The current classification of pituitary adenomas is based on cell type, largely ascertained by immunohistochemistry and electron microscopy. In an application of immunohistochemistry, pathologists have some problems in judging the results. An immunostaining result does not always correspond with a serum hormone level. It is also difficult to determine the nature of a tumor when a few cells are positive. We performed the immunohistochemical stains on 34 pituitary adenomas using polyclonal antibodies to six pituitary hormones [PRL (prolactin), GH (growth hormone), ACTH (adrenocorticotropic hormone), FSH (follicle-stimulating hormone), LH (luteinizing hormone), TSH (thyroid-stimulating hormone)] and compared with serum hormone level. The serum hormone level was increased in 14 cases (41.2%) of PRL, 7 cases (20.6%) of PRL & GH, 6 pleurihormonal cases (17.6%), 4 nonfunctioning cases (11.8%), 2 cases (5.9%) of FSH, and 1 case (2.9%) of GH. The most common immunohistochemical type of pituitary adenoma was 10 prolactinoma cases (38.5%), followed by 7 pleurihormonal cases (26.9%), 4 null cell cases (15.4%), 3 cases of mixed PRL & GH (11.5%), 1 case of ACTH (3.8%) and 1 FSH & LH case (3.8%). The corresponding rates of the serum hormone level and immunostaining results were 94.1% in GH, 88.9% in TSH, 85.7% in LH, 82.4% in ACTH, 66.7% FSH, and 61.8% in PRL. In the immunostaining for FSH, 12 cases showed less than 5% positivity and most of them exhibited the normal serum hormone level. In conclusion, the most common elevated serum hormone and immunohistochemical type of pituitary adenoma was prolactinoma. The corresponding rate of the serum hormone level and immunostaining result was the highest in GH cell adenoma and was the lowest in prolactinoma. The cells showing less than 5% positivity seem to be entrapped normal cells.
Adenoma ; Adrenocorticotropic Hormone ; Antibodies ; Classification ; Coloring Agents* ; Immunohistochemistry ; Luteinizing Hormone ; Lymphocytes, Null ; Microscopy, Electron ; Pituitary Hormones ; Pituitary Neoplasms* ; Prolactinoma

Inflammatory mediators, such as oxidants, TNF-alpha, and IL-6, play a major role in the systemic response to bum injury It has been known that a continuing inflammatory response cause a sepsis and subsequent multiple organ failure. Recent studies have shown that burn patients receiving recombinant human growth hormone(rhGH) therapy have an improvement of the general condition, but the mechanism by which rhGH exerts its effects has not been clearly understood. The aim of this study was to evaluate the effect of rhGH on the early bum injury. Female Sprague-Dawley rats were divided into four groups : control group, bum group, burn plus rhGH treated group, and rhGH only treated group. Animals were killed at 30min., 3, 6, 24, and 48 hours after treatment. Histology and biochemical changes including malondialdehyde(MDA) content, tissue reduced glutathione(GSH) and catalase activity in the lung and liver, and plasma TNF-alpha and IL-6 levels were examined. Lung histology in the bum plus rhGH treated group showed decreased inflammtory response such as neutrophil and lymphocyte infiltrations, interstitial thickening, and edema compared with the bum group. Liver histology in the bum group revealed mild neutrophil and lymphocyte infiltrations, vacuolization .of hepatocytes, disrupted lobular structures, and dilated sinusoids. But liver histology of the bum plus rhGH was similar to control group. Lung and liver MDA in the burn plus rhGH and rhGH only treated groups were decreased with time compared with the burn group. Lung and liver GSH and catalase activities in the bum plus rhGH and GH only treated groups remained significantly increased compared with the bum group for the 48-hours period. Plasma TNF-alpha levels in the bum group remained elevated for the 48-hours period compared with the bum plus rhGH and rhGH only treated groups. Plasma IL-6 levels in the burn group were significantly increased only at first compared with the bum plus rhGH and rhGH only treated groups. These results suggested that rhGH showed inhibitory effects on the inflammatory cell infiltration and lipid peroxidation in the lung and liver after bum injury. Increased GSH levels and catalase activities seemed to be associated with the antioxidant effect of rhGH. But the inhibitory effect of rhGH on plasma TNF- and R-6 levels was not clearly demonstrated.
Animals ; Antioxidants ; Burns ; Catalase ; Edema ; Female ; Hepatocytes ; Human Growth Hormone* ; Humans* ; Interleukin-6* ; Lipid Peroxidation* ; Liver ; Lung ; Lymphocytes ; Multiple Organ Failure ; Neutrophils ; Oxidants ; Plasma* ; Rats* ; Rats, Sprague-Dawley ; Sepsis ; Tumor Necrosis Factor-alpha*

We report 2 cases of pediatric DNTs which presented with intractable seizures and no other associated neurologic abnormalities. They showed typical appearance of DNTs on neuroimaging and histopathology. Most patients with DNT can be cured by surgical treatment with exellent outcome and do not need ratio- or chemotheraphy. This study indicates that it is quite important to consider DNTs as one of differential diagnoses in patients with intractable seizures especially when they present only with seizures without other neurologic symptoms.
Child* ; Diagnosis, Differential ; Humans ; Neoplasms, Neuroepithelial* ; Neuroimaging ; Neurologic Manifestations ; Seizures*

Core decompression is still widely used in avascular necrosis of the femoral head but the results are unpredictable and the indications are not settled yet. The reparative process of the decompressed femoral head is poorly understood. Seven cases in 5 patients were undertaken THRA following failed decompression and these were studied for the radiological and pathological changes of the core tracts. The lesions of failed cases were involved more than 1/3 of femoral head on MRI and all cases were stage II A or B. The extent of the necrotic area in MRI was enlarged with crack, sclerosis and sometimes gas collection. Depression of the subchondral plates were also observed. Capillary ingrowth or neovascularization was not found at all and there were only fibrosis, inflammatory response and foreign body reactions.
Capillaries ; Decompression* ; Depression ; Fibrosis ; Foreign Bodies ; Head* ; Humans ; Magnetic Resonance Imaging ; Necrosis* ; Sclerosis

Three patients with complex partial seizures had dysembryoplastic neuroepithelial tumor (DNET) in temporal lobe. In all cases, longterm video-EEG monitoring showed epileptogenic focus in left temporal lobe where small mass lesion was located. For further seizure localization and functional mapping, subdural grids were placed on left temporal lobe including lesions. Lateral temporal lobectomy with lesionectomy was performed in two cases. Lateral temporal lobe resection and amygdalohippocampectomy was done in one case. The pathological findings of all lesions were characterized by intracortical location, multiple nodular architecture, foci of dysplastic cortical disorganization and the presence of a specific glioneuronal element. All patients have been seizure free.
Epilepsy, Temporal Lobe* ; Humans ; Neoplasms, Neuroepithelial* ; Seizures ; Temporal Lobe*

Melanotic Schwannoma arising from the acoustic nerve is extremely rare and only three cases have been reported. We report an additional case of melanotic schwannoma occuring at the left cerebellopontine angle in a 53-year-old man presented with left facial numbness and tinnitus. After surgical removal of the mass, there has been no evidence of recurrence for 13 months.
Acoustics* ; Cerebellopontine Angle ; Cochlear Nerve ; Humans ; Hypesthesia ; Middle Aged ; Neurilemmoma ; Neuroma, Acoustic* ; Recurrence ; Tinnitus

Central core disease is a rare congenital myopathy characterized by the formation of cores that consist of abnormal arrangement of myofibrils inside the myofibers. We report a 5-year-old Korean girl who showed a fairly typical clinical course of non-progressive muscle weakness. Electrodiagnostic studies showed low-amplitude polyphasic electromyograph and normal nerve conduction velocity. Gastrocnemius muscle biopsy showed central cores in over 80% of the fibers on H&E section. Histochemistry revealed deficient or absent mitochondrial enzyme in the cores and type I predominance. Ultrastructurally both structured and non-structured cores were found separately or simultaneously in one fiber. This case is the first report in the Korean literature.
Child, Preschool ; Female ; Humans ; Microscopy, Electron ; Muscles/pathology/ultrastructure ; Muscular Diseases/*congenital/*pathology

Purpose: This study aimed to evaluate angiographic and contrast enhancement (CE) patterns on three-dimensional (3D) black blood (BB) contrast-enhanced MRI in patients with acute medulla infarction. Materials and Methods: From January 2020 to August 2021, we retrospectively analyzed stroke 3D BB contrast-enhanced magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) findings of patients visiting the emergency room for symptom evaluation of acute medulla infarction. In total, 28 patients with acute medulla infarction were enrolled in this study. Four types of 3D BB contrast-enhanced MRI and MRA were classified as follows: 1=unilateral contrast-enhanced vertebral artery (VA)+no visualization of VA on MRA; 2=unilateral enhanced VA+hypoplastic VA; 3=no enhanced VA+unilateral complete occlusion of VA; 4=no enhanced VA+normal VA (including hypoplasia) on MRA. Results: Of the 28 patients with acute medulla infarction, 7 (25.0%) showed delayed positive findings after 24 hours on diffusion-weighted imaging (DWI). Of these patients, 19 (67.9%) showed CE of the unilateral VA on 3D BB contrast-enhanced MRI (type 1 and 2). Of the 19 patients with CE of VA on 3D BB contrast-enhanced MRI, 18 showed no visualization of enhanced VA on MRA (type 1), and 1 showed hypoplastic VA. Of the 7 patients with delayed positive findings on DWI, 5 showed CE of the unilateral VA and no visualization of the enhanced VA on MRA (type 1). Symptom onset to door time or initial MR check time was significantly shorter in the groups with delayed positive findings on DWI (P<0.05). Conclusion Unilateral CE on 3D BB contrast-enhanced MRI and no visualization of the VA on MRA are related to the recent occlusion of the distal VA. These findings suggest that the recent occlusion of the distal VA is related to acute medulla infarction, including delayed visualization on DWI.

Gliofibroma is a rare astrocytic tumor, composed of a glial component ranging from benign to high grade of malignancy and a consistently benign mesenchymal component. Its exact biological behavior is not fully known. In addition, histogenesis and prognostic factors are also still debatable. We herein present a rare case of gliofibroma in a 25-yr-old male with seizure. A computed tomographic scan of the brain showed a 1.5 cm-sized, enhancing mass with calcification. Histologically, the tumor consisted of glial fibrillary acidic protein (GFAP)-positive glial cells admixed with a mesenchymal component and extensive collagen lay down. The glial cells displayed variable cellularity, but without mitosis or necrosis. Since the MIB-1 labeling index was up to 35.8% in the cellular areas of the glial component, it could be considered to be a predictor of worse prognosis.
Adult ; Astrocytoma/*diagnosis/pathology ; Brain Neoplasms/*diagnosis/pathology ; Glial Fibrillary Acidic Protein/biosynthesis ; Human ; Immunohistochemistry ; Male ; Mitosis ; Necrosis ; Prognosis ; Seizures/complications ; Tomography, X-Ray Computed

BACKGROUND: Korea is an endemic area of viral hepatitis B. In spite of the HBV vaccination program since 1983, the prevalence of HBV antigen had remained high, which was 3.9% in male, 2.7% in female in 1994. But there is no approved management guideline on isolated anti-HBc and the meaning of which is not clear except the evidence of past infection. Therefore, we tried to investigate the factors which influence the seroconversion of anti-HBs during follow-up period. METHODS: Medical records of 239 subject with isolated anti-HBc, who visited a health promotion center from 1995 to 1997 and who were retested at least once during the 1-3 years' follow-up period, were analyzed. RESULTS: The seroconversion rate of anti-HBs was 45.61%(109/239) on the follow-up test. The number of newly vaccinated or non-newly vaccinated subjects during the follow-up period was 156 and 72, respectively. The seroconversion rate of anti-HBs of each group were 57.69%(90/156) and 22.22% (16/72) respectively(p<0.01). The subjects without previous history of HBV vaccination was 103. Among them the seroconversion rate of anti-HBs of the newly vaccinated or the non newly vaccinated group were 59.70%(40/67) and 22.22% (8/36), respectively(p<0.01). Sex, age, BMI, smoking, previous history of HBV vaccination did not influence significantly on the seroconversion rate of anti-HBs among the subjects with isolated anti-HBc. CONCLUSIONS: The seroconversion rate in people with isolated anti-HBc was significantly higher in the newly vaccinated than the non-newly vaccinated regardless of the previous history of HBV vaccination in this study. In spite of the non-differentiation of an-amnestic response from primary antibody response, we can expect to benefit from HBV vaccination in those with isolated anti-HBc.59.70%(40/67) and 22.22% (8/36), respectively(p<0.01). Sex, age, BMI, smoking, previous history of HBV vaccination did not influence significantly on the seroconversion rate of anti-HBs among the subjects with isolated anti-HBc. CONCLUSIONS: The seroconversion rate in people with isolated anti-HBc was significantly higher in the newly vaccinated than the non-newly vaccinated regardless of the previous history of HBV vaccination in this study. In spite of the non-differentiation of an-amnestic response from primary antibody response, we can expect to benefit from HBV vaccination in those with isolated anti-HBc.
Antibody Formation ; Female ; Follow-Up Studies ; Health Promotion ; Hepatitis B ; Humans ; Korea ; Male ; Medical Records ; Prevalence ; Smoke ; Smoking ; Vaccination