1.MRI findings of cryptococcal infection of CNS: The long term follow-up: case report.
Min Yun CHOI ; Chang Hyo SOL ; Chun Phil JUNG ; Byung Soo KIM ; Beung Ho PARK
Journal of the Korean Radiological Society 1993;29(4):693-697
Authors presented the serial changes of brain MRI findings in two cases of cryptococcal meningitis. The MRI findings of the first patient (53-year-old female) consisted of dilated Virchow-Robin spaces, leptomeningeal enhancement, cryptococcomas and hydrocephalus. Dilated Virchow-Robin spaces were noted on the first MR obtained 33 days after symptom onset. The size and number of dilated Virchow-Robin space gradually decreased since 119 days after symptom onset (62 days after treatment). Faint leptomeningeal enhancement was found at cerebellar region on the first MRI, which became more distinct and intense on the day 119, probably due to improper treatment. The leptomeningeal enhancement decreased on the day 156. Mild hydrocephalus was noted on MRI obtained 70 days after symptom onset, which markedly aggravated on the day 119. It decreased after steroid therapy alone. Enhancing crytococcomas of variable size were noted at the right temporal lobe and cerebellum on MRI of the day 119, which decreased in size and number on the day 156. On the day 295 MRI showed nearly disppearance of the dilated Virchow-Robin space, but faint leptomeningeal enhancement, cerebellar crytococcomas and hydrocephalus still remained. The MRI findings of the second patient (36-year-old female) showed the findings similar to those of the first patient. Initial MRI obtained 18 days after symptom onset showed no abnormal findings. Dilated Virchow-robin spaces were noted on the day 36 (13 days after treatment onset), which nearly disappeared on the day 109. Enhancing cryptococcomas in both basal ganglia and cerebral cortex and leptomeningeal enhancement were noted on MRI of the day 136. Both cryptococcomas and leptomeningeal enhancement decreased in size and enhancing degree on the day 157. Hydrocephalus was noted on the day 109.
Basal Ganglia
;
Brain
;
Cerebellum
;
Cerebral Cortex
;
Follow-Up Studies*
;
Humans
;
Hydrocephalus
;
Magnetic Resonance Imaging*
;
Meningitis, Cryptococcal
;
Temporal Lobe
2.MRI findings of cryptococcal infection of CNS: The long term follow-up: case report.
Min Yun CHOI ; Chang Hyo SOL ; Chun Phil JUNG ; Byung Soo KIM ; Beung Ho PARK
Journal of the Korean Radiological Society 1993;29(4):693-697
Authors presented the serial changes of brain MRI findings in two cases of cryptococcal meningitis. The MRI findings of the first patient (53-year-old female) consisted of dilated Virchow-Robin spaces, leptomeningeal enhancement, cryptococcomas and hydrocephalus. Dilated Virchow-Robin spaces were noted on the first MR obtained 33 days after symptom onset. The size and number of dilated Virchow-Robin space gradually decreased since 119 days after symptom onset (62 days after treatment). Faint leptomeningeal enhancement was found at cerebellar region on the first MRI, which became more distinct and intense on the day 119, probably due to improper treatment. The leptomeningeal enhancement decreased on the day 156. Mild hydrocephalus was noted on MRI obtained 70 days after symptom onset, which markedly aggravated on the day 119. It decreased after steroid therapy alone. Enhancing crytococcomas of variable size were noted at the right temporal lobe and cerebellum on MRI of the day 119, which decreased in size and number on the day 156. On the day 295 MRI showed nearly disppearance of the dilated Virchow-Robin space, but faint leptomeningeal enhancement, cerebellar crytococcomas and hydrocephalus still remained. The MRI findings of the second patient (36-year-old female) showed the findings similar to those of the first patient. Initial MRI obtained 18 days after symptom onset showed no abnormal findings. Dilated Virchow-robin spaces were noted on the day 36 (13 days after treatment onset), which nearly disappeared on the day 109. Enhancing cryptococcomas in both basal ganglia and cerebral cortex and leptomeningeal enhancement were noted on MRI of the day 136. Both cryptococcomas and leptomeningeal enhancement decreased in size and enhancing degree on the day 157. Hydrocephalus was noted on the day 109.
Basal Ganglia
;
Brain
;
Cerebellum
;
Cerebral Cortex
;
Follow-Up Studies*
;
Humans
;
Hydrocephalus
;
Magnetic Resonance Imaging*
;
Meningitis, Cryptococcal
;
Temporal Lobe
3.A Case of Adenoma of Nonpigmented Ciliary Epithelium.
Beung Sup PARK ; Saeng Ho LEE ; Baek Ran SONG ; Joong Ha YOO
Journal of the Korean Ophthalmological Society 1998;39(3):604-607
Acquired tumors of the nonpigmented ciliary epithelium are rare diseases. They are difficult to diagnose and present as pseudoadenomatous hyperplasia, adenoma or adenocarcinoma. They exhibit slowly progressive enlargement leading to a subluxated lens, cataract, and secondary glaucoma. And some of the more malignant tumors may extend extrasclerally. We report a case of adenoma of nonpigmented ciliary epithelium which produced a cataract.
Adenocarcinoma
;
Adenoma*
;
Cataract
;
Epithelium*
;
Glaucoma
;
Hyperplasia
;
Rare Diseases
4.Epileptic Nystagmus Associated with Occipital Lobe Epilepsy.
Beung Soo KEE ; Yeung Ju BYUN ; Gun Ju PARK ; Sang Dug SUH ; Seung Miin KIM ; Min Jeung KIM ; Ihn Ho CHO
Journal of the Korean Neurological Association 1995;13(2):378-382
Epileptic seizures of nystagmoid character with the fast -beat to the opposite side of the epileptogenic focus have been described as oculoclonic seizures and epileptic nystagmus. Epileptic nystagmus, especially horizontal, most commonly results from seizure activity involving the occipital cortex, although participation of adjoining portions of the parietal and temporal cortex is possible. The frequency of ictal nystagmus was less than 10% of patients with occipital lobe epilepsy. Although forty-six cases were already reported at the litherature, there was no report in korea. We reported a 20-year old patient who had history of recurrent paroxysmal attacks of epileptic nystagniu, associated with oscillopsia and followed by episodic bilateral blindness and eyelid flutter. Standard and extra occipital electrodes visualized more exact left occipital foci at the videomonitored EEG examination when the patient showed epileptic nystagmus. The ictal Brain SPECT, with the use of 99mTc-HMPAO also localized the seizures to left occipital lobe.
Blindness
;
Brain
;
Electrodes
;
Electroencephalography
;
Epilepsies, Partial*
;
Epilepsy
;
Eyelids
;
Humans
;
Korea
;
Occipital Lobe*
;
Rabeprazole
;
Seizures
;
Technetium Tc 99m Exametazime
;
Tomography, Emission-Computed, Single-Photon
;
Young Adult
5.Tumor Microenvironment Modulation by Neoadjuvant Erlotinib Therapy and Its Clinical Impact on Operable EGFR-Mutant Non–Small Cell Lung Cancer
Beung-Chul AHN ; Charny PARK ; Moon Soo KIM ; Jong Mog LEE ; Jin Ho CHOI ; Hyae Young KIM ; Geon Kook LEE ; Namhee YU ; Youngjoo LEE ; Ji-Youn HAN
Cancer Research and Treatment 2024;56(1):70-80
Purpose:
Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors have greatly improved survival in EGFR-mutant (EGFRm) non–small cell lung cancer (NSCLC); however, their effects on the tumor microenvironment (TME) are unknown. We assessed the changes induced by neoadjuvant erlotinib therapy (NE) in the TME of operable EGFRm NSCLC.
Materials and Methods:
This was a single-arm phase II trial for neoadjuvant/adjuvant erlotinib therapy in patients with stage II/IIIA EGFRm NSCLC (EGFR exon 19 deletion or L858R mutations). Patients received up to 2 cycles of NE (150 mg/day) for 4 weeks, followed by surgery and adjuvant erlotinib or vinorelbine plus cisplatin therapy depending on observed NE response. TME changes were assessed based on gene expression analysis and mutation profiling.
Results:
A total of 26 patients were enrolled; the median age was 61, 69% were female, 88% were stage IIIA, and 62% had L858R mutation. Among 25 patients who received NE, the objective response rate was 72% (95% confidence interval [CI], 52.4 to 85.7). The median disease-free and overall survival (OS) were 17.9 (95% CI, 10.5 to 25.4) and 84.7 months (95% CI, 49.7 to 119.8), respectively. Gene set enrichment analysis in resected tissues revealed upregulation of interleukin, complement, cytokine, transforming growth factor β, and hedgehog pathways. Patients with upregulated pathogen defense, interleukins, and T-cell function pathways at baseline exhibited partial response to NE and longer OS. Patients with upregulated cell cycle pathways at baseline exhibited stable/progressive disease after NE and shorter OS.
Conclusion
NE modulated the TME in EGFRm NSCLC. Upregulation of immune-related pathways was associated with better outcomes.