뇌교종 수술에서 뇌지도화

조진모 ( Jin Mo Cho ),장종희 ( Jong Hee Chang ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2009 대한뇌종양학회지 Vol.8 No.2

The aims of brain glioma surgery are to potentiate adjuvant therapies and to extend survival with maximizing the quality of resection, while minimizing the risk of postoperative neurologic deficits. However, it is often limited by the location and spatial extent of the tumor and its relationship to the eloquent tissue. Moreover, there is interindividual anatomofunctional variability and so, each patient should be evaluated for cortical functional organization, effective connectivity and potential for plasticity. Recently, “maximum safe resection” has been made possible by preoperative functional neuroimaging, intraoperative imaging and image-guided surgery, and intraoperative functional mapping. In each patient, preoperative evaluation of cortical functional organization and relationship between tumor and surrounding brain tissue, and intraoperative evaluation of anatomo-functional connectivity and short-term plasticity using repeated cortical and subcortical stimulation during resection made tailored resection of glioma in eloquent area possible. With continuous accumulation of neuroanatomical & neurophysiological knowledge and experience of preoperative and intraoperative mapping, we could understand more and better about dynamic functional anatomy of brain.

미사 참석자들의 양심을 향한 칼빈의 권고

조진모 ( Jin Mo Cho ) 한국개혁신학회 2009 한국개혁신학 Vol.25 No.-

특집 : 한국 장로교회 분열에 대한 재조명 ; 1950년대 한국 장로교회의 분열 연구: 역사에 나타난 패턴을 중심으로

조진모 ( Jin Mo Cho ) 한국장로교신학회 2011 장로교회와 신학 Vol.8 No.-

이 글은 1950년대에 일어났던 한국 장로교회의 분열(1952, 1953, 1959)의 성격에 대한 연구이다. 국가적으로 어려운 시기에도 분열을 선택하였던 이유가 무엇이었을까? 결론부터 말하자면, 교단의 ``외적 원인``이 나타나기 전에 이미 나타난 ``내적 원인`` 때문이다. 그런데 흥미로운 것은 스코틀랜드 장로교회와 미국 장로교회의 역사에 이미 이와 동일한 패턴이 반복되어 나타났다는 것이다. 1) 외적 원인: 교단 정치 상황 속에서 해석되어야 하는 중요한 사건들을 가리킨다. 스코틀랜드 교회의 ``평신도의 목사 추천령,`` 미국 교회의 ``부흥 운동과 노예제도,`` 한국 교회의 ``신사참배 문제``(1952), ``조선신학교``(1953), 그리고 ``WCC``(1959)가 여기에 속한다. 2) 내적 원인: 교단 내의 보수와 진보 사이의 신학적 갈등이다. 급변하는 세상에서의 교회의 정체성이 가장 중요한 논쟁거리였다. 일반적으로 보수 측은 어떤 변화에도 불구하고 성경의 절대적 권위를 존중하는 장로교회의 신학 전통을 지키려 하였다. 이에 반해 진보는 세상이 요구하는 교회의 모습을 갖추기 위해 장로교회의 신학 전통을 변형할 것도 불사해야 한다고 주장하였다. 초기 한국 장로교회는 비교적 보수적 성격을 띠고 있었다. 그러나 1920년대에 자유주의 신학에 영향을 받은 선교사와 유학파 신학자들이 교단에 영향을 행사하면서 내적 갈등이 시작되었다. 무엇보다 1930년 후반에 일제가 신사참배를 강요하면서 보수 측이 영향력을 잃게 되자 진보 측이 득세하게 되었다. 그 결과, 1945년 해방 이후에는 보수, 진보, 그리고 중도 등 3파로 나뉘게 된다. 흥미로운 것은, 프린스턴 유학 동기였으나 신학적 노선을 달리한 3인(박형룡, 김재준, 한경직)이 각기 다른 신학적 노선을 선택하였다는 것이다. 이들은 향후 결국 교단의 분열을 가져온 ``외적 원인``이 되는 사건의 중심인물이 되었다.` This article examines the divisions made among Korean Presbyterian Church during the 1950s(``52, ``53, ``59). What was the reason for their decision in the midst of national di?cult times? We would conclude that there had been an ``internal`` cause among them long before an ``external`` cause took place. Interestingly, such pattern was repeatedly shown already in the history of the Presbyterian churches in Scotland and America. 1) External Cause: the major events which needs to be interpreted in the context of the denominational politics. It includes ``The Lay Patronage Act`` for the Scotland Presbyterian Chuch, ``Revivalism and Slavery issue`` for the American Presbyterian Church, ``Shintonism``(``52), ``Chosun Theological Seminary``(``53), and ``WCC`` (``59) for the Korean Presbyterian Church. 2) Internal Cause: doctrinal disagreement within the denomination between the conservative side and the progressive side. The prime issue was the identity of the church in the world that changes rapidly. Generally speaking, the conservative side generally showed their interest in preserving the Presbyterian tradition which emphasizes the absolute authority of the Bible. On the other hand, the progressive side claimed the possibility to alter the Presbyterian tradition as a means to shape the church presentable to the world. The Korean Presbyterian Church started with conservative tendency. But ``internal tension`` began in the 1920s when the liberal missionaries and students who studied liberal theology abroad began to have influence on the denomination. Above all, the progressive side took control after the conservatives lost their influence completely In the late 1930s when the Japanese imposed Shintoism aggressively. As a result, three theological tendencies emerged after Korea was liberated from Japan in 1945: conservative, progressive, and moderates. Interestingly, three former students(Hyungrong Park, Jaejun Kim, and Kyungjik Han) at Princeton chose distinctive theological perspectives. They ended up being the main ?gures at each ``internal cause`` which ?nally brought the division among them.

임상 : 발생하수술 전 잘못 진단되었던 뇌하수체 선종과 터키안결절 뇌수막종 환자들의 영상학적 소견과 임상 양상에 관한 분석

조진모 ( Jin Mo Cho ),김의현 ( Eui Hyun Kim ),김선호 ( Sun Ho Kim ),이규성 ( Kyu Sung Lee ),장종희 ( Jong Hee Chang ) 대한뇌종양학회 2012 대한뇌종양학회지 Vol.11 No.1

Objectives:Preoperative differentiation of the histologic etiology of masses involving the sellar and suprasellar region is very important because it determines the treatment modalities, surgical approaches, and the degree of resection. We ana-lyze the imaging findings and clinical symptoms of pituitary adenomas and tuberculum sellae meningiomas which preop-eratively diagnosed as each other falsely. Patients and Methods:Preoperative magnetic resonance images (MRI) and angiography findings of 14 patients with pathologically diagnosed as pituitary adenomas or tuberculum sellae meningioma which considered as each other were reviewed retrospectively. For all patients, the clinical history, laboratory data, MRI and results of ophthalmological ex-aminations were retrospectively reviewed. The following features, usually accepted as useful criteria in the differential diagnosis of these lesion were reviewed; Clinical Symptoms, hormonal deficiency, visibility of pituitary stalk, pattern of enhancement, presence of dural tail sign, presence of tumor brushing on the angiographic findings. Results:All findings except angiographic tumor brushing, were not consistent with each other. All patients presented with visual field defect and have no hormonal deficiency or symptoms. All lesions showed dura based one, no cleavage plane from the pituitary gland or stalk may be due to its large size, and homogeneous enhancement. There was no case of angi-ographic tumor brushing in pituitary adenoma patients. Conclusion:Differentiating pituitary adenoma and tuberculum sellae meningioma can be difficult. MRI is the most com-monly used method for diagnosis in these lesions. However, it is not sufficient for differential diagnosis for these lesions sometimes. Our results shows angiography finding could be a help to differentiate two pathologies. Preoperative cautious evaluation is essential and we think that angiography could be considered to differentiate two lesions.

측뇌실 삼각에 발생한 뇌실내 수막종에 있어 상부 두정-후두 피질경유 접근법의 임상 결과 ; 24례 보고

박세환 ( Se Hwan Park ),조진모 ( Jin Mo Cho ),김의현 ( Eui Hyun Kim ),김선호 ( Sun Ho Kim ),이규성 ( Kyu Sung Lee ),장종희 ( Jong Hee Chang ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2012 대한뇌종양학회지 Vol.11 No.2

Introduction:Intraventricular meningiomas are uncommon subtype of intracranial meningiomas. Trigonal meningiomas consist of the majority of intraventricular meningiomas. The superior parieto-occipital transcortical approach is the most popular approach for removal of them. We analyzed our experience in removal of the trigonal meningiomas that were resected using the superior parieto-occipital transcortical approach. Patients and Methods:Twenty-four patients underwent surgical removal of trigonal meningioma from 1997 to May 2012. Demographics, clinical features, surgical outcomes, histopathologic results and prognosis were analyzed. Results:Study population had a mean age of 51.2 years and a female preponderance of 1 : 1.7. The most common presenting symptom was chronic headache, which was followed by memory impairment, visual disturbance and hemiparesis. Total removal of the tumor was achieved in all cases. Twenty-two (91.7%) tumors were World Health Organization (WHO) grade I while two cases were WHO grade III. There were two cases of intracerebral hemorrhage in the surgical corridor, one case of transient contralateral hemiparesis with cognitive decline, one case of transient contralateral homonymous hemianopsia, one case of aggravation of visual field defect, and one case of hydrocephalus which was successfully treated by ventriculo-peritoneal shunt. Conclusion:The superior parieto-occipital approach is suitable for most of the trigonal meningiomas and total removal of them can be achieved safely.

측뇌실 삼각에 발생한 뇌실내 수막종에 있어 상부 두정-후두 피질경유 접근법의 임상 결과 ; 24례 보고

박세환 ( Se Hwan Park ),조진모 ( Jin Mo Cho ),김의현 ( Eui Hyun Kim ),김선호 ( Sun Ho Kim ),이규성 ( Kyu Sung Lee ),장종희 ( Jong Hee Chang ) 대한뇌종양학회 대한신경종양학회 2014 Brain Tumor Research and Treatment Vol.2 No.1

Introduction:Intraventricular meningiomas are uncommon subtype of intracranial meningiomas. Trigonal meningiomas consist of the majority of intraventricular meningiomas. The superior parieto-occipital transcortical approach is the most popular approach for removal of them. We analyzed our experience in removal of the trigonal meningiomas that were resected using the superior parieto-occipital transcortical approach. Patients and Methods:Twenty-four patients underwent surgical removal of trigonal meningioma from 1997 to May 2012. Demographics, clinical features, surgical outcomes, histopathologic results and prognosis were analyzed. Results:Study population had a mean age of 51.2 years and a female preponderance of 1 : 1.7. The most common presenting symptom was chronic headache, which was followed by memory impairment, visual disturbance and hemiparesis. Total removal of the tumor was achieved in all cases. Twenty-two (91.7%) tumors were World Health Organization (WHO) grade I while two cases were WHO grade III. There were two cases of intracerebral hemorrhage in the surgical corridor, one case of transient contralateral hemiparesis with cognitive decline, one case of transient contralateral homonymous hemianopsia, one case of aggravation of visual field defect, and one case of hydrocephalus which was successfully treated by ventriculo-peritoneal shunt. Conclusion:The superior parieto-occipital approach is suitable for most of the trigonal meningiomas and total removal of them can be achieved safely.

비부비동 미분화암의 두개안면절제술 후 전완부자유피판을 이용한 뇌 척수액 유출 폐쇄 시행 1례

송기재(Kee Jae Song),조진모(Jin Mo Cho),정운용(Woon Yong Jung),김훈(Hoon Kim),홍현준(Hyun Jun Hong) 대한두경부종양학회 2016 대한두경부 종양학회지 Vol.32 No.2

A 37 year-old male presented with sudden right proptosis and bilateral nasal obstruction. A huge tumor was noted in bilateral nasal cavities, ethmoid sinuses and central frontal sinus on magnetic resonance imaging. Right posterior frontal sinus wall and bilateral medial orbital wall was destructed by the tumor. Complete resection of the tumor was performed via minimal invasive craniofacial resection. Histopaghologic examination revealed sinonasal undifferentiated carcinoma (SNUC). Cerebrospinal fluid leakage was developed after 2 days of the surgery. On the 5th day, anterior skull base was reconstructed with forearm free flap (FFF). The patient got 6000cGy of radiotherapy and survived in 27 months of follow up.

임상 : 뇌종양 환자에서 관류강조 자기공명영상의 유용성 및 한계점

장원석 ( Won Suk Chang ),강정한 ( Jeong Han Kang ),조진모 ( Jin Mo Cho ),김진아 ( Jin Na Kim ),김응엽 ( Eung Yeop Kim ),안정용 ( Jung Yong Ahn ),김동석 ( Dong Seok Kim ),장종희 ( Jong Hee Chang ) 대한뇌종양학회 2009 대한뇌종양학회지 Vol.8 No.1

Introduction:Accurate diagnosis and grading of brain tumors are critical to determine the specific treatment planning and prognosis of each tumor type. Evaluation of tumor status during treatment to assess therapeutic response and treatmentrelated complications is also important. Recent developments in the field of magnetic resonance imaging(MRI) have been adopted with varying success in the management of brain tumors. We studied the usefulness and limitation of perfusion MRI, one of new MRI techniques, in patients with a brain tumor. Materials and Methods:We analyzed 100 perfusion MR images in 72 patients who treated between December 2005 to August 2006. The type of lesions was glioma in 62 patients, lymphoma in 11, metastasis in 6, other tumor in 7, and nontumorous lesion in 14. The perfusion MR images were obtained by 3.0T MRI using dynamic contrast enhanced method. We calculated relative cerebral blood volume(rCBV) with dedicated software program. Results:The mean rCBV of high grade gliomas(WHO grade III-IV) was significantly higher than that of astrocytic low grade gliomas(WHO grade II). Additionally, rCBV of glioma and tumor grading showed positive linear correlation. However, the value of rCBV is not correlated with the tumor grade in glioma with oligodendroglioma component. While there was no statistically significant difference of rCBV between low grade gliomas, and lymphomas or metastatic brain tumors, the rCBV of high grade gliomas was higher than that of lymphomas or metastatic brain tumors. The perfusion MRI was also helpful for distinguishing recurrence of high grade gliomas from radiation necrosis, and the rCBV was higher in recurrent cases. Conclusion:Even though perfusion MRI has several limitations such as susceptibility artifact, low resolution, the possibility of errors during interpretation, no absolute diagnostic values, and less effectiveness in hypervascular benign tumors or oligodendroglial tumors, this new MRI technique could be a useful method for preoperative diagnosis of brain mass lesion and assessing the results of treatment.