21 results on '"Doo Sik Kong"'
Search Results
2. The Influence of Biomarker Mutations and Systemic Treatment on Cerebral Metastases from NSCLC Treated with Radiosurgery
- Author
-
Doo-Sik Kong, Ho Jun Seol, Jung-Il Lee, Min Ho Lee, and Do-Hyun Nam
- Subjects
Oncology ,Gamma knife radiosurgery ,medicine.medical_specialty ,Systemic disease ,medicine.medical_treatment ,EGFR ,Radiosurgery ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,Non-small cell lung cancer ,Internal medicine ,medicine ,Anaplastic lymphoma kinase ,Epidermal growth factor receptor ,K-ras ,Clinical Article ,biology ,business.industry ,General Neuroscience ,medicine.disease ,Confidence interval ,ALK ,030220 oncology & carcinogenesis ,biology.protein ,Biomarker (medicine) ,Surgery ,Neurology (clinical) ,Neurosurgery ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
OBJECTIVE The purpose of this study was to analyze outcomes and identify prognostic factors in patients with cerebral metastases from non-small cell lung cancer (NSCLC) treated with gamma knife radiosurgery (GKS) particularly, focusing on associations of biomarkers and systemic treatments. METHODS We retrospectively reviewed the medical records of 134 patients who underwent GKS for brain metastases due to NSCLC between January 2002 and December 2012. Representative biomarkers including epidermal growth factor receptor (EGFR) mutation, K-ras mutation, and anaplastic lymphoma kinase (ALK) mutation status were investigated. RESULTS The median overall survival after GKS was 22.0 months (95% confidence interval [CI], 8.8-35.1 months). During follow-up, 63 patients underwent salvage treatment after GKS. The median salvage treatment-free survival was 7.9 months (95% CI, 5.2-10.6 months). Multivariate analysis revealed that lower recursive partition analysis (RPA) class, small number of brain lesions, EGFR mutation (+), and ALK mutation (+) were independent positive prognostic factors associated with longer overall survival. Patients who received target agents 30 days after GKS experienced significant improvements in overall survival and salvage treatment-free survival than patients who never received target agents and patients who received target agents before GKS or within 30 days (median overall survival: 5.0 months vs. 18.2 months, and 48.0 months with p-value=0.026; median salvage treatment-free survival: 4.3 months vs. 6.1 months and 16.6 months with p-value=0.006, respectively). To assess the influence of target agents on the pattern of progression, cases that showed local recurrence and new lesion formation were analyzed according to target agents, but no significant effects were identified. CONCLUSION The prognosis of patients with brain metastases of NSCLC after GKS significantly differed according to specific biomarkers (EGFR and ALK mutations). Our results show that target agents combined with GKS was related to significantly longer overall survival, and salvage treatment-free survival. However, target agents were not specifically associated with improved local control of the lesion treated by GKS either development of new lesions. Therefore, it seems that currently popular target agents do not affect brain lesions themselves, and can prolong survival by controlling systemic disease status. more...
- Published
- 2016
Catalog
3. Immune Checkpoint Inhibitors for Non-Small-Cell Lung Cancer with Brain Metastasis : The Role of Gamma Knife Radiosurgery.
- Author
-
Min Ho Lee, Kyung-Rae Cho, Jung Won Choi, Doo-Sik Kong, Ho Jun Seol, Do-Hyun Nam, Hyun Ae Jung, Jong-Mu Sun, Se-Hoon Lee, Jin Seok Ahn, Myung-Ju Ahn, Keunchil Park, and Jung-Il Lee
- Subjects
RADIOSURGERY ,NON-small-cell lung carcinoma ,IMMUNE checkpoint inhibitors ,BRAIN metastasis ,METASTASIS ,IPILIMUMAB - Abstract
Objective : Immune checkpoint inhibitors (ICIs) are approved for treating non-small-cell lung cancer (NSCLC); however, the safety and efficacy of combined ICI and Gamma Knife radiosurgery (GKS) treatment remain undefined. In this study, we retrospectively analyzed patients treated with ICIs with or without GKS at our institute to manage patients with brain metastases from NSCLC. Methods : We retrospectively reviewed medical records of patients with brain metastases from NSCLC treated with ICIs between January 2015 and December 2017. Of 134 patients, 77 were assessable for brain responses and categorized into three groups as follows : group A, ICI alone (n=26); group B, ICI with concurrent GKS within 14 days (n=24); and group C, ICI with non-concurrent GKS (n=27). Results : The median follow-up duration after brain metastasis diagnosis was 19.1 months (range, 1--77). At the last follow-up, 53 patients (68.8%) died, 20 were alive, and four were lost to follow-up. The estimated median overall survival (OS) of all patients from the date of brain metastasis diagnosis was 20.0 months (95% confidence interval, 12.5--27.7) (10.0, 22.5, and 42.1 months in groups A, B, and C, respectively). The OS was shorter in group A than in group C (p=0.001). The intracranial disease progression-free survival (p=0.569), local progression-free survival (p=0.457), and complication rates did not significantly differ among the groups. Twelve patients showed leptomeningeal seeding (LMS) during follow-up. The 1-year LMS-free rate in treated with ICI alone group (69.1%) was significantly lower than that in treated with GKS before ICI treatment or within 14 days group (93.2%) (p=0.004). Conclusion : GKS with ICI showed no favorable OS outcome in treating brain metastasis from NSCLC. However, GKS with ICI did not increase the risk of complications. Furthermore, compared with ICI alone, GKS with ICI may be associated with a reduced incidence of LMS. Further understanding of the mechanism, which remains unknown, may help improve the quality of life of patients with brain metastasis. [ABSTRACT FROM AUTHOR] more...
- Published
- 2021
- Full Text
- View/download PDF
4. Gamma Knife Radiosurgery for Brain Metastases from Breast Cancer
- Author
-
Doo Sik Kong, Jung-Il Lee, Do-Hyun Nam, Young-Hyuck Im, Kyung Il Jo, and Ho Jun Seol
- Subjects
Oncology ,Pathology ,medicine.medical_specialty ,medicine.medical_treatment ,Radiosurgery ,Metastasis ,Breast cancer ,Internal medicine ,Medicine ,Intrinsic subtype ,Clinical Article ,business.industry ,Proportional hazards model ,General Neuroscience ,Brain metastasis ,Hazard ratio ,Retrospective cohort study ,Treatment outcomes ,medicine.disease ,Gamma Knife radiosurgery ,Cohort ,Surgery ,Neurology (clinical) ,business - Abstract
Objective The authors conducted a retrospective cohort study to determine prognostic factors and treatment outcomes of brain metastases (BM) from breast cancer (BC) after Gamma Knife radiosurgery (GKS). Methods Pathologic and clinical features, and outcomes were analyzed in a cohort of 62 patients with BM from BC treated by GKS. The Kaplan-Meier method, the log-rank test, and Cox's proportional hazards model were used to assess prognostic factors. Results Median survival after GKS was 73.0 weeks (95% confidence interval, 46.0-100.1). HER2+ [hazard ratio (HR) 0.441; p=0.045], Karnofsky performance scale (KPS) ≥70 (RR 0.416; p=0.050) and systemic chemotherapy after GKS (RR 0.282; p=0.001) were found to be a favorable prognostic factor of overall survival. Actuarial local control (LC) rate were 89.5±4.5% and 70.5±6.9% at 6 and 12 months after GKS, respectively. No prognostic factors were found to affect LC rate. Uni- and multivariate analysis revealed that the distant control (DC) rate was higher in patients with; a small number (≤3) of metastasis (HR 0.300; p=0.045), no known extracranial metastasis (p=0.013, log-rank test), or the HER2+ subtype (HR 0.267; p=0.027). Additional whole brain radiation therapy and metastasis volume were not found to be significantly associated with LC, DC, or overall survival. Conclusion The treatment outcomes of patients with newly diagnosed BM from BC treated with GKS could be affected primarily by intrinsic subtype, KPS, and systemic chemotherapy. Therapeutic strategy and prognosis scoring system should be individualized based on considerations of intrinsic subtype in addition to traditionally known parameters related to stereotactic radiosurgery. more...
- Published
- 2013
5. Treatment Outcomes of Pediatric Craniopharyngioma : A 15-Year Retrospective Review of 35 Cases
- Author
-
Kwang Wook Jo, Ho Jun Seol, Do-Hyun Nam, Doo Sik Kong, Jung Il Lee, and Hyung Jin Shin
- Subjects
Retrospective review ,Pediatrics ,medicine.medical_specialty ,Microsurgery ,Clinical Article ,Radiotherapy ,business.industry ,General Neuroscience ,medicine.medical_treatment ,Treatment outcome ,medicine.disease ,Single Center ,Craniopharyngioma ,Pediatric Craniopharyngioma ,Radiation therapy ,medicine ,Surgery ,Neurology (clinical) ,business - Abstract
Objective The aim of this study was to describe a single center's experience in the management of craniopharyngiomas in children over a 15-year period. Methods The clinical records of pediatric patients treated for craniopharyngiomas between December 1995 and February 2011 were reviewed. Thirty-five pediatric patients diagnosed with craniopharyngioma were treated, and their medical records and imaging data were analyzed retrospectively. Results The mean follow-up duration was 76 months (range, 10-195). Overall survival and local control rates at 10 years were 94.7±5.1% and 37.1±11.9%, respectively. The female-to-male ratio was 16 : 19, and the mean age was 8.6 years (range, 1-17). Initially, gross total resection (GTR) was performed in 30 patients; subtotal resection (STR) followed by radiotherapy was performed in 5 patients. Of the 14 cases that showed recurrence after GTR, 5 patients were treated with GTR, 1 with radiation therapy (RT), 4 with gamma knife radiosurgery (GKRS), and 4 with subtotal resection followed by RT. No patients who underwent RT or GKRS had recurrences. Two cases with recurrence after STR followed by RT were treated with GTR. One patient died of hormonal insufficiency 64 months after the first surgery. The overall median time progression was 51.2 months (range, 3-182) : 49.7 months in the patients who underwent GTR and 60.2 months in the patients who underwent STR followed by RT. Conclusion If safe resection is possible, GTR at the initial treatment should be attempted to reduce the tumor recurrence. However, if the tumor recurs after the first surgery, RT or GKRS with/without reoperation may be an effective salvage treatment for recurrent craniopharyngioma. more...
- Published
- 2012
6. Endoscopic Decompression for Optic Neuropathy in McCune-Albright Syndrome
- Author
-
Doo-Sik Kong, Hyung Jin Shin, Jung-Hoon Noh, and Ho Jun Seol
- Subjects
musculoskeletal diseases ,medicine.medical_specialty ,Case Report ,Fibrous dysplasia ,McCune–Albright syndrome ,Optic neuropathy ,Acromegaly ,medicine ,Endocrine system ,business.industry ,General Neuroscience ,fungi ,McCune-Albright syndrome ,medicine.disease ,Monostotic fibrous dysplasia ,Surgery ,body regions ,Skull ,medicine.anatomical_structure ,lipids (amino acids, peptides, and proteins) ,Neurology (clinical) ,Neurosurgery ,business - Abstract
McCune-Albright syndrome (MAS) is characterized by a triad of poly/monostotic fibrous dysplasia, cafe-au-lait macules and hyperfunctioning endocrinopathies including human growth hormone excess. Acromegaly as a manifestation of endocrine hyperfunction with MAS is uncommon. Surgical excision may be challenging due to the associated severe fibrous dysplasia of the skull base. Through the endoscopic procedures, we treated a case of MAS presenting with compressive optic neuropathy due to fibrous dysplasia and acromegaly caused by growth hormone secreting pituitary adenoma. We reviewed the literature on GH excess in MAS to highlight its surgical and medical challenges. more...
- Published
- 2014
7. Leukoencephalopathy and disseminated necrotizing leukoencephalopathy following intrathecal methotrexate chemotherapy and radiation therapy for central nerve system lymphoma or leukemia
- Author
-
Sung Tae Kim, Do-Hyun Nam, Kwan Park, Ji-Yeon Kim, Doo-Sik Kong, and Jung-Il Lee
- Subjects
Chemotherapy ,Pathology ,medicine.medical_specialty ,Clinical Article ,business.industry ,General Neuroscience ,medicine.medical_treatment ,Central nervous system ,Intrathecal methotrexate ,medicine.disease ,Lymphoma ,Radiation therapy ,Leukoencephalopathy ,Leukemia ,medicine.anatomical_structure ,immune system diseases ,hemic and lymphatic diseases ,medicine ,Surgery ,Methotrexate ,Neurology (clinical) ,business ,medicine.drug - Abstract
Intrathecal methotrexate (MTX) therapy combined with whole brain radiotherapy (WBRT) is one of the major treatment modalities for leukemia and lymphoma involving the central nervous system (CNS). The purpose of this study was to retrospectively determine the incidences of leukoencephalopathy and disseminated necrotizing leukoencephalopathy (DNL) following intrathecal MTX therapy for CNS lymphoma or leukemia and to assess the potential risk factors.Between January 2000 and August 2009, 143 patients with CNS lymphoma or leukemia received intrathecal MTX therapy alone or in combination with WBRT at a single institution. Patients were followed up clinically and radiologically at regular two- or three-month intervals. Medical records were reviewed to obtain information regarding the patients' demographics, medical histories, radiologic characteristics, treatments, and clinical courses.On follow-up MR images, leukoencephalopathy was found in 95 of 143 patients (66.4%). The median time to develop leukoencephalopathy was 6.6 months. Among those with leukoencephalopathy, four patients showed seven extensive white-matter changes with strongly enhancing lesions demonstrating DNL. Histological confirmation was done in six lesions of three patients and radiological diagnosis alone in one patient. Four lesions spontaneously disappeared on MR images without any treatment, with a mean duration of 14 months before disappearance of DNL.Leukoencephalopathy is a common phenomenon that occurs following intrathecal MTX therapy; however, DNL occurs at a very low incidence. For newly developed enhancing lesions, consideration for the occurrence of DNL should be taken to avoid unnecessary invasive procedures or therapies. more...
- Published
- 2010
8. Prognostic factors of hemifacial spasm after microvascular decompression
- Author
-
Kwan Park, Doo-Sik Kong, Hong Rae Kim, and Deok-Joo Rhee
- Subjects
medicine.medical_specialty ,Multivariate analysis ,Clinical Article ,business.industry ,medicine.medical_treatment ,Microvascular decompression ,Logistic regression ,medicine.disease ,Predictive value ,Surgery ,body regions ,Symptom relief ,medicine ,In patient ,Prospective cohort study ,business ,Hemifacial spasm - Abstract
Objective : The factors that influence the prognosis of patients with hemifacial spasm (HFS) treated by microvascular decompression (MVD) have not been definitely established. We report a prospective study evaluating the prognostic factors in patients undergoing MVD for HFS. Methods : From January 2004 to September 2006, the authors prospectively studied a series of 293 patients who underwent MVD for HFS. We prospectively analyzed a number of variables in order to evaluate the predictive value of independent variables for the prognosis of patients undergoing MVD. The patients were followed-up at regular intervals and divided into as cured and unsatisfactory groups based on symptom relief. Uni- and multivariate analyses were performed using logistic regression models. Results : A total 273 of 293 (94.2%) patients achieved symptom relief within one year after the operation. Intraoperatively, the indentation of the root exit zone was observed in 259 (88.5%) patients. Uni- and multivariate analyses revealed that the symptoms at postoperative 3 months (p more...
- Published
- 2009
9. Hemifacial spasm: a neurosurgical perspective
- Author
-
Kwan Park and Doo Sik Kong
- Subjects
medicine.medical_specialty ,integumentary system ,business.industry ,Craniofacial abnormality ,General Neuroscience ,medicine.medical_treatment ,Blepharospasm ,Microvascular decompression ,Review Article ,medicine.disease ,Facial nerve ,Surgery ,body regions ,stomatognathic diseases ,medicine ,Neurology (clinical) ,Myokymia ,Neurosurgery ,medicine.symptom ,business ,Facial electromyography ,Hemifacial spasm - Abstract
Hemifacial spasm (HFS) is characterized by tonic clonic contractions of the muscles innervated by the ipsilateral facial nerve. Compression of the facial nerve by an ectatic vessel is widely recognized as the most common underlying etiology. HFS needs to be differentiated from other causes of facial spasms, such as facial tic, ocular myokymia, and blepharospasm. To understand the overall craniofacial abnormalities and to perform the optimal surgical procedures for HFS, we are to review the prevalence, pathophysiology, differential diagnosis, details of each treatment modality, usefulness of brainstem auditory evoked potentials monitoring, debates on the facial EMG, clinical course, and complications from the literature published from 1995 to the present time. more...
- Published
- 2007
10. Clinical Features and Treatment Outcome of Chordoid Meningiomas in a Single Institute
- Author
-
Ho Jun Seol, Kyung-Il Jo, Hyung Jin Shin, Tae Keun Jee, Jung-Il Lee, and Doo-Sik Kong
- Subjects
Adjuvant radiotherapy ,Pathology ,medicine.medical_specialty ,Clinical Article ,Adjuvant radiation therapy ,business.industry ,General Neuroscience ,Medical record ,Treatment outcome ,medicine.disease ,Chordoid meningioma ,Resection ,Surgery ,Meningioma ,Radiological weapon ,MIB-1 labeling index ,Medicine ,Neurology (clinical) ,business ,Pathological - Abstract
Objective Meningioma is the second most common primary central nervous system neoplasm. In contrast, chordoid meningioma is rare; due to the paucity of cases, little is known about its clinical features or treatment outcomes. The objectives of this study were to describe the clinical characteristics and outcomes for patients with chordoid meningioma. Methods In total, 16 patients, with newly diagnosed chordoid meningioma who underwent surgical excision between 1999 and 2012 were included. We retrospectively evaluated the medical records, radiological findings, and pathological findings. The median follow-up period was 56.5 (range, 3-170) months. The MIB-1 labeling index ranged from 1 to 26.60% (median, 5.04). Results Simpson grade I, II, and III resections were performed in four, nine, and three patients, respectively. The overall recurrence rate was 37.5%. Overall progression-free survival (PFS) after resection was 94.7 months (95% CI=62.9-126.6). Of the 4 patients with Simpson grade I resection, recurrence occurred in one patient. Among the Simpson grade II and III resection groups, eight patients underwent adjuvant radiation therapy and they showed significantly longer PFS (121 months, 95% CI=82.1-159.9) than the patients who underwent surgery alone (40.5 months, 95% CI=9.6-71.3) by the log-rank test (p more...
- Published
- 2014
- Full Text
- View/download PDF
11. The Influence of Biomarker Mutations and Systemic Treatment on Cerebral Metastases from NSCLC Treated with Radiosurgery.
- Author
-
Min Ho Lee, Doo-Sik Kong, Ho Jun Seol, Do-Hyun Nam, and Jung-Il Lee
- Subjects
- *
BRAIN metastasis , *TUMOR markers , *GENETIC mutation , *LUNG cancer complications , *EPIDERMAL growth factor receptors , *PROGNOSIS - Abstract
Objective : The purpose of this study was to analyze outcomes and identify prognostic factors in patients with cerebral metastases from non-small cell lung cancer (NSCLC) treated with gamma knife radiosurgery (GKS) particularly, focusing on associations of biomarkers and systemic treatments. Methods : We retrospectively reviewed the medical records of 134 patients who underwent GKS for brain metastases due to NSCLC between January 2002 and December 2012. Representative biomarkers including epidermal growth factor receptor (EGFR) mutation, K-ras mutation, and anaplastic lymphoma kinase (ALK) mutation status were investigated. Results : The median overall survival after GKS was 22.0 months (95% confidence interval [CI], 8.8-35.1 months). During follow-up, 63 patients underwent salvage treatment after GKS. The median salvage treatment-free survival was 7.9 months (95% CI, 5.2-10.6 months). Multivariate analysis revealed that lower recursive partition analysis (RPA) class, small number of brain lesions, EGFR mutation (+), and ALK mutation (+) were independent positive prognostic factors associated with longer overall survival. Patients who received target agents 30 days after GKS experienced significant improvements in overall survival and salvage treatment-free survival than patients who never received target agents and patients who received target agents before GKS or within 30 days (median overall survival: 5.0 months vs. 18.2 months, and 48.0 months with p -value=0.026; median salvage treatment-free survival: 4.3 months vs. 6.1 months and 16.6 months with p -value=0.006, respectively). To assess the influence of target agents on the pattern of progression, cases that showed local recurrence and new lesion formation were analyzed according to target agents, but no significant effects were identified. Conclusion : The prognosis of patients with brain metastases of NSCLC after GKS significantly differed according to specific biomarkers (EGFR and ALK mutations). Our results show that target agents combined with GKS was related to significantly longer overall survival, and salvage treatment-free survival. However, target agents were not specifically associated with improved local control of the lesion treated by GKS either development of new lesions. Therefore, it seems that currently popular target agents do not affect brain lesions themselves, and can prolong survival by controlling systemic disease status. [ABSTRACT FROM AUTHOR] more...
- Published
- 2017
- Full Text
- View/download PDF
12. Endoscopic Third Ventriculostomy in Patients with Shunt Malfunction
- Author
-
Ho Joon Seol, Hyung Jin Shin, Seunghoon Lee, and Doo Sik Kong
- Subjects
medicine.medical_specialty ,Clinical Article ,business.industry ,Shunt malfunction ,Endoscopic third ventriculostomy ,Retrospective cohort study ,Hardware_PERFORMANCEANDRELIABILITY ,medicine.disease ,Hydrocephalus ,Surgery ,medicine ,In patient ,Neurosurgery ,business - Abstract
This paper presents data from a retrospective study of endoscopic third ventriculostomy (ETV) in patients with shunt malfunction and proposes a simple and reasonable post-operative protocol that can detect ETV failure.We enrolled 19 consecutive hydrocephalus patients (11 male and 8 female) who were treated with ETV between April 2001 and July 2010 after failure of previously placed shunts. We evaluated for correlations between the success rate of ETV and the following parameters : age at the time of surgery, etiology of hydrocephalus, number of shunt revisions, interval between the initial diagnosis of hydrocephalus or the last shunt placement and ETV, and the indwelling time of external ventricular drainage.At the time of ETV after shunt failure, 14 of the 19 patients were in the pediatric age group and 5 were adults, with ages ranging from 14 months to 42 years (median age, 12 years). The patients had initially been diagnosed with hydrocephalus between the ages of 1 month 24 days and 32 years (median age, 6 years 3 months). The etiology of hydrocephalus was neoplasm in 7 patients; infection in 5; malformation, such as aqueductal stenosis or megacisterna magna in 3; trauma in 1; and unknown in 3. The overall success rate during the median follow-up duration of 1.4 years (9 days to 8.7 years) after secondary ETV was 68.4%. None of the possible contributing factors for successful ETV, including age (p=0.97) and the etiology of hydrocephalus (p=0.79), were statistically correlated with outcomes in our series.The use of ETV in patients with shunt malfunction resulted in shunt independence in 68.4% of cases. Age, etiology of hydrocephalus, and other contributing factors were not statistically correlated with ETV success. External ventricular drainage management during the immediate post-ETV period is a good means of detecting ETV failure. more...
- Published
- 2011
- Full Text
- View/download PDF
13. Concurrent Nocardia Related Brain Abscess and Semi-Invasive Pulmonary Aspergillosis in an Immunocompetent Patient
- Author
-
Mi Kyong Joung, Jae-Hoon Song, Doo-Sik Kong, and Kyong Ran Peck
- Subjects
medicine.medical_specialty ,biology ,business.industry ,Case Report ,Nocardia ,Invasive pulmonary aspergillosis ,bacterial infections and mycoses ,biology.organism_classification ,medicine.disease ,Surgery ,Pulmonary aspergillosis ,Medicine ,business ,Brain abscess - Abstract
We describe here the first case of a concurrent brain abscess caused by Norcardia spp. and semi-invasive pulmonary aspergillosis in an immunocompetent patient. After one year of appropriate antimicrobial therapy and surgical drainage of the brain abscess, the nocardia brain abscess and pulmonary aspergillosis have resolved. more...
- Published
- 2011
- Full Text
- View/download PDF
14. Clinical Efficacy of Radiation-Sterilized Allografts for Sellar Reconstruction after Transsphenoidal Surgery
- Author
-
Sejin Kim, Doo-Sik Kong, Kwan Park, Jong Hyun Kim, and Chiman Jeon
- Subjects
Transsphenoidal surgery ,medicine.medical_specialty ,Clinical Article ,business.industry ,General Neuroscience ,medicine.medical_treatment ,Surgery ,Skull ,Cerebrospinal fluid ,medicine.anatomical_structure ,Fascia lata ,Cadaver ,Tissue bank ,medicine ,Neurology (clinical) ,Clinical efficacy ,business ,Csf diversion - Abstract
Objective The aim of this study was to assess the safety and efficacy of radiation-sterilized allografts of iliac bone and fascia lata from cadaver specimens to repair skull base defects after transsphenoidal surgery. Methods Between May 2009 and January 2010, 31 consecutive patients underwent endonasal transsphenoidal surgery and all patients received sellar reconstruction using allografts following tumor removal. The allografts were obtained from the local tissue bank and harvested from cadaver donors. The specimens used in our approach were tensor fascia lata and the flat area of iliac bone. For preparation, allografts were treated with gamma irradiation after routine screening by culture, and then stored at -70℃. Results The mean follow-up period after surgery was 12.6 months (range, 7.4-16 months). Overall, postoperative cerebrospinal fluid (CSF) leaks occurred in three patients (9.7%) and postoperative meningitis in one patient (3.2%). There was no definitive evidence of wound infection at the routine postoperative follow-up examination or during re-do surgery in three patients. Postoperative meningitis in one patient was improved with the use of antibiotics and prolonged CSF diversion. Conclusion We suggest that allograft materials can be a feasible alternative to autologous tissue grafts for sellar reconstruction following transsphenoidal surgery under selected circumstances such as no or little intraoperative CSF leaks. more...
- Published
- 2011
- Full Text
- View/download PDF
15. The Role of Radiosurgery in Patients with Brain Metastasis from Small Cell Lung Carcinoma
- Author
-
Doo Sik Kong, Do Hoon Lim, Jung Il Lee, Yong Chan Ahn, Do-Hyun Nam, and Kwang Wook Jo
- Subjects
medicine.medical_specialty ,Pathology ,Clinical Article ,business.industry ,Medical record ,medicine.medical_treatment ,Retrospective cohort study ,medicine.disease ,Primary tumor ,Radiosurgery ,Metastasis ,Conventional PCI ,Medicine ,Radiology ,Prophylactic cranial irradiation ,business ,Brain metastasis - Abstract
OBJECTIVE The purpose of this retrospective study was to evaluate the outcome of gamma knife radiosurgery (GKRS) and/or whole brain radiation therapy (WBRT) for the treatment of small cell lung carcinoma (SCLC) metastasis to the brain. METHODS From 2000 to 2010, 50 patients underwent GKRS for metastatic brain lesions originating from SCLC. Among these patients, 11 received prophylactic cranial irradiation (PCI) before the development of metastatic lesions (PCI group), and GKRS was performed as an initial treatment for newly diagnosed lesions in 12 patients who had not received PCI (primary GKRS group). In addition, GKRS was performed as a salvage treatment for progressive lesions after WBRT in 27 patients (salvage GKRS group). The medical records and imaging data of all patients were retrospectively analyzed. RESULTS The overall survival of the 50 patients was 20.8 months (range 1-53) after the diagnosis of primary tumor and 12.0 months (range 1-47) after the development of cerebral metastasis. Median survival after GKRS was 4.8 months (range 1-15) in the PCI group, 4.6 months (range 0-18) in the primary GKRS group, and 7.6 months (range 0-33) in the salvage GKRS group. Further treatment for progressive lesions after GKRS was necessary in 15 patients, after a mean interval of 3.8 months. Causes of death were systemic organ failure in 15 patients, deterioration of neurological state in 13 patients, and unknown or combined causes in 16 patients. The local control rate of the lesions treated with GKRS was 76.4% (decreased in 13 patients and stable in 16 patients at the final imaging follow-up (mean 5.60 months). CONCLUSION GKRS is an effective local treatment for brain metastasis from SCLC both as an initial treatment for newly diagnosed lesions after PCI and as a salvage treatment for recurrent or progressive lesions. However, the survival benefit is not significant because most patients die of systemic multi-organ failure with a short life expectancy. more...
- Published
- 2011
- Full Text
- View/download PDF
16. The Efficacy and Safety of Microvascular Decompression for Hemifacial Spasm in Elderly Patients
- Author
-
Doo Sik Kong, Kwan Park, Jeong-A Lee, and Chul Jin Jeon
- Subjects
medicine.medical_specialty ,Cure rate ,Clinical Article ,Palsy ,integumentary system ,business.industry ,Hearing loss ,medicine.medical_treatment ,Operative mortality ,Microvascular decompression ,medicine.disease ,humanities ,Surgery ,medicine ,medicine.symptom ,Complication ,business ,Cranial nerve dysfunction ,Hemifacial spasm - Abstract
The purpose of this study was to examine the efficacy and safety of microvascular decompression (MVD) for hemifacial spasm (HFS) in elderly patients.Between 1997 and June 2008, 1,174 patients had undergone MVD for HFS at our institute. Among these, 53 patients were older than 65 years. We retrospectively reviewed and compared the complication and the cure rates of these patients with those of younger patients.There were 38 females and 15 males. The mean duration of symptoms of HFS of these patients was 94.6 months (range, 12-360 months), compared with 67.2 months (range, 3-360 months) in the younger group. The overall cure rate in elderly patients who underwent MVD for HFS during this period was 96.2%. Permanent cranial nerve dysfunctions, such as hearing loss and facial palsy, were seen in 2 patients (3.8%, 2/53) in the elderly group and 19 patients (1.7%, 19/1121) in the younger group. The difference in permanent cranial nerve dysfunction between the two groups was not statistically significant. There was no operative mortality in either group.Microvascular decompression is the most effective surgical modality available for the treatment of HFS. Results of this study indicate that such technique can be performed in the elderly without higher rates of morbidity or mortality. Any patient with HFS, whose general health is acceptable for undergoing general anesthesia, should be considered as a candidate for MVD. more...
- Published
- 2010
- Full Text
- View/download PDF
17. Transventricular Biopsy of Brain Tumor without Hydrocephalus Using Neuroendoscopy with Navigation
- Author
-
Ji Hye Song, Ho Jun Seol, Doo-Sik Kong, and Hyung Jin Shin
- Subjects
medicine.medical_specialty ,Clinical Article ,Third ventricle ,medicine.diagnostic_test ,business.industry ,Dysembryoplastic Neuroepithelial Tumor ,Pineocytoma ,Brain tumor ,medicine.disease ,Endoscopic Procedure ,Hydrocephalus ,Surgery ,medicine.anatomical_structure ,Biopsy ,medicine ,business ,Ventriculomegaly - Abstract
Objective : It is usually difficult to perform the neuroendoscopic procedure in patients without hydrocephalus due to difficulties with ventricular cannulation. The purpose of this study was to find out the value of navigation guided neuroendoscopic biopsy in patients with peri- or intraventricular tumors without hydrocephalus. Methods : Six patients with brain tumors without hydrocephalus underwent navigation-guided neuroendoscopic biopsy. The procedure was indicated for verification of the histological diagnosis of the neoplasm, which was planned to be treated by chemotherapy and/or radiotherapy as the first line treatment, or establishment of the pathological diagnosis for further choice of the most appropriate treatment strategy. Results : Under the guidance of navigation, targeted lesion was successfully approached in all patients. Navigational tracking was especially helpful in entering small ventricles and in approaching the third ventricle through narrow foramen Monro. The histopathologic diagnosis was established in all of 6 patients : 2 germinomas, 2 astrocytomas, 1 dysembryoplastic neuroepithelial tumor and 1 pineocytoma. The tumor biopsy sites were pineal gland (n = 2), suprasellar area (n = 2), subcallosal area (n = 1) and thalamus (n = 1). There were no operative complications related to the endoscopic procedure. Conclusion : Endoscopic biopsy or resection of peri- or intraventricular tumors in patients without hydrocephalus is feasible. Image-guided neuroendoscopic procedure improved the accuracy of the endoscopic approach and minimized brain trauma. The absence of ventriculomegaly in patients with brain tumor may not be served as a contraindication to endoscopic tumor biopsy. more...
- Published
- 2010
- Full Text
- View/download PDF
18. Combined Hyperactive Dysfunction Syndrome of the Cranial Nerves
- Author
-
Doo-Sik Kong, Kwan Park, Kyung-Hoon Yang, and Joon-Ho Na
- Subjects
medicine.medical_specialty ,Clinical Article ,business.industry ,Cranial nerves ,Mean age ,medicine.disease ,Gastroenterology ,Glossopharyngeal neuralgia ,Surgery ,Trigeminal neuralgia ,Internal medicine ,medicine ,Etiology ,business ,Hemifacial spasm - Abstract
Objective : Combined hyperative dysfunction syndrome (HDS) defined as the combination of HDSs such as trigeminal neuralgia (TN), hemifacial spasm (HFS) and glossopharyngeal neuralgia (GPN), which may or may not occur simultaneously on one or both sides. We reviewed patients with combined HDS and demonstrated their demographic characteristics by comparing them with those of patients with a single HDS. Methods : Between October 1994 and February 2006, we retrospectively studied a series of 1,720 patients who suffered from HDS and found 51 patients with combined HDSs. We analyzed several independent variables in order to evaluate the prevalence and etiologic factors of combined HDS. Results : The combined HDS group accounted for 51 of 1,720 (2.97%) patients with HDS; 27 cases of bilateral HFS, 10 cases of bilateral TN and 14 cases of HFS with TN. Their mean age was 52.1 years (range, 26-79 years). There were 5 men and 46 women. Seven patients had synchronous and 44 patients metachronous onset of HDSs. By comparison of combined and single HDS groups, we found that age and hypertension were closely associated with the prevalence of combined HDS (p < 0.05). Conclusion : This study revealed that combined HDS was very rare. Hypertension and age might be the most important causative factors to evoke combined HDS. more...
- Published
- 2009
- Full Text
- View/download PDF
19. Clinical Features and Treatment Outcome of Chordoid Meningiomas in a Single Institute.
- Author
-
Tae Keun Jee, Kyung-Il Jo, Ho Jun Seol, Doo-Sik Kong, Jung-Il Lee, and Hyung Jin Shin
- Subjects
MENINGIOMA ,ADJUVANT treatment of cancer ,CANCER radiotherapy ,PROGRESSION-free survival ,CANCER relapse ,ONCOLOGIC surgery ,THERAPEUTICS - Abstract
Objective : Meningioma is the second most common primary central nervous system neoplasm. In contrast, chordoid meningioma is rare; due to the paucity of cases, little is known about its clinical features or treatment outcomes. The objectives of this study were to describe the clinical characteristics and outcomes for patients with chordoid meningioma. Methods : In total, 16 patients, with newly diagnosed chordoid meningioma who underwent surgical excision between 1999 and 2012 were included. We retrospectively evaluated the medical records, radiological findings, and pathological findings. The median follow-up period was 56.5 (range, 3- 170) months. The MIB-1 labeling index ranged from 1 to 26.60% (median, 5.04). Results : Simpson grade I, II, and III resections were performed in four, nine, and three patients, respectively. The overall recurrence rate was 37.5%. Overall progression-free survival (PFS) after resection was 94.7 months (95% CI=62.9-126.6). Of the 4 patients with Simpson grade I resection, recurrence occurred in one patient. Among the Simpson grade II and III resection groups, eight patients underwent adjuvant radiation therapy and they showed significantly longer PFS (121 months, 95% CI=82.1-159.9) than the patients who underwent surgery alone (40.5 months, 95% CI=9.6- 71.3) by the log-rank test (p<0.05). Conclusion : Chordoid meningiomas are difficult to manage and have a high rate of recurrence. Complete resection of the tumor is a key determinant of better outcomes. Adjuvant radiation therapy is recommended, eparticulary when Simpson grade I resection was not achieved. [ABSTRACT FROM AUTHOR] more...
- Published
- 2014
- Full Text
- View/download PDF
20. Gamma Knife Radiosurgery for Brain Metastases from Breast Cancer.
- Author
-
Kyung Il Jo, Young-Hyuck Im, Doo Sik Kong, Ho Jun Seol, Do-Hyun Nam, and Jung-Il Lee
- Subjects
RADIOSURGERY ,BRAIN metastasis ,BREAST cancer ,KAPLAN-Meier estimator ,CANCER chemotherapy ,MULTIVARIATE analysis - Abstract
Objective : The authors conducted a retrospective cohort study to determine prognostic factors and treatment outcomes of brain metastases (BM) from breast cancer (BC) after Gamma Knife radiosurgery (GKS). Methods : Pathologic and clinical features, and outcomes were analyzed in a cohort of 62 patients with BM from BC treated by GKS. The Kaplan- Meier method, the log-rank test, and Cox's proportional hazards model were used to assess prognostic factors. Results : Median survival after GKS was 73.0 weeks (95% confidence interval, 46.0-100.1). HER2+ [hazard ratio (HR) 0.441; p=0.045], Karnofsky performance scale (KPS) =70 (RR 0.416; p=0.050) and systemic chemotherapy after GKS (RR 0.282; p=0.001) were found to be a favorable prognostic factor of overall survival. Actuarial local control (LC) rate were 89.5±4.5% and 70.5±6.9% at 6 and 12 months after GKS, respectively. No prognostic factors were found to affect LC rate. Uni- and multivariate analysis revealed that the distant control (DC) rate was higher in patients with; a small number (=3) of metastasis (HR 0.300; p=0.045), no known extracranial metastasis (p=0.013, log-rank test), or the HER2+ subtype (HR 0.267; p=0.027). Additional whole brain radiation therapy and metastasis volume were not found to be significantly associated with LC, DC, or overall survival. Conclusion : The treatment outcomes of patients with newly diagnosed BM from BC treated with GKS could be affected primarily by intrinsic subtype, KPS, and systemic chemotherapy. Therapeutic strategy and prognosis scoring system should be individualized based on considerations of intrinsic subtype in addition to traditionally known parameters related to stereotactic radiosurgery. [ABSTRACT FROM AUTHOR] more...
- Published
- 2013
- Full Text
- View/download PDF
21. Endoscopic Decompression for Optic Neuropathy in McCune-Albright Syndrome.
- Author
-
Jung-Hoon Noh, Doo-Sik Kong, Ho Jun Seol, and Hyung Jin Shin
- Subjects
- *
NEUROPATHY , *ENDOSCOPIC surgery , *SURGICAL decompression , *FIBROUS dysplasia of bone , *SOMATOTROPIN , *ACROMEGALY , *GROWTH hormone-secreting pituitary adenoma , *THERAPEUTICS - Abstract
McCune-Albright syndrome (MAS) is characterized by a triad of poly/monostotic fibrous dysplasia, café-au-lait macules and hyperfunctioning endocrinopathies including human growth hormone excess. Acromegaly as a manifestation of endocrine hyperfunction with MAS is uncommon. Surgical excision may be challenging due to the associated severe fibrous dysplasia of the skull base. Through the endoscopic procedures, we treated a case of MAS presenting with compressive optic neuropathy due to fibrous dysplasia and acromegaly caused by growth hormone secreting pituitary adenoma. We reviewed the literature on GH excess in MAS to highlight its surgical and medical challenges. [ABSTRACT FROM AUTHOR] more...
- Published
- 2014
- Full Text
- View/download PDF
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.