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Kim, Yong-il,Phi, Ji Hoon,Paeng, Jin Chul,Choi, Hongyoon,Kim, Seung-Ki,Lee, Yun-Sang,Kang, Keon Wook,Lee, Ji Yeoun,Jeong, Jae Min,Chung, June-Key,Lee, Dong Soo,Wang, Kyu-Chang Society of Nuclear Medicine 2014 The Journal of nuclear medicine Vol.55 No.9
<P>Indirect revascularization is the most widely used treatment to induce angiogenesis in pediatric moyamoya disease (MMD). Molecular imaging methods targeted for angiogenesis have recently been developed. We performed angiogenesis imaging in indirect revascularization surgery for MMD to evaluate angiogenic activity and its correlation with treatment efficacy. <B>Methods:</B> Twelve patients with pediatric MMD were prospectively enrolled. Encephaloduroarteriosynangiosis surgery was conducted, and <SUP>68</SUP>Ga-Arg-Gly-Asp (RGD) PET was performed 3.7 ± 1.0 mo after surgery. Basal perfusion and stress perfusion (P<SUB>Str</SUB>) in the middle cerebral artery territory were evaluated by acetazolamide-stress brain perfusion SPECT using statistical probabilistic anatomic mapping, at preoperative, early postoperative, and long-term follow-up states. Angiogenic activity was assessed on the images in terms of maximal uptake ratio, volume of increased uptake, and uptake-volume product. <B>Results:</B> Basal perfusion and P<SUB>Str</SUB> were significantly improved after surgery. Increased angiogenic activity was observed in the revascularized area, mainly around the bony flap. Angiogenic activity gradually decreased with time and significantly correlated with the postoperative time interval (<I>P</I> = 0.0015 for maximal uptake ratio and 0.0069 for volume of increased uptake). It was estimated to normalize at 6.3 mo after surgery. Uptake-volume product was inversely correlated with P<SUB>Str</SUB> improvement at the early postoperative state (<I>r</I> = −0.5960, <I>P</I> = 0.0409) and also weakly correlated with P<SUB>Str</SUB> improvement at long-term follow-up (<I>r</I> = −0.5010, <I>P</I> = 0.1165). <B>Conclusion:</B> Angiogenesis PET imaging with <SUP>68</SUP>Ga-RGD was successfully used for the assessment of angiogenic activity in indirect revascularization surgery for MMD, and angiogenic activation measured at approximately 3.7 mo after surgery was inversely correlated with perfusion improvement. The assessment of angiogenic activity using <SUP>68</SUP>Ga-RGD PET is expected to be effective for evaluating the mechanism or efficacy of revascularization treatment.</P>
Transcerebellar biopsy of diffuse pontine gliomas in children: a technical note.
Phi, Ji Hoon,Chung, Hyun-Tai,Wang, Kyu-Chang,Ryu, Seul Ki,Kim, Seung-Ki Springer Verlag 2013 Child’s nervous system Vol.29 No.3
<P>The need for a surgical biopsy for diffuse pontine glioma (DPG) is increasing, and a safer and less invasive procedure is required.</P>
Long-term surgical outcomes of temporal lobe epilepsy associated with low-grade brain tumors
Phi, Ji Hoon,Kim, Seung-Ki,Cho, Byung-Kyu,Lee, Seo Young,Park, Su Yeon,Park, Sung-joon,Lee, Sang Kun,Kim, Ki Joong,Chung, Chun Kee Wiley Subscription Services, Inc., A Wiley Company 2009 Cancer Vol.115 No.24
<B>BACKGROUND:</B><P>Tumor-related temporal lobe epilepsy (TLE) has a high likelihood of medical intractability and requires surgical treatment. The aims of this study were to analyze the long-term surgical outcomes of and to present appropriate surgical strategies for tumor-related TLE.</P><B>METHODS:</B><P>The clinical data of 87 consecutive patients diagnosed with tumor-related TLE were analyzed. The median age at surgery was 22 years. Sixteen patients had a tumor confined to the amygdala or the parahippocampal gyrus, and 10 of them received a tailored lesionectomy without hippocampectomy. The surgical outcome was evaluated based on 3 aspects: seizure control, tumor control, and discontinuation of antiepileptic drugs (AEDs).</P><B>RESULTS:</B><P>The actuarial seizure and tumor control rates at the fifth year postoperatively were 79% and 90%, respectively. Seizure control was highly correlated with tumor control. The following factors were found to be significantly associated with poor seizure control: duration of epilepsy >10 years, presence of a remote focus on surface electroencephalography, and incomplete tumor removal. The actuarial AED maintenance rates were 47% at the second year and 11% at the fifth year. The median time to AED discontinuation was 22 months. A younger age at surgery was found to be significantly associated with an increased chance of AED discontinuation. Tailored resection focusing on the tumor resulted in a favorable outcome, even for tumors confined to the amygdala or the parahippocampal gyrus.</P><B>CONCLUSIONS:</B><P>Surgical treatment of tumor-related TLE resulted in long-term seizure control in the majority of patients. Maximal tumor removal can be recommended for tumor-related TLE. Cancer 2009. © 2009 American Cancer Society.</P>
Phi, Ji Hoon,Park, Sung-Hye,Chung, Chun Kee,Wang, Kyu-Chang,Cho, Byung-Kyu,Kim, Seung-Ki Blackwell Publishing Asia 2009 Pathology international Vol.59 No.10
<P>Glioneuronal tumors are a group of brain tumors that consist of both neuronal and glial cells. The spectrum of glioneuronal tumors is currently expanding, and many atypical glioneuronal tumors require further characterization. Two patients are described who had an atypical glioneuronal tumor with peculiar pathological features. One patient was a 7-year-old girl with a tumor in the right cerebellar hemisphere. This patient had no recurrence after total resection. The other was a 37-year-old man with a tumor in the spinal cord. He suffered incessant recurrence and received operative treatment four times. Although the clinical features (age at diagnosis, tumor location, and recurrence) were very different in these patients, the tumors had a characteristic common feature of atypical cell clusters. Intriguingly, the tumor cells in the clusters expressed both neuronal and oligodendroglial markers, indicating aberrant differentiation. Furthermore, the cluster-forming cells had modest proliferative indices and CD133 expression, indicating their role in the growth of the tumor. It is believed that these atypical cell clusters are a novel pattern of differentiation of glioneuronal tumors and that they need further investigation.</P>
Phi, Ji Hoon,Kim, Dong Gyu,Chung, Hyun-Tai,Lee, Joongyub,Paek, Sun Ha,Jung, Hee-Won Wiley Subscription Services, Inc., A Wiley Company 2009 Cancer Vol.115 No.2
<B>BACKGROUND:</B><P>The radiosurgical treatment of vestibular schwannomas in patients with neurofibromatosis type 2 (NF2) is controversial. The authors investigated the radiologically proven tumor control rate after gamma knife radiosurgery. The factors that affect tumor control and serviceable hearing preservation were analyzed.</P><B>METHODS:</B><P>Thirty-six lesions in 30 patients were included. The median lengths of the clinical and radiologic follow-ups were 48.5 months and 36.5 months, respectively. The median tumor volume was 3.2 cm<SUP>3</SUP>. The mean marginal dose was 12.1 grays (Gy) (range, 8–14 Gy) at an isodose line of 50%±0.6%. The Kaplan-Meier method and Cox proportional hazards model were used for the statistical analyses.</P><B>RESULTS:</B><P>The actuarial tumor control rate was 81%, 74%, and 66%, respectively, in the first, second, and fifth years. Five tumors required a salvage surgery because of tumor control failure. A low marginal dose and a young age at radiosurgery were associated with poor tumor control. Of the 16 tumors with which ipsilateral hearing was serviceable, the actuarial serviceable hearing preservation rates were 50%, 45%, and 33%, respectively, in the first, second, and fifth years. Better ipsilateral hearing (Gardner-Robertson grade 1, compared with grade 2) at the time of radiosurgery was associated with significantly greater serviceable hearing preservation.</P><B>CONCLUSIONS:</B><P>Gamma knife radiosurgery for vestibular schwannomas in NF2 patients provided 5-year tumor control in approximately two-thirds of patients and preserved serviceable hearing in approximately one-third. The rates of other cranial nerve deficits were low, and no secondary malignancy was observed. Radiosurgery should be included in treatment options for NF2 patients. Cancer 2009. © 2009 American Cancer Society.</P>
Coordinated Voltage Control Scheme for Multi-Terminal Low-Voltage DC Distribution System
Trinh Phi Hai,Il-Yop Chung,Taehoon Kim,Juyong Kim 대한전기학회 2018 Journal of Electrical Engineering & Technology Vol.13 No.4
This paper focuses on voltage control schemes for multi-terminal low-voltage direct current (LVDC) distribution systems. In a multi-terminal LVDC distribution system, there can be multiple AC/DC converters that connect the LVDC distribution system to the AC grids. This configuration can provide enhanced reliability, grid-supporting functionality, and higher efficiency. The main applications of multi-terminal LVDC distribution systems include flexible power exchange between multiple power grids and integration of distributed energy resources (DERs) using DC voltages such as photovoltaics (PVs) and battery energy storage systems (BESSs). In multi-terminal LVDC distribution systems, voltage regulation is one of the most important issues for maintaining the electric power balance between demand and supply and providing high power quality to end customers. This paper focuses on a voltage control method for multi-terminal LVDC distribution system that can efficiently coordinate multiple control units, such as AC/DC converters, PVs and BESSs. In this paper, a control hierarchy is defined for undervoltage (UV) and overvoltage (OV) problems in LVDC distribution systems based on the control priority between the control units. This paper also proposes methods to determine accurate control commands for AC/DC converters and DERs. By using the proposed method, we can effectively maintain the line voltages in multi-terminal LVDC distribution systems in the normal range. The performance of the proposed voltage control method is evaluated by case studies.
Jeon Sungmi,Kim Yumin,Phi Ji Hoon,Chung Jee Hyeok 대한성형외과학회 2023 Archives of Plastic Surgery Vol.50 No.1
Patients with Crouzon syndrome have increased risks of cerebrospinal fluid (CSF) rhinorrhea and meningoencephalocele after Le Fort III osteotomy. We report a rare case of meningoencephalocele following Le Fort III midface advancement in a patient with Crouzon syndrome. Over 10 years since it was incidentally found during transnasal endoscopic orbital decompression, the untreated meningoencephalocele eventually led to intermittent clear nasal discharge, frontal headache, and seizure. Computed topography (CT) and magnetic resonance (MR) imaging demonstrated meningoencephalocele in the left frontal-ethmoid-maxillary sinus through a focal defect of the anterior cranial base. Through bifrontal craniotomy, the meningoencepehalocele was removed and the anterior cranial base was reconstructed with a pericranial flap and split calvarial bone graft. Secondary frontal advancement was concurrently performed to relieve suspicious increased intracranial pressure, limit visual deterioration, and improve the forehead shape. Surgeons should be aware that patients with Crouzon syndrome have the potential for an unrecognized dural injury during Le Fort III osteotomy due to anatomical differences such as inferior displacement and thinning of the anterior cranial base.