Ideal Internal Carotid Artery Trapping Technique without Bypass in a Patient with Insufficient Collateral Flow

Internal carotid artery (ICA) trapping can be used for treating intracranial giant aneurysm, blood blister-like aneurysms and ICA rupture during the surgery. We present a novel ICA trapping technique which can be used with insufficient collaterals flow via anterior communicating artery (AcoA) and posterior communicating artery (PcoA). A patient was admitted with severe headache and the cerebral angiography demonstrated a typical blood blister-like aneurysm at the contralateral side of PcoA. For trapping the aneurysm, the first clip was placed at the ICA just proximal to the aneurysm whereas the distal clip was placed obliquely proximal to the origin of the PcoA to preserve blood flow from the PcoA to the distal ICA. The patient was completely recovered with good collaterals filling to the right ICA territories via AcoA and PcoA. This technique may be an effective treatment option for trapping the aneurysm, especially when the PcoA preservation is mandatory.

Change of Anti-type II Collagen Antibody in Rheumatoid Arthritis and Degenerative Arthritis / 대한정형외과학회잡지

PURPOSE: To evaluate the chronological change of serum anti-type II collagen antibody level according to the type of immunoglobulin (i.e. IgG, IgM) in chronic arthritic patients. MATERIALS AND METHODS: The serum levels of anti-type II collagen antibody were determined in three groups (control, degenerative arthritis and rheumatoid arthritis) with ELISA method. In each person, the serum levels of antibody IgG, IgM against human, bovine and chicken type II collagens were determined separately. RESULTS: Since correlation coefficients of ELISA showed high values except in the case of denatured human collagen, ELISA test is regarded as reliable. In terms of denatured human collagen, no constant denaturation pattern induced variable results. With regards to chronological changes, there was no change of IgG titer in all three groups. IgM titer of control group was not varied according to time change. But IgM titer of arthritis group changed from time to time. Chronological changes of antibody titers depended on the types of antigen. In case of human collagen, there were changes of antibody titer in the degenerative arthritis and rheumatoid arthritis groups. And in the case of bovine collagen, change of antibody titer was observed only in the rheumatoid arthritis group. CONCLUSION: Chronological change of IgG titer was not observed in the arthritis group but IgM titer changes are observed in that group. Thus, it might be a topic of future research to evaluate the relationship between the chronological change of IgM antibody and disease aggravation.