OBJECTIVE: Internal carotid artery (ICA) trunk aneurysms are rare constituting about 0.9 to 6.5% of all ICA aneurysms. They may arise from medial, lateral, ventral (posterior) or dorsal (anterior) walls of ICA. The most frequent site of origin is dorsomedial, followed by dorsal, dorsolateral and ventromedial wall. ICA dorsal wall aneurysms can be divided into the saccular type and blister type, which have different shapes, wall histological features and surgical tactics. The authors report an analysis of 27 cases of ICA trunk aneurysms treated with surgical clipping or GDC embolization. METHODS: Of 145 cases of ICA aneurysms from May 1998 to December 2005, we found 27 cases (17.5%) of such unusual aneurysms located at nonbranching sites of the intradural ICA. Features of neuroimagings and medical records were analyzed. RESULTS: Out of 27 aneurysms, 10 were located at ICA dorsal wall, 8 aneurysms were developed at ICA medialwall. Seven aneurysms originated from ICA ventral wall. Seven cases presented with subarachnoid hemorrhage and 20 cases were found unruptured. Two patients had blister-like aneurysm, and the others had saccular aneurysms. All patients were treated successfully with microsurgical clippings or GDC embolization. Microsurgical clipping were performed in 14 cases and among them, removal of anterior clinoid process was done in 12 cases. Eleven aneurysms were occluded with detachabel coil. Two patients underwent balloon occlusion of ICA. Blister aneurysm was clipped including a portion of the normal ICA wall. Good outcomes were obtained in 25 patients, and two patients were dead. CONCLUSION: ICA trunk aneurysms are developed at any site of ICA circumference. Therefore we consider a variety of treatment strategies. On clipping of aneurysms at proximal ICA trunk, removal of anterior clinoid process is important. Endovascular treatment may be good an alternative. However, surgical treatment is essential for blister like aneurysms.
Aneurysm* ; Balloon Occlusion ; Blister ; Carotid Artery, Internal* ; Humans ; Intracranial Aneurysm ; Medical Records ; Subarachnoid Hemorrhage ; Surgical Instruments

Fibrous dysplasia in the orbit and cranial base may involve the optic canal. Although fibrous dysplasia is benign, it may produce a mass effect along the course of the optic nerve which can then induce visual disturbance as well as contour deformities of the skull and facial bone. The treatment of fibrous dysplasia in the orbit and cranial base is to resect the lesion as much as possible and then reconstruct immediately. As well, if there is any evidence of optic canal involvement and disease progression, the treatment of fibrous dysplasia may include optic nerve decompression. It is generally understood that some patients experience improvement of visual function after optic nerve decompression. We performed radical excision and reconstruction by means of autogenous calvarial bone graft and methylmethacrylate in 7 cases. The autogenous calvarial bone was used to reconstruct the orbit. The methylmethacrylate was used to reconstruct bony defect in the temporal area. The orbit was reconstruced into one block which was made of autogenous calvarial bone with a microplate and screw. This method is superior compared to the previous multifragment wiring method with regard to stability, operation time, and appearance. The patients in our series showed satisfactory appearance. In 6 cases, we performed optic nerve decompression. Therapeutic optic nerve decompression was done in 3 cases and prophylatic optic nerve decompression was done in the others. Following therapeutic optic nerve decompression, visual acuity was improved in 2 cases while the others showed a decrease in visual acuity. There was no change of visual acuity and visual field in 1 case after prophylactic optic nerve decompression. However, the others showed decrements in visual acuity or visual field. Therefore, we believe that more attention should be paid during optic nerve decompression procedure and strict indications to that procedure should be applied.
Congenital Abnormalities ; Decompression* ; Disease Progression ; Facial Bones ; Humans ; Methylmethacrylate ; Optic Nerve ; Orbit* ; Skull ; Skull Base* ; Transplants ; Visual Acuity ; Visual Fields

No abstract available.
Anti-Infective Agents* ; Staphylococcus aureus* ; Staphylococcus*

The authors performed prospectively the transcranial Doppler monitoring of bilateral anterior and middle cerebral arteries in 15 patients with ruptured cerebral aneurysm. The entry criteria for the study were confined to the patients who were admitted within 3 days after bleeding and had clinical grades of I, II, or III. The mean frequency shifts of bilateral anterior and middle cerebral arteries were increased immediately after ictus and showed continous further elevation between the 3rd and 8th rupture days. After that, they normalized slowly. The increase of frequency shift preceded clinical ischemic symptoms and an early steep increase of frequency shift was correlated to a high chance for suffering delayed ischemic deficits. The thick clots in subarachnoid cisterns shown on CT scans taken within the third rupture day were correlated well to the severe increase of frequency shifts. The aggressive treatment was done on asymptomatic patients who showed relatively rapid increase of frequency shifts, and they had shown no or trasient mild ischemic symptoms.
Hemorrhage ; Humans ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Prospective Studies ; Rupture ; Tomography, X-Ray Computed

PURPOSE: This study was done to investigate the mediation effects of cognitive emotion regulation on influences of self-differentiation and family function in high school students' problem behavior. METHODS: Study design was a cross-sectional descriptive analysis of causal research. A survey was conducted with 194 students in a C city high school. Data were analyzed using SPSS 21.0 and AMOS 21.0. RESULTS: There were direct effects of self-differentiation (β= -.39, p<.001), adaptive cognitive emotion regulation strategies (β=-.16, p=.004) and maladaptive cognitive emotion regulation strategies (β=.34, p<.001) on problem behavior in these students. A mediator effect was found for self-differentiation, as it had a direct impact on the maladaptive cognitive emotion regulation strategy (β=-.15, p=.014), which then had a direct impact on problem behavior. However, family function had no direct impact on both the maladaptive cognitive emotion regulation strategy and the adaptive cognitive emotion regulation strategy and on problem behavior, no mediator effect was observed. Explanatory power of these variables for problem behavior was 48.0%. CONCLUSION: Study findings suggest that to intervene for problem behavior in high school students, there is a need to develop and utilize programs that not only intervene for self-differentiation but also decrease high school students' use of non-adaptive cognitive emotion regulation.
Humans ; Negotiating* ; Problem Behavior*

Multiple cerebral aneurysms reportedly account for 14-33 % of all cerebral aneurysms. The incidence of multiple aneurysms has been increasing with development of radiological diagnostic tools such as magnetic resonance angiography, digital subtraction angiography and three dimension computed tomography. However, multiple aneurysms arising from same parent artery are uncommon. We have found only a few references as to diagnosis and surgical treatment of such lesions in the literature. Multiple separate aneurysms on same parent artery have been found most frequently on internal carotid artery 2, and then from middle cerebral artery (MCA). Those lesions arising from anterior communicating artery (ACoA) are rare. We report 7 cases (5.21%) of multiple aneurysms developed separately on ACoA and describe angiographic and operative finding of these rare lesions. One hundred and thirty four ACoA aneurysms were operated in our hospital from May 1997 to November 2004. There were only 7 patients with multiple aneurysms on ACoA. Out of 7 cases, four were diagnosed preoperatively and the other 2 were found intraoperatively. Multiple aneurysms may be associated with familiar aneurysms or arteriovenous malformations, however, there was no such case in our series. All patients were treated successfully with single or multiple clippings. Despite the advanced technology in radiological examinations, these lesions may not be detected on preoperative study. Close proximity or smaller size of the lesion may be responsible for the preoperative false negative angiographic findings. It is recommended to keep this possibility in mind during aneurysm surgery. Careful dissection is mandatory to ensure the completeness of aneurysm surgery.
Aneurysm* ; Angiography ; Angiography, Digital Subtraction ; Arteries* ; Arteriovenous Malformations ; Carotid Artery, Internal ; Diagnosis ; Humans ; Incidence ; Intracranial Aneurysm ; Magnetic Resonance Angiography ; Middle Cerebral Artery ; Parents

Multiple cerebral aneurysms reportedly account for 14-33 % of all cerebral aneurysms. The incidence of multiple aneurysms has been increasing with development of radiological diagnostic tools such as magnetic resonance angiography, digital subtraction angiography and three dimension computed tomography. However, multiple aneurysms arising from same parent artery are uncommon. We have found only a few references as to diagnosis and surgical treatment of such lesions in the literature. Multiple separate aneurysms on same parent artery have been found most frequently on internal carotid artery 2, and then from middle cerebral artery (MCA). Those lesions arising from anterior communicating artery (ACoA) are rare. We report 7 cases (5.21%) of multiple aneurysms developed separately on ACoA and describe angiographic and operative finding of these rare lesions. One hundred and thirty four ACoA aneurysms were operated in our hospital from May 1997 to November 2004. There were only 7 patients with multiple aneurysms on ACoA. Out of 7 cases, four were diagnosed preoperatively and the other 2 were found intraoperatively. Multiple aneurysms may be associated with familiar aneurysms or arteriovenous malformations, however, there was no such case in our series. All patients were treated successfully with single or multiple clippings. Despite the advanced technology in radiological examinations, these lesions may not be detected on preoperative study. Close proximity or smaller size of the lesion may be responsible for the preoperative false negative angiographic findings. It is recommended to keep this possibility in mind during aneurysm surgery. Careful dissection is mandatory to ensure the completeness of aneurysm surgery.
Aneurysm* ; Angiography ; Angiography, Digital Subtraction ; Arteries* ; Arteriovenous Malformations ; Carotid Artery, Internal ; Diagnosis ; Humans ; Incidence ; Intracranial Aneurysm ; Magnetic Resonance Angiography ; Middle Cerebral Artery ; Parents

Therapeutic irradiation can induce angiosarcoma. Radiation-induced angiosarcoma constitutes 20% of all angiosarcomas. Although its common site of origin is the skin and subcutaneous tissue, it rarely arises in small or large bowels with a presentation as multifocal abdominal angiosarcomatosis. We report a case of intra-abdominal angiosarcomatosis involving the jejunum, ileum, transverse colon, mesentery and right ovary in a 63-year-old female. It developed 10 years after therapeutic irradiation for squamous cell carcinoma of uterine cervix. She developed panperitonitis due to intestinal perforation. She died from sepsis 3 days after segmental resection of the small bowel and right oophorectomy. We reviewed the previously reported cases and describe the clinicopathologic features of this tumor.
Carcinoma, Squamous Cell ; Cervix Uteri ; Colon, Transverse ; Female ; Hemangiosarcoma ; Humans ; Ileum ; Intestinal Perforation ; Jejunum ; Mesentery ; Middle Aged ; Ovariectomy ; Ovary ; Sepsis ; Skin ; Subcutaneous Tissue

Epinephrine ; Pulmonary Edema