PURPOSE: To report a rare case of lymphocytic hypophysitis in a 31-year-old woman who presented with gradually progressive bilateral visual loss during the third trimester of pregnancy. METHODS: Ophthalmologic examination revealed best corrected visual acuity of 0.02 OD and counting fingers at 20 cm OS. Pupil examination revealed no relative afferent pupillary defect in either eye and intraocular pressure was normal in both eyes. A visual field test revealed nearly total visual defect sparing superotemporal area OD and total defect OS. An MRI of the head was performed. RESULTS: At the time of transsphenoidal surgery following the patient's delivery, a frozen biopsy of the lesion revealed diffuse lymphocytic infilteration and fibrosis of the pituitary gland consistent with the diagnosis of lymphocytic hypophysitis. Postoperatively the patient was treated for hypopituitarism. At 5 weeks postoperative, her best corrected visual acuity was 1.0 OU, and visual field defects resolved in both eyes. On follow-up by telephone for postoperative 7 months, the patient remained visually asymptomatic. CONCLUSIONS: The clinical presentation of lymphocytic hypophysitis may mimic pituitary adenoma, lymphoma, germinoma, and histiocytosis. The diagnosis should be suspected in any pregnant or postpartum patient with an intrasellar or suprasellar mass.
Adult ; Biopsy ; Diagnosis ; Female ; Fibrosis ; Fingers ; Follow-Up Studies ; Germinoma ; Head ; Histiocytosis ; Humans ; Hypopituitarism ; Intraocular Pressure ; Lymphoma ; Magnetic Resonance Imaging ; Pituitary Gland ; Pituitary Neoplasms ; Postpartum Period ; Pregnancy Trimester, Third ; Pregnancy* ; Pupil ; Pupil Disorders ; Telephone ; Visual Acuity ; Visual Field Tests ; Visual Fields

No abstract available.
Catheters*

The authors experienced 52 patients with myasthenia gravis who were diagnosed at the Department of Neurology, Yeungnam University Hospital from August 1985 to January 1996. The following results were obtained through diagnostic evaluation and treatment. 1. The ratio of male to female was 1:1.7 and the most prevalent age group was second decade. 2. The most common initial presentation symptom was ocular(71.2%) and the peak incidence group was stage I (69.3%) according to the modified Osserman's classification. 3. In 16 patients(30.8%), it took more than a year to diagnose due to symptoms which were relapsed and remitting. 4. Of 52 patients, 2 cases were associated with thyroid disease(3.8%) and 2 with insulin-dependent diabetes mellitus(3.8%). 5. All of those who received anticholinesterase and corticosteroid therapy were improved with the exception of 5 cases which were improved after thymectomy and/or plasmapheresis.
Classification ; Female ; Humans ; Incidence ; Male ; Myasthenia Gravis* ; Neurology ; Plasmapheresis ; Thymectomy ; Thyroid Gland

Sertoli-Leydig cell tumor or Brenner tumor is a relatively rare ovarian tumor. Other associated elements in the form of epithelial, mesenchymal, and tumor components of each tumor have been reported. The Sertoli-Leydig cell tumor with a Brenner tumor element has not been documented in the literature, so we are reporting on a case of Sertoli-Leydig cell tumor coexisting with a Brenner tumor. This 62-year-old woman presented with a 4 year history of lower abdominal mass and vaginal bleeding. Exploratory laparotomy was done. The left ovary showed a multiseptated, cystic, yellow-white solid mass, measuring 17.0x13.0x5.0 cm and weighing 985.0 gm. Microscopic examination revealed a tubular or trabecular arrangement of the Sertoli cells and variable numbers of Leydig cells. There were several tumor nests with cystic spaces composed of ovoid cells showing longitudinal nuclear grooving. Sarcomatoid or heterologous elements were not found.
Female ; Humans

PURPOSE: This study was aimed to evaluate the recurrence rate of a giant cell tumor (GCT) of the bone. MATERIALS AND METHODS: The medical records of fifty four patients who were diagnosed with a giant cell tumor of the bone between March 1980 and December 2008 were analysed retrospectively. Among 54 patients, 27 were men, remaining 27 were women with the mean age of 33.1 years (range, 13-67 years). The mean duration of follow-up was 67.1 months. RESULTS: Twenty-one patients (38.9%) had a local recurrence. The mean time to recurrence was 21.5 months (range, 2-59 months). The local recurrence rate of the upper extremities was higher than that of lower extremities. According to Campanacci classification, patients with a grade I diseae had lower recurrence rate than those with grade II or III disease. There was no significant differences in the recurrence rates based on cryotherapy, the filling of bone cement or bone grafts and surgical margin. CONCLUSION: To prevent local recurrence of GCT of bone, curettage of the tumor and elimination of the remaining cells are more important than adjuvant therapy.
Cryotherapy ; Curettage ; Female ; Follow-Up Studies ; Giant Cell Tumors ; Giant Cells ; Humans ; Lower Extremity ; Male ; Medical Records ; Recurrence ; Retrospective Studies ; Transplants ; Upper Extremity

No abstract available.
Pregnancy* ; Ultrasonography*

In order to obsetve the effect of stroke on hypothalamic-pituitary axis, TRH stimulabon test and dexamethasone suppression test(DST) were performed in 52 patients with stroke(cerebral infarction, 16 cases; intracerebral hemorrhage, 15 cases: subarachnoid hemorrhage, 21 cases) and 15 age-sex matched patients control without intracrania disease at Keimyung University Dongsan Hospital from April 1987 to August 1988. The results summarized as follows. 1. The frequency of blunted response on TRH stimulation test is significantly higher in total stroke and patients with cerebral infarction than in control(P<0.06, P<0.05). 2. The frequency of DST non-suppression in patients with cerebral infarction is significantly higher than in control, patients with cerebral hemorrhage and patients with subarachnoid hemorrhage(P<0.001, P<0.01, P<0.01). 3. Patients with left hemispheric stroke tend to show more frequent abnormal neuroendocrine test results than patient with right hemispheric stroke. 4. There are no correlation between abnormal neuroendocrine test results and age, sex, size of stroke and Barthel ADL scale. These results suggest stroke can influence on hypothalamic-pituitary axis, more marked in cerebral infarction and left hemispheric lesion.
Activities of Daily Living ; Axis, Cervical Vertebra ; Cerebral Hemorrhage ; Cerebral Infarction ; Dexamethasone ; Humans ; Infarction ; Stroke* ; Subarachnoid Hemorrhage

No abstract available.
Fistula* ; Humans ; Infant*

OBJECTIVE: The authors reviewed experience with patients harboring intracerebral hematoma (ICH) treated by stereotactic computed tomography (CT) guided thrombolysis and aspiration and evaluated feasibility, safety and prognostic factors of this procedure. METHODS: One hundred and ten patients with supratentorial ICH >25 ml without underlying structural etiology or coagulopathy were recruited. The patients with Glasgow Coma Scale (GCS) <5 were excluded. A catheter was directed stereotactically into the ICH under CT guidance. Hematoma aspiration was followed by instillation of urokinase. This was repeated every 6 hours until less than half of its initial volume remained. For analysis of prognostic factors, we classified them into two groups;good (Glasgow Outcome Scale (GOS) > or =4) and bad (GOS<4) prognosis group, and performed comparative analysis between two groups. RESULTS: Mean age was 59.8 years. The baseline hematoma size ranged from 15 to 72 mL. ICH volume reduced by an average of 74.2%. At 6 months after the procedure, 56 patients had achieved a good recovery, 29 patients were dependent, and 10 remained vegetative. Fifteen patients died in hospital. The main good prognostic factors were young age, small ICH volume, high GCS, absence of rebleeding, underlying disease and complications. CONCLUSION: CT-guided thrombolysis and aspiration appears safe and effective in the reduction of ICH volume. Patients of ICH presenting with bad prognostic factors should require frequent radiological investigation and more meticulous procedure. Further studies are needed to assess optimal thrombolytic dosage and must include controlled comparisons of mortality, and disability outcome.
Catheters ; Glasgow Coma Scale ; Hematoma* ; Humans ; Mortality ; Prognosis ; Urokinase-Type Plasminogen Activator

The authors presented a family whose 4 siblings had been suffered from oculopharyngeal muscular dystrophy of autoscmal recessive trend, with symptoms of progressive ptosis, external ophthalmoplegia, dysarthria, dysphagia and facial muscle atrophy, and we performed HLA study on these 9 family members which showed no interrelationship between oculopharyngeal muscular dystrophy and HLA Haplotypes.
Atrophy ; Deglutition Disorders ; Dysarthria ; Facial Muscles ; Haplotypes ; Histocompatibility Testing* ; Humans ; Muscular Dystrophy, Oculopharyngeal* ; Ophthalmoplegia ; Siblings