve and incidence of the surgical complication as well as the extent of surgical resection. Results : The age of patients ranged from 21 to 62 years, with a mean of 50 years. Of 18 patients operated in our center by the translabyrinthine approach, wide exposure with total removal of the mass was possible in 16 cases (88.8%). The facial nerve was anatomically preserved in 88.8%. At six-month follow-up, facial nerve function was good(Grade I-II) in 15 patients(83%) and acceptable(I-IV) in all patients. Although the jugular bulb was highly placed is five patients, gross total resection was possible without facial nerve injury in all patients by the translabyrinthine approach. One patient experienced CSF leakage after surgery, but there was no patient with disabling deficit. Conclusion : Use of the translabyrinthine approach for removal of vestibular schwannomas resulted in good anatomical and functional preservation of the facial nerve, with minimal incidence of morbidity and no mortality. In cases of high jugular bulb impacted into mastoid bone, total removal was possible by displacing the jugular bulb with Surgicel cellulose and placement of bone wax.
뇌하수체 졸증 후에 자발적으로 소멸된 뇌하수체 종양 -증례보고-
조광욱 ( Kwang Wook Jo ),박성만 ( Sung Man Park ),박익성 ( Ik Seong Park ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2009 대한뇌종양학회지 Vol.8 No.2
Pituitary apoplexy refers to a clinical syndrome caused by the sudden expansion of a pituitary tumor that compresses nearby structures. In spite of much debate, if there is a neurolo-ophthalmic problem, emergent surgical decompression has been known as the ideal treatment. However, we experienced a rare case in which a pituitary tumor showed spontaneous regression after apoplexy. The tumor was only given conservative care. Thus, the authors will report on the case with a brief literature review.
임상 : 앞머리쪽우묵 및 안장옆 부위의 종양에 대한 눈썹절개를 통한 눈확위 접근법
백병석 ( Byung Suck Baik ),조광욱 ( Kwang Wook Jo ),김영우 ( Young Woo Kim ),김상돈 ( Sang Don Kim ),박익성 ( Ik Seong Park ),백민우 ( Min Woo Baik ) 대한뇌종양학회 2008 대한뇌종양학회지 Vol.7 No.2
Objectives:Keyhole surgery through supraorbital route with eyebrow incision is minimal invasive technique for anterior cranial fossa pathology. Traditional method need to remove supraorbital rim, result in postoperative ecchymosis around eye. The authors performed surgery without removal of supraorbital rim and want to introduce the surgical technique and results. Methods:Among the patients who were found to have the tumor in the anterior cranial fossa and parasellar area, 9 patients were operated by supraorbital approach. There are 2 tuberculum sellar meningiomas, 3 anterior skull base meningiomas, 1 parasellar cavernous hemangioma, 1 Rathke`s cleft cyst, 1 metastatic tumor and 1 optic glioma. Skin incision was made along lateral two third of eyebrow. Small size craniotomy was made just upper part of supraorbital rim. The opening size was 1.5×2.5 cm. Next technique is almost same with traditional supraorbral approach. The surgical results were studied retrospectively. Results:Largest tumor was 4×5×5 cm in size. Gross total removal was possible in all the patients. There was no surgical mortality and imaging study showed no surgical complication without one case. One patient suffered from hypothalamic dysfunction and sustained moderately disabled state for 6 months but the others showed excellent outcome(modified Rankin Score 0 to 1). The average postoperative hospital day was 9.6 days except 1 patient. All patients were satisfied with cosmetic results. Short Form-36® health survey showed excellent self estimation after surgery. Conclusion:Minimal invasive approach through eyebrow incision can achieve same results like conventional craniotomy in selected case. Supraorbital rim removal is not an obligation during this procedure.
박익성,허필우,이길송,최창락 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.9
‘Duplication of the middle cerebral artery’ is a rere vascular anomaly of the brain. The authors experienced a case of duplication of the middle cerebral artery in a patient with a posterior communicating artery aneurysm. It was demonstrated by angiography and confirmed at surgery. The neck of aneurysm was succesfully clipped. Postoperative course was uneventful.