BACKGROUND: Using c-fos expression one of the immediate early gene, as a marker of altered neuronal response, we investigated the effect of superior cervical ganglion block (SCGB) exhibiting the same effect of SGB of human on the activity of several brain regions which are considered as located on autonomic neural pathway and neuroendocrine axis in rat. METHOD: The 48 Sprague-Dawley strain rats were divided into 4 groups, as saline/stress (control) group, SCGB/stress (tested) group, saline group, SCGB group. Superior cervical ganglion block was conducted in the SCGB/stress group and SCGB group while saline/stress and saline group were sham operated. After then restraint stress was imposed on the animals of SCGB/stress group and saline/stress group. And 2 hour after injection (saline, SCGB group) or restraint stress (saline/stress, SCGB/stress group), c-fos protein (Fos) was localized by immunocytochemistry. RESULTS: Much stronger Fos immunoreactivity was induced in the several brain region of control group rats compared to other three groups and the numbers of Fos positive cell count of tested group were significantly decreased in paraventricular hypothalamic nucleus (p<0.01), A5 (p<0.01), raphe pallidus (p<0.05), nucleus tractus solitaius (p<0.01) compared to control group. CONCLUSION: This study demonstrate that superior cervical ganglion block attenuates stress induced neuronal activities of paraventricular hypothalamic nucleus, A5, raphe pallidus, nucleus tractus solitarius.
Animals ; Axis, Cervical Vertebra ; Brain* ; Cell Count ; Genes, vif ; Humans ; Immunohistochemistry ; Neural Pathways ; Neurons ; Paraventricular Hypothalamic Nucleus ; Rats* ; Rats, Sprague-Dawley ; Solitary Nucleus ; Superior Cervical Ganglion*

An 84-year-old woman had an ovoid shallow ulcer with an elevated, indurated, pigmented border on the left cheek. Histological examination revealed a moderately differentiated squamous cell carcinoma and a solar keratosis with abundant melanocytes and melanin pigment. Ultrastructurally, the keratinocytes contained numerous melanosomes in their cytoplasms and the melanocytes in the squamous cell carcinoma and the solar keratosis had mature melanosomes.
Aged, 80 and over ; Carcinoma, Squamous Cell* ; Cheek ; Cytoplasm ; Epithelial Cells* ; Female ; Humans ; Keratinocytes ; Keratosis ; Melanins ; Melanocytes ; Melanosomes ; Ulcer

Metastatic tumor to the eye is the most common type of intraocular malignancy. The most common primary site of the intraocular metastatic tumor is the breast in women and the lung in men respectively and the choroid is by far the most common site for intraocular metastasis. We experienced a case of chroidal metastasis in a patient with pancreatic carcinoma which is not published in Korea. So, we review that case with the literatures related with metastatic pancreatic cancer to the choroid.
Breast ; Choroid* ; Female ; Humans ; Korea ; Lung ; Male ; Neoplasm Metastasis* ; Pancreatic Neoplasms

Metastatic tumor to the eye is the most common type of intraocular malignancy. The most common primary site of the intraocular metastatic tumor is the breast in women and the lung in men respectively and the choroid is by far the most common site for intraocular metastasis. We experienced a case of chroidal metastasis in a patient with pancreatic carcinoma which is not published in Korea. So, we review that case with the literatures related with metastatic pancreatic cancer to the choroid.
Breast ; Choroid* ; Female ; Humans ; Korea ; Lung ; Male ; Neoplasm Metastasis* ; Pancreatic Neoplasms

OBJECTIVE: Chronic hydrocephalus is one of the major complications following aneurysmal subarachnoid hemorrhage(SAH). However the incidence and predicting factors requiring shunting after SAH is not precisely known. The authors investigated the incidence of chronic hydrocephalus, timing of shunting procedure, and factors to predict the need for shunting in patients with aneurysmal SAH. PATIENTS AND METHODS: A series of 209 patients admitted to our institute from January 1993 to December 1997, who presented with SAH and underwent craniotomy for aneurysm clipping were studied retrospectively. Chronic hydrocephalus was defined as clinically and radiographically demonstrated hydrocephalus that lasted 2 weeks or longer after initial hemorrhage and that required shunting. The author divided study group into shunt group(SG, n=20) and non-shunt group(NSG, n=189). Patients were evaluated based on following factors: age, sex, history of hypertension and diabetes mellitus, consciousness at admission, Hunt-Hess grade, the presence of intracranial hemorrhage, Graeb's score, bifrontal index(BFI), Fisher grade, amount of SAH, location of aneurysm, time of aneurysm clipping, rebleeding, and vasospasm. RESULTS: The incidence of chronic hydrocephalus was 9.6%(20/209). The timing of the shunting procedure ranged from 16 days to 150 days after initial hemorrhage with the average being 77(+/-37)days. In a univariate analysis with chi-square test, age, consciousness, Hunt-Hess grade, amount of SAH, BFI, Fisher grade, and Graeb's score were significantly related with the need for shunting(p<0.05). In a multivariate logistic regression analysis, odds ratio was calculated for each variables. If the odds ratio of below 60 year of age was 1.0 then that of above 61 was 5.4(p<0.001). If the odds ratio of alert/drowsy was 1.0 then that of stupor/coma was 4.4(p<0.05). If the odds ratio of 0 of Graeb's score was 1.0 then that of 1-10 was 4.3(p<0.05). If the odds ratio of amount of SAH below score 3 was 1.0 then that of above score 4 was 1.8. If the odds ratio of BFI below 30 was 1.0 then that of above 31 was 1.1. CONCLUSION: The development of chronic hydrocephalus after aneurysmal SAH is multifactorial, but should be strongly suspected in patients with older age, decreased level of consciousness or IVH at admission. The patients require a shunt from 2 weeks to 5 months from the time of their initial hemorrhage.
Aneurysm* ; Consciousness ; Craniotomy ; Diabetes Mellitus ; Hemorrhage ; Humans ; Hydrocephalus ; Hypertension ; Incidence ; Intracranial Hemorrhages ; Logistic Models* ; Odds Ratio ; Retrospective Studies ; Subarachnoid Hemorrhage*

Gastric volvulus can either present as an acute or chronic symptoms according to the degree of gastric rotation and subsequent obstruction. The diagnosis of gastric volvulus is often difficult and is mainly based on imaging studies. We describe a case of mesenteroaxial gastric volvulus associated with paraesophageal hernia, well demonstrated on upper gastrointestinal (UGI) series and coronal reconstructed CT image.
Diagnosis ; Hernia, Hiatal* ; Intestinal Volvulus* ; Stomach Volvulus ; Stomach*

OBJECTIVE: Earlier reports have revealed that the incidence of posttraumatic hydrocephalus (PTH) is higher among patients who underwent decompressive craniectomy (DC). The aim of this study was to determine the influencing factors for the development of PTH after DC. METHODS: A total of 693 head trauma patients admitted in our hospital between March 2004 and May 2007 were reviewed. Among thee, we analyzed 55 patients with severe traumatic brain injury who underwent DC. We excluded patients who had confounding variables. The 33 patients were finally enrolled in the study and data were collected retrospectively for these patients. The patients were divided into two groups: nonhydrocephalus group (Group I) and hydrocephalus group (Group II). Related factors assessed were individual Glasgow Coma Score (GCS), age, sex, radiological findings, type of operation, re-operation and outcome. RESULTS: Of the 693 patients with head trauma, 28 (4.0%) developed PTH. Fifty-five patients underwent DC and 13 (23.6%) developed PTH. Eleven of the 33 study patients (30.3%) who had no confounding factors were diagnosed with PTH. Significant differences in the type of craniectomy and re-operation were found between Group I and II. CONCLUSION: It is suggested that the size of DC and repeated operation may promote posttraumatic hydrocephalus in severe head trauma patients who underwent DC.
Brain Injuries ; Coma ; Confounding Factors (Epidemiology) ; Craniocerebral Trauma ; Craniotomy ; Decompressive Craniectomy ; Humans ; Hydrocephalus ; Incidence ; Retrospective Studies

Sinus pericranii is a rare vascular anomaly consisting of abnormal venous communication between intra- andextracranial circulation. We report one case, confirmed by surgery, and describe the radiological findings ofDoppler ultrasonography, CT and MR imaging.
Magnetic Resonance Imaging ; Sinus Pericranii* ; Ultrasonography

PURPOSE: To report a patient with Freeman-Sheldon syndrome with blepharophimosis. METHODS: A 4-year-old girl with congenital facial abnormalities consistent with Freeman-Sheldon syndrome presented with complaints of blepharophimosis. The characteristic features of microstomia, down-slanting palpebral fissure, blepharoptosis, and telecanthus were also found. Y-V epicanthoplasty and levator aponeurosis resection were performed. RESULTS: Surgical intervention to correct ptosis and telecanthus led to initially fair cosmetic results, but one month later an unexpected decrease in interpalpebral fissure height was noted. CONCLUSIONS: Freeman-Sheldon syndrome with blepharophimosis is very rare. It was necessary to correct blepharoptosis, telecanthus, and blepharophimosis in the oculoplastic service in this case.
Blepharophimosis ; Blepharoptosis ; Child, Preschool ; Female ; Humans ; Microstomia

OBJECTIVE: The lack of anatomical knowledge for the anterior cervical microforaminotomy is liable to injure the neurovascular structures. The surgical anatomy is examined with special attention to the ventral aspect exposed in anterior cervical microforaminotomy. METHODS: In 16 adult formalin fixed cadaveric cervical spine, the author measured the distances from the medical margin of the longus colli to the medical wall of the ipsilateral vertebral artery and the angle for the ipsilateral vertebral artery. The distances from the lateral margin of the posterior longitudinal ligament to the medial margin of the ipsilateral medial wall of the vertebral artery, to the ipsilateral dorsal root ganglion was measured too. RESULTS: The distance from the medial margin of the longus colli to the ipsilateral vertebral artery was 13.3~14.7mm and the angle for the ipsilateral vertebral artery was 41~42.5 degrees. The range of distance from the lateral margin of the posterior longitudinal ligament to the ipsilateral vertebral artery was 11.9~16.1mm, to the ipsilateral dorsal root ganglion was 11.6~12.9mm. CONCLUSION: These data will aid in reducing neurovascular injury during anterior cervical approaches.
Adult ; Cadaver ; Formaldehyde ; Ganglia, Spinal ; Humans ; Longitudinal Ligaments ; Spine ; Vertebral Artery