악성신경교 분화를 보이는 재발성 뇌실외 신경세포종 - 증례보고-

장인복,박세혁,황형식,김덕환,남은숙,조병문,신동익,오세문,Chang, In-Bok,Park, Se-Hyuck,Hwang, Hyung-Sik,Kim, Duck-Hwan,Nam, Eun Sook,Cho, Byung-Moon,Shin, Dong-Ik,Oh, Sae-Moon The Korean Neurosurgical Society 2001 Journal of Korean neurosurgical society Vol.30 No.4

37세 남자 환자로 경련발작을 주소로 본원에 내원하였고, 조직검사상 뇌실외 신경세포종으로 진단 받았으며, 방사선 치료를 받고 퇴원하였다. 11년후 언어장애, 우측 편마비를 주소로 다시 내원 하였다. 뇌 전산화 단층촬영과 뇌 자기공명영상에서 좌측 두정엽과 측두엽에 종양 크기의 증가, 뇌부종 및 석회화가 동반된 소견을 보여 종양 절제술을 시행 받았다. 조직검사상에서 1987년 처음 입원 시에는 투명세포질을 가진 작은 원형세포와 원섬유가 풍부하고 가유두상 양상을 보이는 중심 신경세포종으로 진단되었다. 그러나, 1998년 두 번째 조직 검사상에서 대부분의 종양세포는 심한 이형성을 보이는 신경교세포로 구성되었으며, 유사분열, 다형성핵 등이 관찰되었고, 면역염색상 glial fibrillary acidic protein에서 양성을 보였다. 일부에서는 작고 둥근 세포들의 군집이 보였으며, synaptophysin에 양성을 보였다. 중심 신경세포종은 젊은 성인에서 호발하고 주로 측뇌실이나 제 3 뇌실의 몬로공 주위에서 발생하는 비교적 드문 종양으로, 신경교 분화를 보이는 경우는 있으나 악성분화를 보이는 경우와 뇌실외 발생은 드물다. 본 교실에서는 11년전 중심 신경세포 종으로 진단 받은 후 악성 신경교 분화를 보이는 뇌실외 신경세포종을 경험하였기에 보고한다. We present a case of recurrent extraventricular neurocytoma with malignant glial differentiation in left temporoparietal area. A 37-year-old man with presentation of generalized seizure had undergone biopsy of brain tumor in left parietal area in 1987, which revealed extraventricular neurocytoma and radiotherapy was followed. Postoperative course was uneventful until eleven years after biopsy, when he became gradually aphasic and right hemiplegic. Brain CT and MRI revealed enlargement of tumor with peritumoral edema and calcifications. He underwent subtotal tumor removal in 1998. Microscopic examination of second biopsy specimen revealed presence of large areas composed of anaplastic glial cells with frequent mitosis, nuclear pleomorphism, large eosinophilic cytoplasm and eccentric nuclei, resembling gemistocytes, which were strongly immunoreactive to glial fibrillary acidic protein(GFAP) but not to synaptophysin(SNP). Also focal areas of neuronal cells were found, which were immunoreactive to SNP but not to GFAP. These histologic findings imply that this recurred tumor was a high grade, mixed tumor with divergent differentiation of neuronal and astrocyte lineage. We report a rare case of extraventricular cerebral neurocytoma with malignant glial differentiation with review of the literature.

안와내 가성종양 1예 - 증 례 보 고 -

장인복,조병문,황형식,박세혁,신동익,오세문,Chang, In Bok,Cho, Byung Moon,Hwang, Hyung-Sik,Park, Se-Hyuck,Shin, Dong-Ik,Oh, Sae-Moon 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.1

Intraorbital pseudotumors are inflammatory lesions of the orbit of unknown etiology, which initially mimic an orbital neoplasm. The authors report a case of intraorbital pseudotumor presenting with painful exophthalmos. A 45-year-old male patient had a two-week history of acute progressive exophthalmos and diplopia. Right orbit was explored through transcranial route and the mass was biopsied, which revealed dense inflammatory cells and fibrosis. He subsequently underwent corticosteroid therapy and symptoms improved gradually. The literatures were reviewed.

Risk of Seizures after Operative Treatment of Ruptured Cerebral Aneurysms

장인복,조병문,신동익,심영보,박세혁,오세문,Chang, In-Bok,Cho, Byung-Moon,Shin, Dong-Ik,Shim, Young-Bo,Park, Se-Hyuck,Oh, Sae-Moon The Korean Neurosurgical Society 2001 Journal of Korean neurosurgical society Vol.30 No.6

목 적 : 파열된 뇌동맥류 수술후 경련발작은 잘 알려진 합병증으로 항경련제 치료가 요구된다. 저자들은 뇌동맥류 파열에 의한 지주막하출혈 환자에서 수술후 경련발작의 위험인자를 조사하여 경련발작 치료에 임상적 의의를 비교 하고자 한다. 방 법 : 1990년부터 1996년까지 파열된 뇌동맥류로 개두술을 시행한 321명의 환자중 1년 이상 추적관찰(1~4.6년)하였던 206명을 대상으로 후향적 방법으로 조사하였다. 모든 환자는 수술후 3~18개월 동안 예방적 항경련제 치료를 받았다. 경련발작에 기여하는 요인으로서 연령, 성별, 내원 당시 신경학적 상태, 수술전후 전산화단층촬영소견, Hunt-Hess grade, Fisher grade, 뇌동맥류의 위치, 고혈압의 기왕력, 수술시기, 그리고 지연성 신경학적 결손 등을 조사하여 비교 분석하였다. 통계적 검증분석 방법으로 chi-square test와 Fisher's exact test를 이용하였다. 결 과 : 평균 추적관찰기간은 1.8년으로 206명중 18명이 경련발작 소견을 보여 8.7%의 발생률을 보였다. 연령에서 나이가 적을수록, 파열된 동맥류의 위치가 중뇌동맥인 경우에서 경련발작이 높게 나타났다. 지연성 신경학적 결손을 보인 42명의 환자에서 8명(19%)이 경련발작이 발생하여 높은 통계학적 유의성을 보였다. 또한 고혈압의 기왕력, 수술후 뇌전산화촬영상 뇌경색등도 이와 관련성이 있었고, 수술전후 뇌내혈종의 소견이 관찰되면 또한 경련발작이 높게 발생되었다. 그러나 Hunt-Hess grade, Fisher grade, Glasgow Outcome Scale, 그리고 출혈후 수술의 시기 등은 경련발작의 발생빈도와는 통계학적 유의성을 보이지 않았다. 결 론 : 뇌동맥류 파열에 의한 수술후 경련발작의 위험인자로 낮은 연령, 중뇌동맥류, 지연성 신경학적 결손, 수술후 뇌전산화촬영상 뇌경색소견, 고혈압, 그리고 수술전후 뇌내혈종의 유무 등이 연관되었고, 이러한 경련발작의 유발인자를 인지함으로서 수술후 경련발작에 대한 예방과 치료에 도움을 줄 수가 있으며 이에 대한 전향적 연구가 요구된다. Objective : Postoperative seizure is a well documented complication of aneurysm surgery. The purpose of the present study was to analyze risk factors for postoperative seizure. Methods : Between January 1990 and December 1996, we performed craniotomy for ruptured cerebral aneurysms in 321 patients. Among them 206 patients who could be followed up for more than 1 year(range, 1 to 4.6 years) were enrolled to present study. All patients were treated with anticonvulsants for 3 to 18 months postoperatively. We analyze the incidence of postoperative seizure in different sex and age groups, and risk factors associated with postoperative seizures following aneurysm rupture. For statistical processing chi-square test and Fisher's exact test were used. Results : In the follow-up period of 1 to 4.6 years(mean, 1.8 years) postoperative seizure appeared in 18 out of 206 patients(8.7%). Mean latency between the operation and the first seizure was 6 months(range, 3 weeks to 18 months). The age of the patients has significant influence on the risk of seizure, it occurred more often in younger patients(p =0.0014). Aneurysm location in the MCA was associated with a significantly a higher risk of seizure(p = 0.042). Eight patients(19%) out of 42 patients who suffered delayed ischemic neurologic deficit(DID) developed seizure. Delayed ischemic neurologic deficit was associated with significantly a higher risk of seizure(p =0.019). Infarct and hypertension were associated with significantly a higher risk of seizure(p <0.05). pre- or postoperative intracranial hematoma(intracerebral or epidural hematoma) was associated with significantly a higher risk of seizure(p <0.0001). H-H grade, Fisher grade, Glasgow Outcome Scale of patients and timing of operation after subarachnoid hemorrhage had no significant relation with the risk of seizure. Conclusion : Factors associated with the development of postoperative seizure were middle cerebral artery aneurysm, delayed ischemic neurologic deficit, infarct on late postoperative CT scan, hypertension, pre or postoperative intracranial hematoma(intracerebral or epidural hematoma). Identification of the risk factors may be help to focus the antiepileptic drug threapy in cases prone to develop seizures. Prospective evaluation is indicated.

Change of Growth and Bed Soil Chemistry according to Chitosan Treatment Method of Ginseng (Panax ginseng C. A. Meyer)

Jin Yu(유진),Young Chang Kim(김영창),In Bea Jang(장인배),In Bok Jang(장인복) 한국약용작물학회 2022 한국약용작물학회 학술대회논문집 Vol.2022 No.1

성상세포종에서 혈관내피세포 성장인자의 발현

박세혁,장인복,김창현,조용준,조병문,신동익,오세문,김덕환,남은숙,Park, Se-Hyuck,Chang, In-Bok,Kim, Chang-Hyun,Cho, Young-Jun,Cho, Byung-Moon,Shin, Dong-Ik,Oh, Sae-Moon,Kim, Duk-Whan,Nam, Eun-Sook 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.6

Objective : Angiogenesis, the proliferation of capillary endothelial cells, is a vital component in the development, progression, and metastasis of many human tumors. Vascular endothelial growth factor(VEGF) is an endothelial cell-specific mitogen and induces angiogenesis and vascular permeability. The features of glioblastoma, distinct from low grade astrocytomas, are the presence of necroses and vascular endothelial proliferation. In this study, we investigated VEGF expression in the different grades of astrocytomas and determined whether VEGF expression correlates with development of glioblastoma and progression of astrocytomas. Patients and Methods : Forty seven patients with astrocytic tumors(24 males and 23 females), aged 3 to 65 years, were evaluated. Immunohistochemical staining was carried out using labelled streptavidin biotin method and primary antibody was a antirabbit polyclonal Ab against N-terminus region of VEGF165(Oncogene research product, MA, USA). Immunoreactivity(IR) was classified into no IR(absent or a trace of stain), moderate IR and intense IR by level of staining amount and intensity. Results : Six pilocytic astrocytomas showed 3 no IR and 3 moderate IR, 10 astrocytomas showed 2 no IR, 6 moderate IR and 2 intense IR, 12 anaplastic astrocytomas showed I no IR, 7 moderate IR and 4 intense IR and 19 glioblastomas showed 1 no IR, 11 moderate IR and 7 intense IR. Immunoreactivity was significantly different between low and high grade of tumors but there was no significant difference between anaplastic astrocytomas and glioblastomas. Gemistocytic tumor cells represented the predominent VEGF-immunoreactive cell types, as compared with compactly-arranged small tumor cells. In glioblastomas VEGF IR was observed in both perinecrotic and vital tumor areas. Conclusion : VEGF seems to be a important angiogenic factor in anaplastic astrocytomas and glioblastomas and VEGF expression may contribute to neovascularization of human astrocytomas.

침수 시간과 침수 수위가 인삼 생육 및 광합성 특성에 미치는 영향

서수정(Su Jeoung Suh),문지원(Ji Won Moon),장인복(In Bok Jang),김영창(Young Chang Kim),김동휘(Dong Hwi Kim),유진(Jin Yu) 한국약용작물학회 2021 한국약용작물학회지 Vol.29 No.6

Background: Abnormal climate change induces many environmental disasters, including flooding. Panax ginseng C. A. Meyer is highly sensitive to waterlogging, but the experimental approaches to understanding the mechanism are relatively scarce. Methods and Results: Waterlogging was applied to 2-year-old ginseng plant in July under artificial conditions for 1, 2, 3, and 5 days at two different water levels: above the soil surface [WA(+)] and below the rhizome level [WA(-)]. Growth properties and photosynthetic characteristics were measured during waterlogging, and in the recovery period after waterlogging had stopped. Shoot death was evident in ginseng plants that were treated with WA(+) for 5 days. Growth inhibition in root diameter and root weight were severe when waterlogging lasted more than 3 days, and when the water level was above the soil surface. Chlorophyll fluorescences, F<SUB>v</SUB>/F<SUB>m</SUB>, was significantly decreased during the recovery period in WA(+) for 5 days. Photosynthetic rate and stomatal conductance were influenced after waterlogging, depending on waterlogging duration and water levels. Conclusions: The degree of damage to ginseng upon waterlogging was dependent on the duration and water level. These results will be helpful to understand the waterlogging response of ginseng, and suggest that photosynthetic characteristics can be used as an indicator of damage from waterlogging.

Comparison of Growth and Environment according to Cultivation Type in Yam (Dioscorea polystachya Turcz.)

Jin Yu(유진),Young Chang Kim(김영창),Su Gyeong Jeon(전수경),Sung Cheol Ku(구성철),In Bok Jang(장인복),Jun Hong Park(박준홍) 한국약용작물학회 2022 한국약용작물학회 학술대회논문집 Vol.2022 No.1

전이성 육모막암종에 의한 다발성 뇌동맥류

안경록 ( Kyoung Rok Ahn ),장인복 ( In Bok Chang ),류경식 ( Kyung Sik Ryu ),조병문 ( Byung Moon Cho ),오세문 ( Sae Moon Oh ),박세혁 ( Se Hyuck Park ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2005 대한뇌종양학회지 Vol.4 No.2

We report a case of meatstatic choriocarcinoma mimicking systemic necrotizing vasculitis on cerebral angiogram. A 35- year-old female presented with right side hemiplegia and drowsy mental status. Computed tomography(CT) scan revealed an intracerebral hemorrhage in the left frontal region. Cerebral angiogram showed multiple microaneurysms arising from the bilateral anterior cerebral artery and middle cerebral arteries. Renal angiogram showed multiple microaneurysms arising from the left distal renal artery. Chest CT scan revealed multiple metastatic lesions in the left lower lung field. The hematoma and microaneurysms were surgically removed. Choriocarcinoma was diagnosed on histologic examination. Despite of postoperative chemotherapy, she died 1 month after operation.

키토산과 UV처리에 따른 2년생 인삼의 생육특성 및 성분변화

문지원(Ji Won Moon),장인배(In Bae Jang),장인복(In Bok Jang),김영창(Young Chang Kim),서수정(Su Jeoung Suh) 한국약용작물학회 2021 한국약용작물학회지 Vol.29 No.4

Background: Ginseng is a medicinal plant known for its pharmacological effects as a secondary metabolite. Ginsenosides and polyphenols are the most important compounds of ginseng. These compounds and biological active depend on the cultivation conditions. Methods and Results: We used chitosan and an ultraviolet (UV) light elicitor on a 2-year old ginseng plant for increasing active compounds and biological activity. The chitosan that we used were obtained from Gryllus bimaculatus (chitosan A) and mealworm beetle (chitosan B). Chitosan B enhanced the growth, active ingredient content and physiological activity of ginseng overall. Although UV had a negative effect on ginseng growth, it increased the active compound content and biological activity. Conclusions: Chitosan is an eco-friendly organic material, believed to be easy to treat in growing ginseng. Therefore, the use of chitosan is thought to be an appropriate agent to increase the amount of ginsenoside, and enhance others compounds and physiological activity.

저온처리 온도와 상대습도가 2년생 인삼의 동해에 미치는 영향

서수정(Su Jeoung Suh),문지원(Ji Won Moon),권나영(Na yeong Kwon),장인복(In Bok Jang),김영창(Young Chang Kim),장인배(In bae Jang) 한국약용작물학회 2021 한국약용작물학회지 Vol.29 No.3

Background: Abrupt cold, especially frost after seedling emergence, in spring causes servere losses in ginseng yield as it is a perennial crop and has a determinate growth. Although abnormal temperature occurs more frequently, the physiological aspects of ginseng to cold stress are poorly understood. Here we report the freezing response of ginseng under artificial conditions. Methods and Results: Cold treatment at -4℃ for 16 h resulted in a 21.4% damage rate in a cold chamber, however, no damage was observed at -2℃ and -4℃ for 2, 4, 6, or 8 h. High humidity increased the damage rate to 59.9% even at the higher temperature (RH 95%, -3℃) than the ambient temperature (RH 66%, -4℃) of the cold chamber. Seedlings early in the leaf expansion were damaged more than older ones. The quantum yield (Fv/Fm) of cold-damaged seedlings was lower than the control or seedlings without visual symptoms. The root weight of a damaged seedling one month after cold treatment was 58% of control. Conclusions: Our results suggested that visual symptoms are correlated with photosynthetic ability and yield after freezing stress in ginseng. We expect our results to contribute to the further understanding of ginseng freezing stress.