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

No abstract available.
Heterotaxy Syndrome*

No abstract available.
Anterior Cruciate Ligament* ; Patellar Ligament*

No abstract available.
Heart Septal Defects, Ventricular* ; Pulmonary Valve Stenosis*

No abstract available.

Chylous ascites in neonates is an unusual and etiologically poor understood entity. We report a male newborn who suffered from abdominal distension and respiratory distress after birth. Paracentesis was performed and ascitic fluid was obstained. Analysis of the fluid revealed cell count (RBC 10,000/mm3, WBC 800/mm3: segmented form-72%, lymphocyte form- 28%), protein 4,100 mg/dl, glucose 57 mg/dl, cholesterol 53 mg/dl, triglyceride 28 mg/dl. Culture of ascitic fluid grew no bacteria. A plain film of abdomen and abdominal sonogram showed massive ascites. On the 4th hospital day, gastrografin enema showed microcolon and ileal atresia. On the 6th hospital day, ileocolostomy has been performed and operative findings sho- wed blind pouch in terminal ileum, massive inflammation and extensive adhesion on peritoneum. After operation, he gained weight by continuous gavage feeding. He discharged on the 36th hospital day.
Abdomen ; Ascites ; Ascitic Fluid ; Bacteria ; Cell Count ; Cholesterol ; Chylous Ascites* ; Diatrizoate Meglumine ; Enema ; Glucose ; Humans ; Ileum ; Infant, Newborn ; Inflammation ; Lymphocytes ; Male ; Paracentesis ; Parturition ; Peritoneum ; Triglycerides

No abstract available.
Child* ; Heart Diseases* ; Heart* ; Humans ; Mass Screening*

High frequency jet ventilation(HFJV) induces adequate gas exchange with tidal volume smaller than that of other conventional ventilation method. In critically ill patients, HFJV reduces the unwanted hemodynamic effects of conventional ventilation caused by the increase in intrathoracic pressure. But general anesthesia with jet ventilator has been dependent only on intravenous anesthetics. Therefore, this study was done to administer inhalation anesthetics(N2O, enflurane) during HFJV. This study was carried out from June 1992 to January 1993 in the 64 operated patients who beIonged to ASA class I, II in Chung Ang University Hospital The 22 patients using conventional ventilation were control group and the other 42 patients who had inhalation anesthesia by using HFJV were experimental group. In all patients, blood pressure and heart rate were checked on preinduction, postinductive 0, 5, 10, 15, 20, and 30 minutes. The result were as follows I) Systolic blood pressure was increased just on postinduction in both groups(P<0.05). It was decreased from postinductive 5 minutes to 30 minutes in control group, but there was no change in experimental group(P<0.05). 2) Diastolic blood pressure was increaeed just on postinduction in both groups(P<0.05). But it was increased from postinductive 5 minutes to 30 minutes in experimental group(P<0.05). 3) Mean blood pressure was increased just on postinduction in both groups(P<0.05). It was increased from postinductive 5 minutes to 15 minutes in control group and from postinductive 5 minutes to 30 minutes in experimental group(P<0.05). 4) Heart rate was increased just on postinduction and postinductive 5 minutes in control groupg <0.05), and increased from postinductive 0 minute to postinductive 30 minutes in experimental group(P<0.05). 5) pH was increased on postinductive 30 minutes compared to that of preinduction in both groups(P <0.05). 6) PaCO2 was more decreased on postinductive 30 minutes than preinduction in both groups (P<0.05), but there was no clinical significance. And PaO2 was increased at postinductive 30 minutes(P<0.05), which resulted from the increase of FiO2. As above results, inhalation anesthesia with HFJV is supposed to be useful if the difficulty of controlling the concentration of inhalation anesthetics and the contamination of operating room by expelled inhalation anesthetics were solved.
Anesthesia, General ; Anesthesia, Inhalation* ; Anesthetics, Inhalation ; Anesthetics, Intravenous ; Blood Pressure ; Critical Illness ; Heart Rate ; Hemodynamics ; High-Frequency Jet Ventilation* ; Humans ; Hydrogen-Ion Concentration ; Inhalation* ; Operating Rooms ; Tidal Volume ; Ventilation ; Ventilators, Mechanical

Superficial migratory thrombophlebitis (SMT) represents multiple, tender, often cordlike nodules, usuallyion the legs but occationally on the arms. In some instances the nodules slowly migrate along the course of a vein. It can occur in association with carcinoma of internal organ or other diseases but also idiopathically. In 1865 Trousseau first wrote about that patients who have carcinoma involving an internal organ are prone to develop thrombophlebitis in one or more superficial veins so he drew attention to the fact that thrombophlebitis may be a first presenting sign of carcinomatosis. In fact, it is not uncommon for the ordinary thrombotic lesions to be observed several months or even a year before the carcinoma would otherwise diagnosed. So the clinical manifestation of SMT may be very important dermatologic finding to find hidden cancer of visceral organ. We present two cases of SMT, first case is a 25-year-old male patient who had multiple, tender nodules on both lower extremities and second case is 32-year-old male patient who had multiple, tender, linear, often cordlike nodules along the inner aspect of right lower extremity. Because we could not find any internal carcinoma or other diseas esexcept histories of hepatitis, we regard them as idiopathic type, but continuous follow up observation must be needed under the importance of possible presence of internal carcinoma.
Adult ; Arm ; Carcinoma ; Follow-Up Studies ; Hepatitis ; Humans ; Leg ; Lower Extremity ; Male ; Thrombophlebitis* ; Veins

Herpes Gestationis is a rare polymorphous, vesiculobullous disease of pregnancy and puerperium. It is characterized by rapidly progressive skin eruption heraled initially by severe generalized pruritus. Erythematous papules and urticaria like plaques rapidly appear followed by grouped, tense, vesiculobullous eruptions. A 23 year-old pregnant woman was admitted to our departrnent of dermatology hecause of erythematous patches with pruritic vesiculobullous and pustular eruption on the whole body since third week of conception, Biopsy specimen of bullous skin lesion showed spongiosis of epidermal cells, mild necrosis of basal cells, subepidermal bulla, edema, of papillary derrnis and perivascular infiltration of inflammatory cells. Ultrastructural findings showed mild necrosis of basal cells, bulla above or below basement membrane zone and partial separation of basal larnina. Direct immunofluorescences of bullous lesion and normal appearing skin demonstrated deposition of IgG in linear pattern along basement rnembra,ne zone. After treatment with systemic corticosteroid and antihistamin, the lesions were cleared, leaving residual hyperpigmentation, and she delivered normal female baby.
Basement Membrane ; Biopsy ; Blister ; Dermatology ; Edema ; Female ; Fertilization ; Fluorescent Antibody Technique, Direct ; Humans ; Hyperpigmentation ; Immunoglobulin G ; Necrosis ; Pemphigoid Gestationis* ; Postpartum Period ; Pregnancy ; Pregnant Women ; Pruritus ; Skin ; Transcutaneous Electric Nerve Stimulation ; Urticaria ; Young Adult