An 84-year-old female presented with bilateral giant intracavernous carotid artery aneurysms manifesting as right total ophthalmoplegia and trigeminal nerve paresis. Computed tomography and magnetic resonance imaging showed the two aneurysms as one fused mass, so the initial diagnosis was a parasellar tumor occupying the bilateral cavernous sinuses. The correct diagnosis required cerebral angiography. Considering her age, no surgical or interventional treatment was given. Eight months later, her right eye movement partially recovered and she had no further symptoms. There was no definite causative factors other than aging in this case.

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A number of approaches have been proposed for the treatment of intracavernous giant aneurysms. In the present study, we have analyzed long-term surgical outcome of 27 consecutive cases of our ex-perience. All the cases were unruptured and symptomatic, showing symptoms such as extraocular movement disorder or visual disturbances. Thirteen cases were male and 14 cases were female. The age of the patients ranged between 11 and 75 years (average 52.2 years) and follow-up periods were between 1 and 20 years (average 7.7 years). Abducens nerve was disturbed in 20 cases, oculomotor nerve in 12 cases, optic nerve in six cases, trigeminal nerve in six cases, and trochlear nerve in five cases. In addi-tion to conventional angiography, three-dimensional computed tomographic angiography, balloon test occlusion (BTO), slow injection angiography, aneurysmography, and single photon emission computed tomography with BTO were used to determine a method of treatment. Therapeutic modalities of the present series were as follows: four cases were unoperated, common carotid artery ligation was per-formed in eight cases, internal carotid artery (IC) ligation in three cases, IC ligation plus superficial tem-poral artery (STA)-middle cerebral artery (MCA) anastomosis in four cases, IC ligation plus high flow vein bypass in three cases, IC trapping plus STA-MCA anastomosis in three cases, and direct clipping in two cases. Although two cases showed early and late ischemic complications, other cases demonstrat-ed improvement of cranial nerve dysfunction relatively soon after surgical treatment and long-term outcome was generally good. It is concluded that good long-term surgical outcome is obtained for in-tracavernous giant aneurysms by selecting adequate surgical treatment based upon careful preopera-tive evaluation of these aneurysms using sophisticated diagnostic methods.

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インクジェットの歴史を振り返るとともに，各方式の記録原理と特徴を説明する．さらにこれらの方式の現況を簡単に紹介する．次にインクジェットプリンタの基本性能向上と，課題解決のために1980年代から導入された新規技術，および導入の背景をまとめる．
シンプルなプロセスを特徴とした機能集中型のマーキング技術であるインクジェットは，主に基本構成要素技術の性能向上や機能付加に依存しながら発展し，応用領域を拡大してきた．基本構成要素技術の性能向上の鈍化が見られる現在，これまでの発展モデルでこれまでと同じ方向に進んだ場合，大きな成長は望めない．
今後もインクジェットの成長を持続するためには2つの進むべき道が残されている．1つは基本構成要素技術の性能向上による機能集中型のまま価値提供を続けられる応用へ成長の方向を変更することであり，もう1つは周辺技術を付加し，機能を分担してより上位の課題解決を図る，すなわち ｢機能分担型｣ マーキングへ成長モデルを変換することである．

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側脳室体中央部側方-放射冠に小梗塞の見られた17例について検討した.CT上多くは直径2cm弱で被殻上部にまで達している.性質を纒めると, (1) 発症から症状完成までに時間を要する例が多い. (2) 危険因子として高血圧, 耐糖能異常を持つ例が多い. (3) 血圧が良好にコントロールされている状態での発症が少なくない. (4) ヘマトクリットは必ずしも上昇していない. (5) 臨床症状は上肢, 特に遠位部に強いpure motor hemiplegiaの形をとる. (6) 内頸動脈siphonから前・中大脳動脈主幹部にかけての硬化所見の目立つ例が多い, となる. (5) は, 大脳皮質の上肢運動野から内包に至る線維がこの部を通っていることに起因するのであろう.その他は, 境界域あるいは終末枝梗塞の性質に該当する.これは中大脳動脈皮質枝と穿通枝の境界域または同穿通枝の終末枝領域の梗塞に相当するため, と考えられる.逆に緩徐進行性の上肢遠位部に強いpure motorhemiplegiaを呈する例ではこの部位の梗塞を考える必要があり, 臨床診断上有用な知見と考える.

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In natural disasters, the agricultural activity sometimes suffers enormous damage such as failure of an irri-gation tank and a water channel. To produce an agricultural commodity in such emergency circumstances, water has to be supplied by temporary works. In many cases, the water supply line is temporarily built from undamaged tanks or head works. In this paper, the selection method of the temporary irrigation water supply line with GIS was presented. The digital elevation model having 2.5 m resolution was used in GIS. The functions of GIS software were used as much as possible because the method has to be easily and quickly operated. Since the facility has to be constructed economically and rapidly, it was assumed that the water supply line would be constructed on the ground surface without excavation works and the gravity irrigation of a closed type pipeline would be adopted. For the siphon design, the location giving the high negative pressure was avoided. To examine the selected routes, the indexes indicating the ratio of positive pressure, the length of the line and the undulation of the route were introduced. It was found that the method using the information of elevation gave the economic route and the method using the gradient and slope direction information gave the safe and easy constructible route.

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肺葉切除後の胸腔ドレーンの挿入は必須の処置と考えられているが，胸腔ドレーンの留置は患者の疼痛の原因となり，体動制限や離床の妨げとなるため適正な使用が望まれる。待機的葉切除に対する術後回復強化プロトコルは未確立で効果を総括するのは時期尚早であるが，周術期管理の標準化には有用である。エビデンスに基づいた胸腔ドレーンの標準管理方法として以下の 7項目を推奨する。①胸腔ドレーンの挿入は 1本，②胸腔ドレーンの持続吸引については強いエビデンスはない，③術後胸部 X線撮影は選択的に行う，④胸腔ドレーンのルーチンのミルキングは推奨しない，⑤胸水の排液量は 24時間で体重の 5倍までなら胸腔ドレーン抜去に支障をきたさない可能性がある，⑥吸息時または呼気時のいずれかでバルサルバ法を用いた胸腔ドレーン抜去後の気胸の発生率に差を認めない，⑦デジタル胸腔ドレナージシステムは定量的評価が可能で管理の標準化に結び付く可能性がある。

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The author discribed mainly the position of the supratentorial larger vessels in relation to fixed points of the skull during the different periods of age growth. Our material of 100 carotid angiographies of normal children of up to the 15 years of age was compared with the data of other foreign authors. If the Neuropediatrician do not have any such accurate knowledge of the position according processes, they will give often false diagnosis angiographically. This might be serious problem for patients.
First of all, the most important thing is to get the accurate angiogram. This means the correct head fixation and accurate projection of the central x-ray to the children. Therefore, general anesthesia are almost necessary for the younger children. This thing might seems to be troublesome for Neuropediatrician, but they will get much informative data from these angiograms, if they performe these method above mentioned.
At this time, technical problem, the indication and side-effects had not been mentioned here. And also infratentorial vessel will discribe on the next time.

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