The development of immuohistochemistry and the application of electron microscopy have revolutionized our understanding of the pathopysiology of pituitart adenoma. The clinical value of functional characterization of pituitary adenoma has been realized. Immunohistochemical stains using polyclonal antibodies to six pituitary hormones (GH, PRL, ACTH, TSH, FSH & LH) were performed to classify the pituitary adenoma and to investigate the relationship between the results of the immunohistochemical study and pared to the serum hormone level. The results are summarized as follows: The Most common clinical type of pituitary adenoma was prolactinoma and the second was nonfunctioning adenoma. However, the most common immunohistological type of pituitary adenoma was null cell adenoma, the second one, lactotrope adenoma and the third one, mixed sommatotrope & lactotrope adenoma. In the clinically nonfunctioning adenoma cases, null cell adenoma were present in 75%; gonadotrope adenoma and corticotrope adenoma were present in 25%, while the serum prolactin level was increased in ten of the twenty cases(50%) of the null cell adenoma. When the serum prolactin level was increased above the 150ng/ml, the tumor cells gave positive reactions in 95.2% of cases immunohistochemically. But in the cases of GH, FSH & LH, the tumor cells gave positive reactions in 100%, 75%, and 66.7%, respectively. In the case of increased serum prolactin level, more than 50% and 30% proportion of tumor cells showed positive reactions in the micro- and macroadenoma, respectively.
Adenoma

A case of pigmented villondular synovitis is reported in a 32 years old woman, who exhibited bulbulous supra-patellar bulging with dull pain on the right knee joint. Aspiration yielded thick purplish brown effusion from the knee joint and roentgenologically negative. Synovectomy through two seperate para-patellar incision were carried out, and no recurrence of symptom was demonstrable in 2 years post-operative follow-up. A brief summary of literatures is Submitted.
Female ; Follow-Up Studies ; Humans ; Knee Joint ; Recurrence ; Synovitis ; Synovitis, Pigmented Villonodular

Ovarian carcinoma is a serious disease in women. Some reports revealed all-trans-retinoic acid (tRA) inhibited the proliferation of ovarian carcinoma cell lines and induced apoptosis. The aim of this study was to evaluate the anticancer and apoptotic effects of tRA and the expression of the retinoic acid receptor (RAR) alpha, beta, gamma, p53, bcl-2, and c-myc genes on the ovarian carcinoma cell lines, NIH OVCAR3 and SKOV3. In both cell lines, the proliferation of tumor cells was inhibited and characteristic morphologic patterns of apoptosis were shown after treatment of tRA. The number of apoptotic cells and the percentage of apoptosis were increased after treatment of tRA. The gel electrophoresis revealed the DNA ladder pattern in the NIH OVCAR3. Gene expressions were observed using northern blotting. There was no RARalpha expression in both cell lines. In NIH OVCAR3, there was no changes in the expression of RARbeta and bcl-2 gene. The RARgamma gene expression of tRA treated group was slightly increased, but p53 gene expression was decreased, and c-myc gene was not expressed. In SKOV3, the expressions of RARbeta, gamma, and p53 genes were increased and that of bcl-2 was decreased in the tRA treated group. There was no change in c-myc gene expression. These results suggest tRA has anticancer and apoptotic effect on both ovarian carcinoma cell lines. RARbeta, RARgamma, bcl-2, and p53 gene expressions were correlated with these effects of tRA on SKOV3 but not on NIH OVCAR3.
Apoptosis* ; Blotting, Northern ; Cell Line* ; DNA ; Electrophoresis ; Female ; Gene Expression ; Genes, bcl-2 ; Genes, myc ; Genes, p53 ; Humans* ; Receptors, Retinoic Acid ; Tretinoin*

Antigen processing (TAP, HLA-DM and LMP) genes map within the major histocompatibility complex (MHC) class II region between the HLA-DQB1 and -DPB1 loci, and are involved in the processing of peptides bound to HLA class I or class II molecules. In order to determine the allele frequencies of antigen processing genes and the various linkage disequilibria existing among these genes, we have analyzed TAP1, TAP2, HLA-DMA, and HLA-DMB, LMP2, LMP7 polymorphisms in 184 unrelated healthy Koreans using the rnethod of PCR-SSCP, ARMS-PCR and PCR-RFLP. The frequencies of antigen processing genes were TAP1A (77.7%), TAP1*B (17.1%), TAP1*C (5.2%), TAP2*A (41.6%), TAP2*B (31.3%), TAP2*C (3.3%), TAP2*D (0.8%), TAP2*E (6.5%), TAP2*G (0.8%), HLA-DMA*0101 (81.5%), HLA-DMA*0102 (18.2%), HLA-DMA*0103 (0.3%), HLA-DMB*0101 (42.9%), HLA-DMB*0102 (19.0%), HLA-DMB*0103 (38.0%), LMP2*R (78.8%), LMP2*H (21.2%), LMP7*A (35.3%), LMP7*B (56.0%), LMP7*C (4.9%), and LMP7*D (3.8%). We also analysed two- locus association among each locus. Many significant positive associations were observed between these two loci, such as between HLA-DMB and TAP1, between HLA-DMA and HLA-DMB, between LMP2 and LMP7, and between TAP1 and LMP7. Conversely, any significant linkage disequilibrium was not detected between HLA-DMB and LMP2. These results could be used as control data for disease association and population genetics studies in Korean population.
Antigen Presentation* ; Gene Frequency ; Genetics, Population ; Linkage Disequilibrium ; Major Histocompatibility Complex ; Peptides

Optic nerve sheath meningioma arises from the arachnoid cap cell of optic nerve sheath and comprises most of primary orbital meningioma. We experienced a rare case of optic nerve sheath meningioma originating in the left orbit. A 44-year-old woman had suffered from visual disturbance in the left eye for 3 years and had only light perceptibility for the recent 6 months. The right eye was normal. Brain CT scan and MRI revealed a 2x0.8 cm sized fusiform solid mass in the left retrobulbar area. Under the impression of optic nerve tumor. excision of the mass including a small segment of the optic nerve was performed. The tumor was a yellowish firm, relatively well demarcated mass that encircled the optic nerve without infiltrating it. Microscopically it was a typical meningioma, meningothelial type. The recovery of visual acuity was impossible due to resection of optic nerve but there was no evidence of recurrence for u months.
Female ; Humans ; Meningioma

We report a case of a 41-year-old female patient who suffered from the acute abdominal pain for several hours after eating raw sea-fishes. After the fibergastroscopy and the abdominal C-T scan, the clinicians found a gastric submucosal mass and performed the explolaparotomy to get an wedge of stomach. Sections revealed a larva surrounded by phlegmonous inflammation with intense eosinophilic infiltration in the widened gastic submucosa. The larva presented the characteristics of the Anisakis: two lateral chords with renette cell, thich smooth cuticle and well developed musculature.
Female ; Humans

Neuroblastoma, ganglioneuroblastoma and ganglioneuroma are derived from primordial neural crest cells and can be conceptualized as three different maturational manifestations of a common neoplasm. To assess the validity of immunohistochemistry and DNA Ploidy in the diagnosis of neuroblastic tumor in terms of prognostication, histologic and immunohistochemical evaluation with NB-84, neuron specific enolase(NSE) and S-100 protein and flow Cytometric DNA analysis were done on 21 neuroblastomas and 19 ganglioneuromas. Thirteen of 21 neuroblastomas were undifferentiated and 8 differentiating in type. Eleven of the 19 ganglioneuromas were mature in type and 8 had immature foci. Eighty one percent of neuroblastomas were positive for NB-84, 100% for NSE and 67% for S-100 protein, respectively. All ganglioneuromas were positive for NSE and S-100 protein, in contrast, only immature foci in ganglioneuroma were positive for NB-84. B-84 reacted positively with undifferentiated and differentiating neuroblasts including neuropil but not with mature ganglion cells. In contrast, NSE reacted positively with all components of neuroblastic tumor and S-100 protein mainly with cells of Schwannian differentiation. Three of eight(37.5%) differentiating neuroblastomas were strongly positive for NB-84 in contrast with seven of thirteen(53.8%) undifferentiated tumors, reflecting that undifferentiated cells tended to be positive for NB-84 in neuroblastoma. Twenty two percent of neuroblastoma showed diploidy and 78% aneuploidy including 11% of near-diploidy. Seven of eight(87.5%) differentiating neuroblastomas in contrast with seven of ten(70%) undifferentiated tumors showed aneuploidy. By contrast, 53% of ganglioneuroma showed diploidy and 47% aneuploidy with DNA index ranged from 1.12 to 1.19. Three of nine(33.3%) mature ganglioneuromas in contrast with five of eight(62.5%) ganglioneuromas with immature foci showed aneupolidy. Differentiating neuroblastoma tended to be aneuploid and ganglioneuroma with immature foci tended to be near-diploid. In conclusion, immunohistochemistry for NB-84, NSE and S-100 protein is useful for confirming neuronal, both neuronal and Schwannian, and Schwannian differentiation, respectively. Immunohistochemistry together with flow cytometric DNA analysis would be helpful to confirm the immature foci in ganglioneuroma.
Neuroblastoma

The present study is aimed to investigate the clinical and pathologic features of GI lymphomas and the immunocytochemical characteristics, using 71 cases of primary GI lymphomas examined at the Department of Pathology, Yonsei University College of Medicine, Youngdong Serverance Hospital and Yonsei University Wonju College of Medicine from January, 1976 to December, 1985. Results obtained were as follows: 1) Sixty eight cases were Non-Hodgkin's lymphoma and 3 Hodgkin's lymphoma. Surgical resection was done in 58 patients and surgical biopsy in 13. 2) The primary sites of the tumors were stomach, small intestine, ileocecal area and large intestine in a descending order of frequency. 3) The mean age at the time of diagnosis was 45 years. The tumor of the small intestine was generally detected in the younger age and that of the large intestine in the older age. The overall male to female ratio was 1.9 : 1. 4) Abdominal pain was the most common presenting symptom irrespective of the sites of the tumor. Duration of the symptoms were evenly distributed from hours to 12 monthes. 5) The size of the tumors was less than 10 cm in the largest dimension in most of the cases (79.3%). The gross types of the GI lymphomas were ulcerative (27.6%), polypoid (20.7%), multinodulated (17.2%) and diffuse thickening. The rate of lymph node involvement was 44.4% in tumors confined to the serosa, while 82.6% in tumors with serosal penetrations. 6) Classification of 68 cases of Non-Hodgkin's lymphoma according to Working Formulation revealed 50 cases of intermediate grade, 13 cases of high grade and 5 cases of low grade. According to Rappaport classification, all were diffuse types, among which diffuse histiocytic type was the most common. According to Lukes-Collins classification, 60 cases were B cell types, 4 cases genuine histiocytes types and 3 cases T cell types. Most of the gastric and intestinal lymphomas belonged to the follicular center cell (small and large cleaved, large cleaved) types. 7) Immunoperoxidase stains were done in 55 cases of malignant lymphomas. Thirty (65.9%) of 47 B cell lymphomas revealed a positivity for B cell markers. Twenty three (48.9%) of them showed a monoclonality, in which kappa/IgG pattern was most frequently demonstrated. Four cases of true histiocytic lymphomas were positive for alpha-1-antichymotrypsin and lysozyme, the former of which was seemed to be a more sensitive marker for histiocytic differentiation. An attempt was made to evaluate the significance of the degree of reactive histiocytic infiltrates within the lymphoma in relation to the progosis, but correlation could not be made because of the limited cases.
Female ; Male ; Humans ; Biopsy

The authors report two cases of arare post-spinal complication which were hypertension, tachycardia, hyperpyrexia and localized clonic convulsion of the back and lower extremities. Spinal anesthesia was performed with Tetocaine(Tetracaine made in Japan) and 10% dextrose ampule (made by Dongindang, Korea) and by multiple heat sterilization. One recovered well in 14 days with intensive care and medication, and was discharged in one month without any sequelate. The other died 3 hours following spinal anesthesia. We consider the probable causes of the complication as contamination the spinal anesthetic, 10% dextrose and spinal tray, OR deterioration of the spinal anesthetic or the 10% dextrose due to multiple heat sterilization.
Anesthesia, Spinal ; Glucose ; Hot Temperature ; Hypertension* ; Critical Care ; Lower Extremity ; Seizures* ; Sterilization ; Tachycardia*

We have had a case of unilateral vocal cord paralysis following endotracheal anesthesia for abdominal surgery. Electromyographic examination of the intrinsic laryngeal muscle to study the nerve injury was not done but we have considered that the recurrent laryngeal nerve was injured following endotracheal anesthesia according to the post-operative laryngeal view and recovery progress. Som factors of nerve injury such as overrotation of the neck during the operation, pressure on the nerve by an overexpanded cuff, vulnerability and the anatomy of the nerve were all deemed to do possible causes, and we considered the interaction of this combination responsible for the nerve injury. The recovery were relatively good and healed within 80 dyas after operation.
Anesthesia* ; Laryngeal Muscles ; Neck ; Recurrent Laryngeal Nerve ; Vocal Cord Paralysis*