전두골에 발생한 콜레스테롤 육아종 1례 - 증례보고 -

이상원,차승헌,박동준,송근성,최창화,이영우,Lee, Sang Weon,Cha, Seung Heon,Park, Dong June,Song, Geun Sung,Choi, Chang Hwa,Lee, Young Woo 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.6

Cholesterol granuloma of frontal bone is a rare disease which usually occurs at the lateral part of the supraorbital ridge. This expanding lesion grows slowly and extends into the orbit and anterior cranial fossa. The most common symptom is proptosis. This granuloma is composed of a granulomatous reaction surrounding cholesterol crystals. Surgical treatment involves aspiration of contents and stripping or curettage of the lining which is highly successful. We experienced a case of cholesterol granuloma of frontal bone with huge intracranial extension, which was cured by surgical removal. The clinical features, radiologic, and pathologic finding were discussed and the pertinent literatures were reviewed.

뇌실-복강 단락 원위도관의 심장내전위 - 증례보고 -

김병주,차승헌,박동준,송근성,최창화,이영우,Kim, Byung Joo,Cha, Seung Heon,Park, Dong June,Song, Geun Sung,Choi, Chang Hwa,Lee, Young Woo 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.2

Ventriculoperitoneal(V-P) shunt has been used as a popular method for surgical treatment of hydrocephalus. But complications such as infection, mechanical obstruction and failure of flow rate sometimes make painful stress to neurosurgeons and patients. Of particular, migration of distal V-P shunt catheter to extraperitoneal space has rarely been reported. Even rarer is intracardiac migration of distal V-P shunt catheter. Authors report a such case and discuss the possible mechanism and preventive method.

임상 : 상재발성 중추 신경계 임파종에 대한 감마 나이프 수술의 효과와 한계

이수헌 ( Su Heon Lee ),차승헌 ( Seung Heon Cha ),허병익 ( Beong Ik Hur ),강동완 ( Dong Wan Kang ),조원호 ( Won Ho Cho ),최창화 ( Chang Hwa Choi ) 대한뇌종양학회 2011 대한뇌종양학회지 Vol.10 No.2

Introduction: Although there has been no established treatment protocol for central nervous system lymphoma (CNSL), high dose methotrexatae therapy with or without external beam radiotherapy (EBRT) is generally adopted as a standard therapeutic regimen. However, recurrence of CNSL following standard treatment is often observed, even within the pre-viously irradiated field. Therefore, we thought that Gamma knife surgery (GKS) can be an excellent alternative measure for recurrent CNSL after initial treatment. The purpose of this study was to investigate the effectiveness of GKS for the CNSL as a palliative treatment modality. Materials and Methods: We retrospectively reviewed 21 recurrent CNSL lesions in 5 patients underwent GKS Between January 2007 and December 2010. There were two male and three female patients and their age was 41-72 years (median 52.2) old at the time of the first GKS. All patients were confirmed as diffuse large B-cell lymphoma through the patho-logic diagnosis. Three patients had primary CNSL, and the remaining two patients had CNS involvement of systemic lymphoma. All patients had a history of previous chemotherapy and/or radiotherapy. Results: All patients were treated without severe adverse effects. The target volume was 0.1-38.4 mL (median 5.2). The marginal dose was 12-20 Gy (median 18.7) to the 50% isodose line. Follow up MR images revealed complete response (CR) and partial response (PR) in 95% cases. The neurologic symptoms disappeared or improved rapidly in all patients. However all of the patients showed recurrent CNSL 1 to 10 months (mean : 4 month) after GKS. Median overall survival time and median intracranial relapse-free survival time was 9.1 months and 4.6 months, respectively. Conclusion: GKS might be used as a safe and excellent treatment modality in the patients with recurrent CNSL. More-over, GKS provides the rapid clinical improvement within the short interval from the treatment. However, despite its rapid palliative effect, short-term effectiveness period limited its usefulness. Therefore, adjuvant chemotherapy is essen-tial following GKS in the CNSL.

임상 : 상두개강내에 상의 세포종의 임상적 결과와 여후 인자

이수헌 ( Su Heon Lee ),차승헌 ( Seung Heon Cha ),남경협 ( Kyoung Hyup Nam ),조원호 ( Won Ho Cho ) 대한뇌종양학회 2012 대한뇌종양학회지 Vol.11 No.1

Objective: Ependymomas are infrequently seen tumors that have been defined as neoplasm arising from ependymal cells lining the ventricles and the central canal of the spinal cord. As prognostic factor, histological features and surgical resection and the efficacy of prophylactic radiation remain controversial in the management of intracranial ependymoma. We analyzed a series of patients with intracranial ependymoma to review our strategy of treatment and prognostic factor. Materials and Methods: Between Jan 2001 and Dec 2008, 11 patients have been under treatment at our institute. Seven cases involved Grade II lesion according to the World Health Organization (WHO) classification of ependymoma, and four cases involved Grade III lesion. Postoperative radiation was performed in eight cases and chemotherapy was administered in three childhood patients. We analyzed the result of treatment and prognosis according to recurrence of tumor. Results: Overall recurrence rates were significantly lower in patients with Grade II ependymoma and in patients who had undergone gross total resection of the tumor. Three patients (27.3%) revealed progression or recurrence from 12 to 65 months (median 29.7 months) after diagnosis. In two patients, the ependymoma recurred only at the original tumor site. One patients experienced both local and distant relapse as spinal seeding. Histologic grade and extent of resection were related with tumor recurrence or progression. Among eight cases underwent adjuvant radiotherapy (Five cases of Grade II, Three cases of Grade III), three cases of Grade III revealed tumor progression and none of Grade II cases showed tumor progression. Conclusion: Histologic grade is the important prognostic factor with respect to patient survival, tumor recurrence and tumor progression. Although there was no statistical significance, progression rate is higher in young age and infratentorial tumors. Grade III ependymoma is more common in young age and infratentorial area.

재발성 뇌실내출혈을 일으킨 경연수접합부 동정맥기형 - 증례보고 -

이상원,최창화,차승헌,박동준,송근성,이영우,Lee, Sang Weon,Choi, Chang Hwa,Cha, Seung Heon,Park, Dong June,Song, Geun Sung,Lee, Young Woo 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.6

Cervicomedullary junction arteriovenous malformation(AVM) is extremely rare. The authors present a case of a cervicomedullary junction AVM in a 31-year-old woman presenting with recurrent intraventricular hemorrhage (IVH). Magnetic resonance imaging revealed the AVM(of a size of approximately $2{\times}2.5{\times}4cm$) extending from a lower medulla to C2-3 level. Vertebral angiography demonstrated a tightly coiled vascular mass with multiple feeders (radiculomedullary arteries) and irregular-shaped aneurysm at distal part of feeder originating at right C-1 level. The patient underwent superselective embolization of upper nidus and the aneurysm. The pertinent literature is reviewed, and diagnostic and therapeutic implications are discussed.

례뇌하수체 선종과 동반되어 안상조에 발생한 지주막 낭종

남경협 ( Kyoung Hyup Nam ),차승헌 ( Seung Heon Cha ),조원호 ( Won Ho Cho ),최병관 ( Byung Kwan Choi ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2012 대한뇌종양학회지 Vol.11 No.1

Objectives: Arachnoid cysts are a relatively rare pathological entity, and a suprasellar arachnoid cyst is quite rare. We report on an extremely rare case of a suprasellar arachnoid cyst associated pituitary adenoma and discuss the possible pathogenesis. Clinical Presentation: A 24-year-old man was admitted to the hospital with a history of headache, visual field defect, gait disturbance, syncope, and urinary incontinence. Computed tomography showed severe hydrocephalus. Preoperative magnetic resonance images revealed a mass lesion in the sella turcica with suprasellar extension and a coexisting large supra- and parasellar cyst. Transcranial surgery was performed for the removal of the tumor mass and cyst. Ventricle size normalized after the operation. He exhibited an uneventful recovery without neurologic deficits or endocrinologic abnor-malities. Conclusion: We present clinical, radiological, and histopathological findings and discuss the possible pathogenesis of a suprasellar arachnoid cyst associated pituitary adenoma.

펜톤산화 및 백색부후균을 이용한 축산폐수 중의 난분해성 물질의 제거

원찬희(Chan Hee Won),차승헌(Seung Heon Cha),이순영(Soon Young Lee) 大韓環境工學會 2003 대한환경공학회지 Vol.25 No.6

조기에 두개골 전이를 일으킨 여포성 갑상선암 -증례보고-

조원호 ( Won Ho Cho ),차승헌 ( Seung Heon Cha ),송근성 ( Geun Sung Song ),최창화 ( Chang Hwa Choi ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2007 대한뇌종양학회지 Vol.6 No.2

Metastasis to the skull frequently occurs in patients with lung, breast and prostate cancer. However, skull metastases from thyroid carcinoma have been rarely reported. Thyroid carcinoma usually have a long clinical course before the diagnosis of skull metastasis, however we experienced an unusual early skull metastasis from thyroid carcinoma. We review the literature on skull metastasis from thyroid follicular carcinoma and report a case of a 55-year-old female who presented with lytic skull metastasis of thyroid follicular carcinoma. She had a history of thyroid surgery for a thyroid nodule 1 year ago. She complained of painless scalp mass over the left parietal region. Radiological investigations revealed a lytic skull mass in the left parietal region. The histological diagnosis was skull metastasis from thyroid follicular carcinoma. The patient was given whole body I131 radio-iodine internal radiation and thyroid stimulating hormone(TSH) suppression therapy.

뇌하수체 종양에 대한 경접형동접근술의 효과

전진호 ( Jin Ho Jeon ),차승헌 ( Seung Heon Cha ) 대한뇌종양학회 2004 대한뇌종양학회지 Vol.3 No.2

Objective:The transsphenoidal approach(TSA) for pituitary tumor has evolved significantly since it was described initially during the first decade of the 20th century. This study was to evaluate the efficacy of TSA and prognosis of pituitary tumor after TSA. Methods:We analyzed 51 cases of pituitary tumor which underwent transsphenoidal approach about radiologic findings, symptoms, results and prognosis from 2000 to 2002 with literature review. Statistical analysis was performed using paired t-test with SPSS Ver 11.0 and considered significant for value less than 0.05. Results:There were 35 functional adenomas, 11 nonfunctional adenomas and 5 other lesions among 51cases. Follow up MRIs show that remnant mass after TSA existed on medial compartment of cavernous sinus and suprasellar area that didn`t descend during TSA in spite of valsalva maneuver. 7 cases(13.7%) recurred after TSA. Among them 3 case underwent repeated TSA and the other 1 case endured transcranial approach and gamma-knife radiosurgery applicated to another 2 cases. There was statistical significance between stage and extent of removal(p=0.0005). There were no significant complications and mortality related to TSA. Conclusion:Although remnant rate of pituitary tumor after TSA was 45%, this approach offered excellent decompression to optic chiasm and could be a safe and effective approach to pituitary tumor if it is supported with endoscope introduction to sellar fossa and additional therapy such as gamma-knife radiosurgery.

임상 : 뇌하수체 선종에 대한 경접형동접근술의 임상분석

양문석 ( Moon Seok Yang ),차승헌 ( Seung Heon Cha ),조원호 ( Won Ho Cho ),이상원 ( Sang Won Lee ),송근성 ( Geun Sung Song ),최창화 ( Chang Hwa Choi ) 대한뇌종양학회 2007 대한뇌종양학회지 Vol.6 No.2

Objective:Transsphenoidal approach(TSA) for pituitary tumor has evolved significantly since it was described initially during the first decade of the 20th century. This study was to evaluate the efficacy of TSA and prognosis of pituitary adenoma after TSA. Methods:This study included 132 cases of pituitary adenoma which underwent transsphenoidal approach from 2000 to 2006. We analyzed radiologic findings, symptoms, results, prognosis and reviewed the literatures. Mean follow-up period was 22 months. Statistical analysis was performed using paired t-test and considered significant for value less than 0.05. Results:There were 80 functional adenomas, 52 non-functional adenomas among 132 cases. Tumors were removed totally in 63.6% and subtotally in 36.4%. Follow-up magnetic resonance imagings(MRIs) showed that remnant mass after TSA existed on medial compartment of cavernous sinus and suprasellar area that did not descend during the operation in spite of Valsalva maneuver. 18 cases(13.6%) recurred after TSA. Among them, 4 cases underwent repeated TSA, 2 cases endured transcranial approach and Gamma-Knife radiosurgery applied to another 11 cases. A case which had been removed totally, but presented hormonal symptoms after 6 months. There was statistically significance between stage and extent of removal(p=0.0012). There was no major complications and mortality related to TSA. Conclusion:Although remnant rate of pituitary adenoma after TSA was 38.0%, this approach offered excellent decompression to optic chiasm. It could be a safer and more effective approach to pituitary adenoma if it is supported with endoscopic introduction to pituitary fossa and additional therapy such as Gamma-Knife radiosurgery.