1.Intraoperative Visual Evoked Potential Monitoring in Endoscopic Endonasal Surgery for Nonpituitary Adenoma Suprasellar Tumors
Young Nam KWON ; Hwa Reung LEE ; Myung Jae LEE ; Young Ung KIM ; Seung Woo KIM ; Ha Young SHIN ; Sung-Min KIM ; Ju Hyung MOON ; Jong Hee CHANG ; Eui Hyun KIM
Journal of Clinical Neurology 2026;22(2):221-228
Background:
and Purpose Intraoperative visual evoked potential (VEP) monitoring has been studied mainly in pituitary adenoma, while its role in nonpituitary suprasellar tumors has remained unclear. This study evaluated the predictive usefulness of intraoperative VEP monitoring during endoscopic endonasal surgery (EES) and aimed to identify optimal alarm criteria for visual outcomes.
Methods:
We retrospectively analyzed a cohort of 87 patients who underwent EES with intraoperative VEP monitoring between April 2021 and September 2023. Visual outcomes were evaluated preoperatively and at short-term (≤3 months) and long-term (12 months) followups, with visual deterioration at these time points defined as worsening of either visual acuity or the visual field. Reductions in the VEP amplitude were quantified using both the maximum intraoperative decrease and the final amplitude after recovery. Receiver operating characteristic (ROC) curve analyses were performed to identify the optimal alarm thresholds, and the sensitivity, specificity, positive predictive value, and negative predictive value were calculated for short-term and long-term visual deteriorations.
Results:
Short-term and long-term visual deteriorations were detected in 12 (9.2%) and 5 (3.8%) of the 130 analyzed eyes, respectively. ROC curve analyses identified ≥40% and ≥30% reductions in the N75–P100 amplitude as optimal alarm criteria for short-term and long-term visual deteriorations, respectively. A 30% reduction without intraoperative recovery demonstrated markedly higher sensitivity than the conventional 50% alarm threshold for short-term (58.3% vs. 33.3%) and long-term (80.0% vs. 20.0%) outcomes, while maintaining acceptable specificity (82.2% and 80.8%, respectively).
Conclusions
A 30% reduction in amplitude represents a more-sensitive and clinically relevant alarm threshold than a 50% reduction for intraoperative VEP monitoring during EES for nonpituitary suprasellar tumors. Incorporating both the magnitude and recovery pattern of VEP amplitude changes may improve the accuracy of predictions of long-term visual deterioration. However, the potential for false positives warrants cautious interpretation, and further studies are needed to validate the impact of intraoperative VEP monitoring on visual outcomes.
2.Maternal exposure to airborne particulate matter during pregnancy and lactation induces kidney injury in rat dams and their male offspring: the role of vitamin D in pregnancy and beyond
Min Hwa SON ; Eujin PARK ; Hyung Eun YIM ; Yoon Jeong NAM ; Yu-Seon LEE ; Eui Kyung CHOI ; Sang Hoon JEONG ; Ju‑Han LEE
Kidney Research and Clinical Practice 2024;43(5):648-662
Little is known about the transgenerational effects of maternal exposure to fine particulate matter (PM2.5) on offspring kidney health. This study investigated the effect of maternal administration of PM2.5 or PM2.5 with vitamin D during pregnancy and lactation on renal injury in rat dams and their offspring. Methods: Nine pregnant Sprague-Dawley rats received oral administration of normal saline, airborne PM2.5, or PM2.5 with vitamin D from gestational day 11 to postpartum day 21. Kidneys of rat dams (n = 3 for each group) and their male offspring (n = 5 for each group) were taken for analysis on postpartum or postnatal day 21. Results: Maternal PM2.5 exposure increased glomerular damage, tubulointerstitial injury, and cortical macrophage infiltration in both dams and pups; all increases were attenuated by vitamin D administration. In dam kidneys, PM2.5 increased the protein expression of vitamin D receptor (VDR), klotho, and tumor necrosis factor-α; vitamin D lessened these changes. The expressions of renin, nuclear factor erythroid 2-related factor 2 (Nrf2), and nuclear factor-kappa B (NF-κB) p50 decreased in rat dams exposed to PM2.5. In offspring kidneys, exposure to maternal PM2.5 reduced the expression of VDR, renin, angiotensin-converting enzyme (ACE), Nrf2, and NF-κB p50, but increased cytochrome P450 24A1 expression. Maternal vitamin D administration with PM2.5 enhanced VDR, ACE, and NF-κB p50 activities in pup kidneys. Conclusion: PM2.5 exposure during nephrogenesis may exert transgenerational renal impairment, and maternal vitamin D intake could attenuate PM2.5-induced kidney damage in mothers and their offspring.
3.Maternal exposure to airborne particulate matter during pregnancy and lactation induces kidney injury in rat dams and their male offspring: the role of vitamin D in pregnancy and beyond
Min Hwa SON ; Eujin PARK ; Hyung Eun YIM ; Yoon Jeong NAM ; Yu-Seon LEE ; Eui Kyung CHOI ; Sang Hoon JEONG ; Ju‑Han LEE
Kidney Research and Clinical Practice 2024;43(5):648-662
Little is known about the transgenerational effects of maternal exposure to fine particulate matter (PM2.5) on offspring kidney health. This study investigated the effect of maternal administration of PM2.5 or PM2.5 with vitamin D during pregnancy and lactation on renal injury in rat dams and their offspring. Methods: Nine pregnant Sprague-Dawley rats received oral administration of normal saline, airborne PM2.5, or PM2.5 with vitamin D from gestational day 11 to postpartum day 21. Kidneys of rat dams (n = 3 for each group) and their male offspring (n = 5 for each group) were taken for analysis on postpartum or postnatal day 21. Results: Maternal PM2.5 exposure increased glomerular damage, tubulointerstitial injury, and cortical macrophage infiltration in both dams and pups; all increases were attenuated by vitamin D administration. In dam kidneys, PM2.5 increased the protein expression of vitamin D receptor (VDR), klotho, and tumor necrosis factor-α; vitamin D lessened these changes. The expressions of renin, nuclear factor erythroid 2-related factor 2 (Nrf2), and nuclear factor-kappa B (NF-κB) p50 decreased in rat dams exposed to PM2.5. In offspring kidneys, exposure to maternal PM2.5 reduced the expression of VDR, renin, angiotensin-converting enzyme (ACE), Nrf2, and NF-κB p50, but increased cytochrome P450 24A1 expression. Maternal vitamin D administration with PM2.5 enhanced VDR, ACE, and NF-κB p50 activities in pup kidneys. Conclusion: PM2.5 exposure during nephrogenesis may exert transgenerational renal impairment, and maternal vitamin D intake could attenuate PM2.5-induced kidney damage in mothers and their offspring.
4.Maternal exposure to airborne particulate matter during pregnancy and lactation induces kidney injury in rat dams and their male offspring: the role of vitamin D in pregnancy and beyond
Min Hwa SON ; Eujin PARK ; Hyung Eun YIM ; Yoon Jeong NAM ; Yu-Seon LEE ; Eui Kyung CHOI ; Sang Hoon JEONG ; Ju‑Han LEE
Kidney Research and Clinical Practice 2024;43(5):648-662
Little is known about the transgenerational effects of maternal exposure to fine particulate matter (PM2.5) on offspring kidney health. This study investigated the effect of maternal administration of PM2.5 or PM2.5 with vitamin D during pregnancy and lactation on renal injury in rat dams and their offspring. Methods: Nine pregnant Sprague-Dawley rats received oral administration of normal saline, airborne PM2.5, or PM2.5 with vitamin D from gestational day 11 to postpartum day 21. Kidneys of rat dams (n = 3 for each group) and their male offspring (n = 5 for each group) were taken for analysis on postpartum or postnatal day 21. Results: Maternal PM2.5 exposure increased glomerular damage, tubulointerstitial injury, and cortical macrophage infiltration in both dams and pups; all increases were attenuated by vitamin D administration. In dam kidneys, PM2.5 increased the protein expression of vitamin D receptor (VDR), klotho, and tumor necrosis factor-α; vitamin D lessened these changes. The expressions of renin, nuclear factor erythroid 2-related factor 2 (Nrf2), and nuclear factor-kappa B (NF-κB) p50 decreased in rat dams exposed to PM2.5. In offspring kidneys, exposure to maternal PM2.5 reduced the expression of VDR, renin, angiotensin-converting enzyme (ACE), Nrf2, and NF-κB p50, but increased cytochrome P450 24A1 expression. Maternal vitamin D administration with PM2.5 enhanced VDR, ACE, and NF-κB p50 activities in pup kidneys. Conclusion: PM2.5 exposure during nephrogenesis may exert transgenerational renal impairment, and maternal vitamin D intake could attenuate PM2.5-induced kidney damage in mothers and their offspring.
5.Maternal exposure to airborne particulate matter during pregnancy and lactation induces kidney injury in rat dams and their male offspring: the role of vitamin D in pregnancy and beyond
Min Hwa SON ; Eujin PARK ; Hyung Eun YIM ; Yoon Jeong NAM ; Yu-Seon LEE ; Eui Kyung CHOI ; Sang Hoon JEONG ; Ju‑Han LEE
Kidney Research and Clinical Practice 2024;43(5):648-662
Little is known about the transgenerational effects of maternal exposure to fine particulate matter (PM2.5) on offspring kidney health. This study investigated the effect of maternal administration of PM2.5 or PM2.5 with vitamin D during pregnancy and lactation on renal injury in rat dams and their offspring. Methods: Nine pregnant Sprague-Dawley rats received oral administration of normal saline, airborne PM2.5, or PM2.5 with vitamin D from gestational day 11 to postpartum day 21. Kidneys of rat dams (n = 3 for each group) and their male offspring (n = 5 for each group) were taken for analysis on postpartum or postnatal day 21. Results: Maternal PM2.5 exposure increased glomerular damage, tubulointerstitial injury, and cortical macrophage infiltration in both dams and pups; all increases were attenuated by vitamin D administration. In dam kidneys, PM2.5 increased the protein expression of vitamin D receptor (VDR), klotho, and tumor necrosis factor-α; vitamin D lessened these changes. The expressions of renin, nuclear factor erythroid 2-related factor 2 (Nrf2), and nuclear factor-kappa B (NF-κB) p50 decreased in rat dams exposed to PM2.5. In offspring kidneys, exposure to maternal PM2.5 reduced the expression of VDR, renin, angiotensin-converting enzyme (ACE), Nrf2, and NF-κB p50, but increased cytochrome P450 24A1 expression. Maternal vitamin D administration with PM2.5 enhanced VDR, ACE, and NF-κB p50 activities in pup kidneys. Conclusion: PM2.5 exposure during nephrogenesis may exert transgenerational renal impairment, and maternal vitamin D intake could attenuate PM2.5-induced kidney damage in mothers and their offspring.
6.Three Cases of Recalcitrant Pediatric Tinea Capitis Successfully Treated with Griseofulvin
Eui-Sung JUNG ; Sang-Kyung LEE ; Il-Jae LEE ; Kyung-Hwa NAM ; Seok-Kweon YUN ; Han-Uk KIM ; Jin PARK
Annals of Dermatology 2023;35(Suppl2):S247-S251
Tinea capitis is an infection of the scalp hair follicles and surrounding skin that primarily occurs in prepubertal children. Microsporum canis remains the most common pathogen causing tinea capitis in Asian countries, including South Korea, although the causative organism of this condition varies across geographical regions and time periods. Systemic antifungal agents are the mainstay treatments for tinea capitis; however, the therapeutic responses to antifungal drugs may vary depending on the causative species, and treatment failure may occur owing to drug resistance. Although dermatophytosis resistant to clinical treatment have been increasingly encountered, recalcitrant tinea capitis cases have rarely been reported. Herein, we report three cases of tinea capitis caused by M. canis in children. All three patients showed unsatisfactory clinical responses to prolonged courses of oral terbinafine or itraconazole without achieving mycological cure; however, they were successfully treated with oral griseofulvin. Although griseofulvin is not currently available or licensed for use in many countries, including South Korea, it is one of the most effective agents against Microsporum species and remains the most widely used first-line treatment for tinea capitis in children, based on dermatology textbooks and reliable treatment guidelines.
7.Clinicopathological and Dermoscopic Features of Clear Cell Acanthoma
Kyung-Hwa NAM ; Eui-Sung JUNG ; Jin PARK ; Seok-Kweon YUN
Korean Journal of Dermatology 2021;59(1):25-32
Background:
Clear cell acanthoma is a rare benign epidermal tumor that is considered a nonspecific reactive dermatosis. To date, no reports have described systematic analyses of clear cell acanthoma in Koreans.
Objective:
We investigated the clinical, histopathological, and dermoscopic features of clear cell acanthoma.
Methods:
In this study, we evaluated 14 lesions of clear cell acanthoma.
Results:
We observed female predominance (male:female ratio 1:1.3), and the mean patient age was 55.8±18.0 years (range 15∼76 years), with the peak incidence observed in patients in their 60s. Notably, 57.1% of lesions developed on the lower extremities. The lesion was most commonly misdiagnosed as seborrheic keratosis. Histopathological examination revealed a well-demarcated area of keratinocytes with pale-staining cytoplasm and psoriasiform epidermal hyperplasia and mild spongiosis, exocytosis of neutrophils, and thinned suprapapillary plates. Dermoscopic examination showed a clear cell acanthoma with characteristic vascular findings, including pinpoint red dots, globular red dots, and glomeruloid structures with linear or reticular patterns.
Conclusion
Clear cell acanthoma commonly presents as a small solitary lesion measuring <1 cm in diameter that occurs on the lower extremities in women in their 60s. Histopathological characteristics of this lesion include Periodic acid Schiff-positive with pale cytoplasm, and dotted, globular, and glomeruloid vessels with a linear or reticular pattern on dermoscopy. This was a single-center, small-sized retrospective study; however, in our view, the results of this study would contribute to the literature by providing a better understanding of clear cell acanthoma in Koreans.
8.Basal Cell Carcinoma Arising on the Palm
Eui-Sung JUNG ; Sang-Woo PARK ; Sang-Kyung LEE ; Kyung-Hwa NAM ; Jin PARK ; Nae-Ho LEE ; Seok-Kweon YUN
Korean Journal of Dermatology 2020;58(7):480-482
Basal cell carcinoma (BCC) is the most common type of skin cancer. It typically develops on sun-exposed and hair-containing areas of the body, such as the head and neck regions. The occurrence on the palms and soles is very rare. A 66-year-old Korean woman presented with a red elliptical ulcerative nodule on her left palm. Biopsy revealed basaloid cell mass and nests in the dermis with basal cells containing dark and elongated nuclei. She was diagnosed with basal cell carcinoma, and wide excision with full-thickness skin graft was performed. To the best of our knowledge, no case of basal cell carcinoma on the palm without basal cell nevus syndrome has been reported in Korean literature. Herein, we report this case owing to its rare occurrence on such location.
9.Syringoma Localized to the Umbilicus
Kyung-Hwa NAM ; Sang-Woo PARK ; Hyun-Bin KWAK ; Eui-Sung JUNG ; Sang-Kyung LEE ; Do-Hyeon KIM ; Seok-Kweon YUN
Annals of Dermatology 2020;32(5):434-436

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