The occipitofrontalis muscle is generally regarded as one muscle composed of two muscle bellies joined through the galea aponeurotica. However, two muscle bellies have different embryological origin, anatomical function and innervations. We report a case of angiosarcoma of the scalp in a 63-year-old man whose MR showed that the superficial fascia overlying the occipital belly becomes the temporoparietal fascia and ends at the superior end of the frontal belly. Beneath the superficial fascia, the occipital belly of the occipitofrontalis muscle becomes the galea aponeurotica and inserts into the underside of the frontal belly. The presented case report supported the concept of which the occipitofrontalis muscle appears to be composed of two anatomically different muscles.
Fascia* ; Hemangiosarcoma* ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Muscles* ; Scalp ; Subcutaneous Tissue

Although most cases of posterior reversible encephalopathy syndrome (PRES) are reversible, irreversible lesions as a form of hemorrhage or infarction have been described. PRES as a complication of systemic lupus erythematosus (PRES-SLE) is associated with hypertension or use of immunosuppressive agents. We present a case of recurrent atypical PRES-SLE, which showed restricted diffusion in the first manifestation of SLE, resulted in parenchymal hemorrhagic transformations in the recurrent episode.
Diffusion ; Hemorrhage ; Humans ; Hypertension ; Immunosuppressive Agents ; Infarction ; Lupus Erythematosus, Systemic

The medial longitudinal fasciculus (MLF) is myelinated composite tract, lying near the midline, ventral to periaqueductal grey matter that plays a key role in coordinating eye movements. A lesion of the MLF results in an ipsilateral adduction deficit and a contralateral abducting nystagmus, referred to as an internuclear ophthalmoparesis. The blended tract with adjacent white matter in pons and midbrain is indistinguishable on brain imaging such as CT and MRI. Until now, to the best of our knowledge, MLF is not delineated on in vivo MRI. We present a case showing the whole connecting courses of MLF lesion on MRI in a patient with inflammatory demyelinating disorder.
Deception ; Demyelinating Diseases ; Eye Movements ; Humans ; Magnetic Resonance Imaging* ; Mesencephalon ; Myelin Sheath ; Neuroimaging ; Ophthalmoplegia* ; Pons

An 18-year-old man presented as marked proteinuria on urinalysis. Abdominal ultrasonography and computed tomography indicated the presense of horseshoe kidney without any other abnormalities. A percutaneous computed tomography (CT) guided renal biopsy was done. Of 6 glomeruli obtained, global sclerosis was found in 2. Some segments of affected glomerulus showed peripheral solidifications and focal hyalinosis, which are Periodic acid-Schiff and Masson Trichrome stain positive. The diagnosis of horseshoe kidney with focal segmental glomerulosclerosis (FSGS) was made by clinical and pathological findings. The authors report here a case of FSGS occurring in horseshoe kidney which has not yet been reported in Korea.
Adolescent ; Azo Compounds ; Biopsy ; Eosine Yellowish-(YS) ; Glomerulonephritis ; Glomerulosclerosis, Focal Segmental ; Humans ; Kidney ; Korea ; Methyl Green ; Proteinuria ; Sclerosis ; Urinalysis

A 61-year-old man was admitted to the emergency room complaining of a severe left exophthalmos caused by frontal and ethmoid sinus mucoceles that were visualized on a brain computerized tomogram. In addition, he had coexisting ankylosing spondylitis with a 20 year duration that resulted in total fixation of the cervical spine and progressive thoracic kyphosis. An unruptured anterior communicating artery aneurysm was found incidentally on the cerebral angiogram. We report that the anesthetic management for endoscopic sinus surgery of a frontal sinus mucocele in a patient with coexisting severe cervical spine ankylosing spondylitis and an unruptured cerebral aneurysm requires a detailed preoperative assessment of the airway, cardiac, pulmonary, and neurologic system. This case highlights the need for careful measures to avoid rupturing the cerebral aneurysm by the increased blood pressure induced by endotracheal intubation and the infiltration of an epinephrine-containing local anesthetic.
Blood Pressure ; Brain ; Emergencies ; Ethmoid Sinus ; Exophthalmos ; Frontal Sinus ; Humans ; Intracranial Aneurysm ; Intubation, Intratracheal ; Kyphosis ; Middle Aged ; Mucocele ; Spine ; Spondylitis, Ankylosing

A 51-year-old man developed anterograde amnesia following the ingestion of glufosinate ammonium. Brain MRI revealed hyperintense lesions involving the bilateral hippocampus and parahippocampal gyrus, and the right occipital lobe. The mechanism underlying acute glufosinate ammonium intoxication and the differential diagnosis of hippocampal lesions are discussed.
Ammonium Compounds* ; Amnesia, Anterograde* ; Brain ; Diagnosis, Differential ; Eating ; Herbicides ; Hippocampus* ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Occipital Lobe ; Parahippocampal Gyrus ; Poisoning

OBJECTIVES: In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. METHODS: This research introduces the development conditions of hospital information system at Gachon University Gil hospital, information about the development of the enterprise resource planning (ERP), a medical service process improvement system, and the personal health record (PHR) system. RESULTS: The medical service process and work efficiency were improved through the medical service process improvement system, which is the most common hospital information system at Gachon University Gil hospital and which includes an emergency medical service system, an online evaluation system and a round support system. CONCLUSIONS: Gachon University Gil hospital developed medical service improvement systems to increase work efficiency of medical team and optimized the systems to prove the availability of high-quality medical services for patients and their families. The PHR-based personalized health care solution is under development and will provide higher quality medical service for more patients in the future.
Delivery of Health Care ; Electronic Health Records ; Emergency Medical Services ; Health Records, Personal ; Hospital Information Systems ; Humans ; Information Systems ; Management Information Systems ; Quality of Health Care

PURPOSE: Fentanyl was reported to inhibit the alpha1-adrenoceptor agonist-induced contraction. The goal of this in vitro study was to identify the alpha1-adrenoceptor subtype primarily involved in the fentanyl-induced attenuation of phenylephrine-induced contraction in isolated endothelium-denuded rat aorta. MATERIALS AND METHODS: Aortic rings were suspended in order to record isometric tension. Concentration-response curves for phenylephrine (10-9 to 10-5 M) were generated in the presence or absence of one of the following drugs: fentanyl (3x10-7, 10-6, 3x10-6 M), 5-methylurapidil (3x10-8, 10-7, 3x10-7 M), chloroethylclonidine (10-5 M) and BMY 7378 (3x10-9, 10-8, 3x10-8 M). Phenylephrine concentration-response curves were generated in the presence or absence of fentanyl in rings pretreated with either 3x10-9 M prazosin, 10-9 M 5-methylurapidil or 3x10-9 M BMY 7378. RESULTS: Fentanyl (10-6, 3x10-6 M) attenuated phenylephrine-induced contraction in the rat aorta. 5-Methylurapidil and BMY 7378 produced a parallel rightward shift in the phenylephrine concentration-response curve. The pA2 values for 5-methylurapidil and BMY 7378 were estimated to be 7.71 +/- 0.15 and 8.99 +/- 0.24, respectively. Fentanyl (10-6 M) attenuated phenylephrine-induced contraction in rings pretreated with 10-9 M 5-methylurapidil, but did not alter the rings when pretreated with 3x10-9 M BMY 7378. Pretreatment of the rings with chloroethylclonidine showed a 72.9 +/- 2.3% reduction in phenylephrine-induced maximal contraction. CONCLUSION: The results suggest that fentanyl attenuates phenylephrine-induced contraction by inhibiting the pathway involved in the alpha1D-adrenoceptor-mediated contraction of the rat aorta.
Adrenergic alpha-Agonists/*pharmacology ; Adrenergic alpha-Antagonists/*pharmacology ; Animals ; Aorta/*drug effects ; Clonidine/analogs & derivatives/pharmacology ; Fentanyl/*pharmacology ; Male ; Phenylephrine/*pharmacology ; Piperazines/pharmacology ; Rats ; Rats, Sprague-Dawley ; Vasoconstriction/*drug effects

Brain damage resulting from perinatal cerebral hypoxia and ischemia is a major cause of acute mortality and neurological disabilities, including cerebral palsy (CP) and cognitive dysfunction. In order to establish an experimental hypoxia-ischemia (HI) model of CP for the screening of therapeutics, we operated bilateral common carotid artery ligation (BCAO) and monolateral carotid artery occlusion (MCAO), followed by 15 min of hypoxia (8% oxygen) in 4-day-old rats, and evaluated neurobehavioral disorders. After surgery, the survival rates of male and female BCAO rats were 33.3 and 7.1%, respectively, whereas 100% and 82.4% MCAO rats survived. In neurobehavioral performances, both male and female BCAO rats showed delayed achievement of righting reflex, in contrast to a negligible effect in MACO animals. However, both BCAO and MCAO rats exhibited impairment of cliff avoidance performances, although the physical dysfunction was more severe in BCAO than in MCAO. In global locomotor activity, MCAO rats also displayed decreased fast-moving time comparable BCAO animals, and increased resting and slow-moving times. In addition, MCAO rats showed marked learning and memory deficit in passive avoidance performances, similar to BCAO animals. From immunostaining analyses, severe degradation and loss of myelin basic proteins were observed in the brain of BCAO rats, in contrast to a mild aggregation in MCAO animals. Therefore, it is suggested that MCAO should be a more suitable CP model than BCAO, based on the high survival rate, relatively-mild brain injury, and enough neurobehavioral disorders for the research on preventive and therapeutic compounds.
Achievement ; Animals ; Anoxia ; Brain ; Brain Injuries ; Carotid Arteries ; Carotid Artery, Common ; Cerebral Palsy ; Demyelinating Diseases ; Female ; Humans ; Hypoxia, Brain ; Infant ; Ischemia ; Learning ; Ligation ; Male ; Mass Screening ; Memory Disorders ; Models, Theoretical ; Motor Activity ; Myelin Basic Protein ; Rats ; Reflex, Righting ; Survival Rate

An anorectal foreign body can cause serious complications such as incontinence, rectal perforation, peritonitis, or pelvic abscess, so it should be managed immediately. We experienced two cases of operative treatment for a self-inserted anorectal foreign body. In one, the foreign body could not be removed as it was completely impacted in the anal canal. We failed to remove it through the anus. A laparotomy and removal of the foreign body was performed by using an incision on the rectum. Primary colsure and a sigmoid loop colostomy were done. A colostomy take-down was done after three months. The other was a rectal perforation from anal masturbation with a plastic device. We performed primary repair of the perforated rectosigmoid colon, and we didea sigmoid loop colostom. A colostomy take-down was done three months later. Immediate and proper treatment for a self-inserted anorectal foreign body is important to prevent severe complications, and we report successful surgical treatments for problems caused by anorectal foreign bodies.
Abscess ; Anal Canal ; Colon ; Colon, Sigmoid ; Colostomy ; Foreign Bodies ; Laparotomy ; Masturbation ; Peritonitis ; Plastics ; Rectum