척수 종양 654예의 임상 분석(1973-1999)

최우진,정천기,조병규,김현집,Choe, Woo Jin,Chung, Chun-Kee,Cho, Byung-Kyu,Kim, Hyun Jib 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.8

Objective : The spinal cord tumors(including vertebral tumors) are increasingly diagnosed and operated due to development of refined diagnostic and therapeutic tools. It is necessary to re-evaluate clinical features and surgical results of spinal cord tumors with increasing cases and developing treatment modalities. The authors reviewed the spinal cord tumor cases to evaluate their clinical characteristics. Material and Methods : The retrospective review of 654 cases of spinal cord tumors between 1973 and 1999 was done. The clinical features, pathological analysis and surgical results were analyzed and compared to the literature. The results of the study are analyzed with a more detailed consideration of each of major pathologies : neurogenic tumors, meningeal tumors, neuroepithelial tumors, and metastatic tumors. Results and Conclusion : The spinal cord tumor was most common in the 5th decade of age(145 cases, 22.1%) and 78 cases(11.9%) were found in children under 15 years of age. The ratio of male to female was 1.2 : 1. The pathologic diagnosis was neurogenic tumor in 266 cases(40.7%), neuroepithelial tumor in 131(20.0%), metastatic tumor in 118(18.0%), and meningeal tumor in 94(14.4%) in the order of frequency. The tumor was located most frequently in the thoracic area(36.5%) and in the intradural extramedullary space(38.1%). The most common initial presentation was pain(40.1%) and the mean duration for presentation to operation was 14.8 months. The total or gross total removal was possible in 404 cases(61.7%) and the surgical result on the postoperative one month was recovery or improvement in 424 cases(64.8%), stationary in 188(28.7%), progression in 42(6.4%). As a surgical complication, there was a spinal deformity(12 cases), wound infection(5 cases), aspiration pneumonia(5 cases) etc. Neurogenic tumors and menigiomas showed good surgical results, whereas neuroepithelial tumors(except ependymoma) and metastatic tumors showed relatively poor prognosis.

척수 혈관모세포종의 임상 분석

이대규,최우진,김동윤,이철희,정천기,김현집,Lee, Dae Kyu,Choe, Woo Jin,Kim, Dong Yoon,Lee, Chul Hee,Chung, Chun Kee,Kim, Hyun Jib 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.11

Objectives : The authors present a retrospective analysis of 14 patients treated for spinal cord hemangioblastoma (SCH) between Dec. 1986 and Mar. 2000. This study was conducted to evaluate and compare the difference of the functional outcomes associated with the extent of surgical removal of SCH. Methods : Eleven patients were male and three patients were female. Their mean age was 37.2 years that ranged from 19 to 62 years. Preoperative magnetic resonance(MR) imaging of the spine was performed in all cases, and preoperative angiography in eleven cases. They were followed from 15 months to 161 months(median follow-up period, 47 months), and we investigated the change of neurological symptoms and functional outcomes with radiological features, especially on MR imaging. Results : Six patients were accompanied by von Hippel-Lindau disease, and three of them had multiple CNS tumors. Thirteen patients had intramedullary tumor, and the remaining one had extradural. Syringomyelia around the tumor was observed in ten cases. All patients underwent surgical removal, and gross total removal(GTR) was achieved in ten cases. Preoperative embolization was performed in four cases. In four patients who were treated with preoperative embolization, intraoperative loss of blood was minimal and GTR was possible. One patient developed a transient swallowing difficulty postoperatively without permanent postoperative neurological deficits. In three of four patients in whom GTR was not possible, their functional outcomes were worsened postoperatively. The functional status at discharge was improved in seven patients, stationary in four patients, and worse in three. At the last follow-up(15-161 months), one of four patients who had been stationary at discharge showed improvement but, the rest did not show any change. All patients who showed neurological improvement were patients with GTR, and the patients with GTR had significant better outcome than those without GTR(p=0.015). Conclusion : Surgical treatment, and especially, GTR is considered as treatment of choice for spinal cord hemangioblastoma. Preoperative embolization may prevent intraoperative bleeding and improve surgical outcome.

전두부 두개골을 침범한 염증성 근섬유모세포종 -증례보고-

김태호 ( Tae Ho Kim ),최우진 ( Woo Jin Choe ),이승준 ( Seung Jun Lee ),이종주 ( Jong Joo Rhee ),이혜경 ( Hye Kyung Lee ),이채혁 ( Chae Heuck Lee ),김명수 ( Myoung Soo Kim ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2006 대한뇌종양학회지 Vol.5 No.1

Inflammatory myofibroblastic tumor(IMT) includes a diverse group of lesions characterized by inflammatory cell infiltration and variable fibrotic responses, which mimic neoplastic lesions. IMTs of the head and neck occur most commonly in the orbits, and their occurrence in the skull is rare. To our knowledge, only eight cases of IMTs of the skull(excluding cases in the eye and maxillary sinus) have been reported in Korea. We report a case of IMT involving the frontal bone. A 43-year-old man presented with right frontal pain. A right frontal scalp mass had been removed at another hospital one month ago, but the pain persisted. Brain computed tomography showed a suspected sclerotic lesion near the right coronal suture, with an enhancing epidural mass. A lesion of the frontal bone was removed by craniectomy. The cortical bone appeared pinkish-brown color. Dura mater adherent to the bone showed an inflammatory reaction and thickening and it was removed. Duroplasty and cranioplasty were performed. The pathology test indicated IMT. IMT must be distinguished from other infectious, granulomatous, and neoplastic lesions. It requires an aggressive approach including surgical intervention, with resection of all the bone and dura mater involved. We describe the diagnosis and treatment of skull IMT.

임상 : 역형성 핍지교종 환자의 치료 결과에 관한 연구

이성호 ( Sung Ho Lee ),고영초 ( Young Cho Koh ),최우진 ( Jin Woo Choe ),조요한 ( Yo Han Cho ),노홍기 ( Hong Gee Roh ),홍세미 ( Se Mi Hong ),임소덕 ( So Duck Lim ),이채혁 ( Chae Heuck Lee ) 대한뇌종양학회 2008 대한뇌종양학회지 Vol.7 No.2

Objects:To evaluate prognostic impacts of surgical extent, postoperative Karnofsky performance status(KPS), and chemotherapy( CTx) in patients with anaplastic oligodendroglioma(AO), the authors analyzed the overall survival(OS) and progression free survival(PFS) in these patients according to those factors. Methods:Twenty nine patients with AO, who had undergone surgery by a single surgeon at the three university hospitals where the senior author had been active staff during the last 20 years, were enrolled in this retrospective analysis. Maximal safe resection was tried in all cases with or without neuronavigation techniue. The extent of removal was evaluated by immediate postoperative MRI. Impact of surgical extent, CTx, and postoperative KPS were evaluated on the OS and PFS in these patients. Results:Thirteen men and 16 women patients with the mean age at the diagnosis of 42.9 years(7-71 yrs) were included in this study. The mean follow-up duration was 61.8 months(3-237 months) and 12 patients died of tumor progression during the follow-up. There was no operative mortality. Gross total resection(GTR) was done in 15 patients, and either subtotal resection(STR) or partial resection(PR) was done in 14 patients. Of the 29 patients 26 were subjected to conventional radiotherapy(RT). The three remaining patients in poor KPS, less than 60, didn`t undergo RT. Twenty patients were subjected to CTx either with PCV(procarbazine, CCNU, vincristine) or Temozolomide(TMZ). Nineteen patients tolerated well the CTx with mild to moderate hematological or other toxicities and could finish the 6 or 7 cycles of PCV or TMZ. During the follow-up, tumor recurrences had been observed in 13 patients, for whom additional operations and /or salvage CTx were tried. GTR affects significantly on OS and PFS(p<0.01). Good postoperative KPS was also favorable for OS and PFS(p<0.05). Adjuvant CTx either with PCV or TMZ in addition to RT in patients with AO was not statistically significant prognostic impact for OS and PFS in this study(p>0.05). Conclusion:From this single-surgeon-operated series, the authors could confirm significant prognostic impacts of radical surgery, and good postoperative KPS in patients with AO on PFS and OS.

원발성 중추신경계 림프종의 과거력을 가진 환자에서의 후각신경모세포종

이주용(Joo-Yong Lee),고영초(Young-Cho Koh),조준(Joon Cho),최우진(Woo Jin Choe),임소덕(So-Dug Lim),박호권(Ho-Kwon Park),김진국(Jin-Kook Kim) 대한두개저학회 2006 대한두개저학회지 Vol.1 No.1

Olfactory neuroblastoma is a rare malignant tumor arising from the olfactory neuroepithelium. A 48-year-old male patient with a prior medical history of primary Central Nervous System (CNS) lymphoma presented with severe epistaxis of sudden onset. Radiologic study revealed a left ethmoidal tumor. A biopsy done at a local ENT clinic revealed a highly malignant tumor. Minimally invasive craniofacial resection was undergone for this malignant tumor with anterior skull base invasion. Pathology confirmed the diagnosis of olfactory neuroblastoma with no evidence of primary CNS lymphoma. We report a case of olfactory neuroblastoma in a patient with a history of primary CNS lymphoma.

두개골에 발생한 Idiopathic Massive Osteolysis of the Skull -증례보고-

김용만 ( Yong Man Kim ),고영초 ( Young Cho Koh ),이채혁 ( Chae Heuk Lee ),최우진 ( Woo Jin Choe ),박효일 ( Hyo Il Park ) 대한뇌종양학회 2003 대한뇌종양학회지 Vol.2 No.2

The authors report a case of idiopathic massive osteolysis of the parietal bone. A 37-year-old male was admitted with the complaints of headache. The depression of the skull was palpable. Plain skull X-ray and brain computed tomography(CT) revealed a diffuse massive osteolytic lesion at the left parietal bone without any evidence of new bone formation or skull tumor. Cranioplasty was performed and through biopsy idiopathic massive oeteolysis was confirmed. The authors report this case with the literature review, and discuss clinical, radiological features, and management methods of this rare case.

후두개와에 발생한 신경장관난종 : 증례보고 Case Report

최우진,유헌,정희원,최기영,조병규 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.6

Groenblad_Strandberg's Syndrome

최기용,최우진,조재춘 大韓眼科學會 1969 大韓眼科學會雜誌 Vol.10 No.1

Dilated and Fixed Pupil

이송희,최우진 大韓眼科學會 1968 大韓眼科學會雜誌 Vol.9 No.4