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분류 전체보기

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희소돌기아교세포종 (Oligodendroglioma) 개요 희소돌기아교세포종은 뇌에서 발생하는 종양 중 하나로, 주로 백질에서 발견되는 희소돌기아교세포에서 유래합니다. 이 세포들은 신경 수초(myelin)를 생산하고 유지하는 역할을 합니다. 이 종양은 교모세포종과 역형성 별 아교세포종에 이어 세 번째로 흔한 신경교종입니다.  분류 및 진단2016년 WHO 분류에 따르면, 희소돌기아교세포종의 진단은 분자생물학적 검사를 통해 이루어집니다. IDH1 또는 IDH2 변이와 1p/19q 동반결손이 있는 경우에만 희소돌기아교세포종으로 진단됩니다. 조직학적 분류는 상대적으로 성장속도가 느린 WHO 2등급 희소돌기아교세포종과 더 악성이고 빠르게 성장하는 WHO 3등급 역형성 희소돌기아교세포종(anaplastic oligodendroglioma)으로 나뉩니다.   유전학적 특성..
교종의 분류 및 특징 교종은 성인에서 가장 흔한 일차성 뇌종양으로, 미국에서는 인구 10만 명당 6.5명꼴로 발생합니다. 교종은 WHO에 의해 등급별로 분류되며, 저등급 교종(low-grade glioma)과 고등급 교종(high-grade glioma)으로 나뉩니다. 저등급 교종 (WHO 1, 2등급): 별아교세포종 (astrocytoma) 희소돌기아교세포종 (oligodendroglioma) 희소돌기-별아교세포종 (oligoastrocytomas)  고등급 교종 (WHO 3, 4등급): 역형성 별아교세포종 (anaplastic astrocytoma) 역형성 희소돌기아교세포종 (anaplastic oligodendroglioma) 교모세포종 (glioblastoma)    2016년 WHO 뇌종양 분류 개정판  이 개정판은..
분할방사선치료 (Fractionated Radiotherapy) 개요 방사선치료의 발전뇌 종양에 대한 방사선 치료는 2차원 치료에서 시작하여 현재는 3차원 입체조형치료, 세기변조 방사선 치료, 영상 유도 방사선 치료, 사이버나이프 및 감마나이프 기반 방사선수술 등의 다양한 형태로 발전했습니다. 가장 대표적인 방법으로는 세기조절 방사선치료와 3차원 입체조형치료가 있으며, 일반적으로 1.8-2 Gy의 분할 선량으로 매일 치료하는 통상 분할 방사선치료(conventionally fractionated radiotherapy)가 사용됩니다. 표적체적 정의 및 설정표적체적의 정의 GTV (Gross Target Volume): 육안으로 보이는 종양 또는 종양 수술 절제연을 포함합니다. CTV (Clinical Target Volume): 육안으로 보이는 종양 주위의 미세 침윤 영역..
각성개두술(awake craniotomy)과 뇌 지도화(brain mapping) 각성개두술은 개두술 동안 마취를 시행하고, 뇌병변을 수술하는 중에는 환자를 각성시켜 의식이 있는 상태로 진행하는 수술법입니다. 이 과정에서 뇌피질이나 피질하 뇌 부위에 전기 자극을 주어 특정 기능을 억제하거나 유발시켜 해당 뇌 기능의 위치를 정확하게 파악하여 뇌 지도화를 수행합니다. 특히 언어 기능의 뇌 지도화에는 각성개두술이 필수적입니다. 1) 각성수술의 유용성각성수술은 뇌종양, 특히 신경교종의 수술에서 최대한 종양을 제거하는 데 중요한 역할을 합니다. 연구에 따르면, 신경교종에서 종양의 제거 정도는 치료 후 여명, 신경학적 증상의 호전 및 악성 변이의 위험성에 직접적인 영향을 미칩니다. 최대한 종양을 절제하면서도 수술로 인한 위험성을 최소화하는 최대안전절제(maximal safe resection)가..
Endoscopic Approaches for Brain Tumors 1. IntroductionAs modern architect Walter Gropius once said, "Technique does not require art, but art requires technique." This sentiment is particularly true for endoscopic surgery, a field heavily dependent on technological advancements. Endoscopic surgery has a history spanning over a century, first used to treat hydrocephalus in the early 20th century. Remarkably, it predates ventricular shu..
Thoracic Unilateral Laminectomy for Bilateral Decompression by Unilateral Biportal Endoscopy 18.1 IntroductionConventional thoracic laminectomy remains the standard surgical approach for treating thoracic spine pathologies such as thoracic spinal stenosis and ossified ligamentum flavum (OLF) . However, this procedure can involve extensive removal of bony and musculoligamentous structures, necessitating fusion surgery to prevent iatrogenic instability, which can lead to postoperative bac..
Unilateral Biportal Endoscopy for Cervical Decompressive Laminectomy 17.1 IntroductionCervical myelopathy, resulting from degenerative cervical spondylosis, cervical disc protrusion, or cervical ossification of the posterior longitudinal ligament (OPLL), often necessitates surgical interventions. Traditional surgeries include decompressive laminectomy, laminoplasty, anterior cervical discectomy and fusion, anterior cervical corpectomy, or combined anterior-poster..
Complications and Management 12.7.1 Dural TearMost dural tears are manageable with a fibrin collagen patch (TachoComb). For small tears, apply the patch and recommend 5 to 7 days of bed rest. For larger tears exceeding 10 mm, repair the dural defect directly using sutures under endoscopic guidance or convert to microscopic surgery if necessary.12.7.2 Postoperative HematomaControl bleeding from the removed bone using bone wa..
Surgical Steps 12.5.2 Initial Working Space and Bone Working (Fig. 12.3 and Video 12.1) After positioning the endoscope and the semi-tubular retractor through each portal, the initial working space is made under endoscopic guidance. Coagulate the soft tissue overlying the cranial lamina using an RF probe to identify the inferior edge of the cranial lamina and the interlaminar space (Fig. 12.3a). Perform ipsila..
Lumbar Interbody Fusion by Unilateral Biportal Endoscopy 12.1 IntroductionGold standard techniques such as transforaminal lumbar interbody fusion (TLIF) or posterior lumbar interbody fusion (PLIF), conventionally used for the treatment of degenerative lumbar spinal disease, have disadvantages such as postoperative back pain and paraspinal muscle atrophy due to muscle dissection or retraction . Recently, a technique for lumbar interbody fusion by unila..

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