Obstruction of the inferior vena cava may presented with unusual and varied pathologic condition and be due to thrombus, extension of tumor, extrinsic compression, or intrinsic caval disease. Thrombus is major cause of obstruction of the inferior vena cava and congenital absence of the inferior vena cava with azygos continuation is extremely rare. In congenital absence of the inferior vena cava (Infrahepatic interruption of inferior vena cava with azygos continuation), infrahepatic inferior vena cava is obliterated but infrarenal portion of the inferior vena cava is patent. In this anormaly, blood from the lower extremities and kidney drained into azygous vein and hemiazygous vein via ascending lumbar vein which eventually into the superior vena cava. These anormaly is seen in 0.6% of patients with congenital heart disease, particularly in cases of polysplenia. We experienced one case of congenital absence of the infrahepatic inferior vena cava, which involved infrarenal portion and the common iliac vein with azygos continuation in 63-year-old male. He was complained of lower abdominal pain, constipation. We report this case with reviewing literatures.
Abdominal Pain ; Constipation ; Heart Defects, Congenital ; Humans ; Iliac Vein ; Kidney ; Lower Extremity ; Male ; Middle Aged ; Thrombosis ; Veins ; Vena Cava, Inferior* ; Vena Cava, Superior

No abstract available.
Lymphohistiocytosis, Hemophagocytic*

PURPOSE: This study was conducted to determine the correlation between the incidence of chronic lung disease and the combined use of gentle ventilation and high-frequency ventilation. METHODS: The subject group consisted of 63 very low birthweight infants of less than 1500gm who were born and survived through ventilator treatment in the Fatima neonatal intensive care unit for four years from January 1995 to December 1998. The analysis was performed retrospectively with medical records. Ventilator treatment was based on the combined use of gentle ventilation and high-frequency ventilation by means of the flow interruptor type of Infant star. High- frequency ventilation was carried out for 24 hours after surfactant replacement, when PaCO2 exceeded 60mmHg, or if the period of gentle ventilation exceeded one week. When the results of arterial blood gas analysis and the state of the body became stable, the aggressive weaning was performed. RESULTS: For 49(77.8%) of 63 infants, the weaning was possible within seven days. The other 14 infants(22.2%) needed ventilator treatment for more than seven days. The mean duration of ventilator treatment was 12.3 days. The causes of weaning failure included sepsis, patent ductus arteriosus, chronic lung disease, and intraventricular hemorrhage. Two infants who had received ventialtor treatment for more than two weeks were found to have incidence of chronic lung disease. CONCLUSION: It is suggested that the combined use of gentle ventilation and high-frequency ventilation can help reduce pulmonary damage, and it will be important to shorten the period of ventilator treatment.
Blood Gas Analysis ; Ductus Arteriosus, Patent ; Hemorrhage ; High-Frequency Ventilation ; Humans ; Incidence* ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Lung Diseases* ; Lung* ; Medical Records ; Retrospective Studies ; Sepsis ; Ventilation* ; Ventilators, Mechanical ; Weaning

Familial combined hyperlipidemia is one af the manogenic disorders frequently found in humans and is seen in 0.5~2% of the general populatian, accounting for at least 10% of persons with pemature atlmmcletusis. The distinguishing feature of familial combined hyperlipidemia, in camparison with other single-gene abnarmalities of lipoprotein metabolism, is that not all affected members have the same plasma lipid phenotype; some individuals have an elevation of cholesterol concentration alane(type IIa lipoprotein pattern), while some athers have an elevation of triglyceride concentration alone(type IV pattem), and still others have elevations of both values(type IIb pattem). In any one persan, the lipid phenotype can change as a result of dietary or drug treatment. Familial combined hyperlipidemia should be suspected in those subjects with moderate hypertriglyceridemia and/or moderate hypercholestaolemia (lipoprotein types IIa, Ilb, IV), especially when premature coronary heart disease is evident in the family histary. Low plasma HDL-cholesterol, obesity, insulin resistance and hyperuricemia are often . Family members affected by familial combined hyperlipidemia should be identified and be treated, since tbe condition is associated with premature caronary heart diasease. We have found one family of familial combined hyperlipidemia with one member(case 1) associated with insulin resistance, hyperuricemia and gout, and another member(case 2) associated with diabetes mellitus and infertiTity.
Cholesterol ; Coronary Disease ; Diabetes Mellitus ; Gout ; Heart ; Humans ; Hyperlipidemia, Familial Combined* ; Hypertriglyceridemia ; Hyperuricemia ; Insulin Resistance ; Lipoproteins ; Metabolism ; Obesity ; Phenotype ; Plasma ; Triglycerides

PURPOSE: The purpose of this study was to develop a dental image processing system using a three-dimensional (3D) camera and stereovision technology. The reliability of the system for measuring axial wall convergence angles was evaluated. MATERIALS AND METHODS: The new system predicted 3D coordinate points from 2D images and calculated distances and angles between points. Two examiners measured axial wall convergence angles for seven artificial abutments using a traditional tracing-based method (TBM) and the stereovision-based method (SVBM). Five wax abutment models of simplified abutment forms were made and axial wall convergence angles of wax models were measured by both methods. The data were statistically analyzed at the level of significance, 0.05. RESULTS: Intraclass correlation coefficients showed excellent intra-examiner and inter-examiner reliabilities for both methods. Bland-Altman plots and paired t-tests showed significant differences between measurements and true values using TBM; differences were not significant with SVBM. CONCLUSION: This study found that the SVBM reflected true angle values more accurately than a TMB and illustrated an example of 3D computer science applied to clinical dentistry.
Dentistry

PURPOSE: In the early 1990's laparoscopic hernioplasty gained popularity worldwide. Thereafter, laparoscopic surgeons have attempted to improve cosmesis using single port surgery. This study aims to introduce and assess the safety and feasibility of single port laparoscopic total extraperitoneal (TEP) hernia repair with a nearly-scarless umbilical incision. METHODS: Sixty three single port laparoscopic TEP hernia repairs were performed in sixty patients from June 2010 to March 2011 at Incheon St. Mary's Hospital, with the use of a glove single-port device and standard laparoscopic instruments. Demographic and clinical data, intraoperative findings, and postoperative course were reviewed. RESULTS: Of the 63 hernias treated, 31 were right inguinal hernias, 26 were left inguinal hernias and 3 were both inguinal hernias. There was one conversion to conventional three port laparoscopic transabdominal preperitoneal hernioplasty. Mean operative time was 62 minutes (range, 32 to 150 minutes). There were no intraoperative complications. Postoperative complications occurred in two cases (wound seroma and urinary retension) and were successfully treated conservatively. Mean hospital stay was 2.15 days. CONCLUSION: Single port laparoscopic TEP hernia repair is safe and feasible. Umbilical incision provides an excellent cosmetic outcome. Prospective randomized studies comparing single port and conventional three port laparoscopic TEP repairs with short-term outcome and long-term recurrence rate are needed for confirmation.
Cosmetics ; Hernia ; Hernia, Inguinal ; Herniorrhaphy ; Humans ; Intraoperative Complications ; Length of Stay ; Operative Time ; Postoperative Complications ; Pyrazines ; Recurrence ; Seroma

PURPOSE: In the early 1990's laparoscopic hernioplasty gained popularity worldwide. Thereafter, laparoscopic surgeons have attempted to improve cosmesis using single port surgery. This study aims to introduce and assess the safety and feasibility of single port laparoscopic total extraperitoneal (TEP) hernia repair with a nearly-scarless umbilical incision. METHODS: Sixty three single port laparoscopic TEP hernia repairs were performed in sixty patients from June 2010 to March 2011 at Incheon St. Mary's Hospital, with the use of a glove single-port device and standard laparoscopic instruments. Demographic and clinical data, intraoperative findings, and postoperative course were reviewed. RESULTS: Of the 63 hernias treated, 31 were right inguinal hernias, 26 were left inguinal hernias and 3 were both inguinal hernias. There was one conversion to conventional three port laparoscopic transabdominal preperitoneal hernioplasty. Mean operative time was 62 minutes (range, 32 to 150 minutes). There were no intraoperative complications. Postoperative complications occurred in two cases (wound seroma and urinary retension) and were successfully treated conservatively. Mean hospital stay was 2.15 days. CONCLUSION: Single port laparoscopic TEP hernia repair is safe and feasible. Umbilical incision provides an excellent cosmetic outcome. Prospective randomized studies comparing single port and conventional three port laparoscopic TEP repairs with short-term outcome and long-term recurrence rate are needed for confirmation.
Cosmetics ; Hernia ; Hernia, Inguinal ; Herniorrhaphy ; Humans ; Intraoperative Complications ; Length of Stay ; Operative Time ; Postoperative Complications ; Pyrazines ; Recurrence ; Seroma

In order to test if nestin is a useful marker for various types of progenitor cells, we explored nestin expression in the retina during development. Nestin expression was co-evaluated with bromodeoxyuridine (BrdU) labeling and Griffonia simplicifolia isolectin B4 (GSIB4) histochemistry. Nestin immunoreactivity appears in cell soma of dividing neural progenitor cells and their leading processes in retinas from embryonic day (E) 13 to E20, in accordance with a BrdU-labeled pattern. At postnatal day (P) 5, it is restricted to the end feet of Muller cells. BrdU-labeled nuclei were mainly in the inner part of the inner nuclear layer in postnatal neonates. The retinal vessels demarcated with GSIB4-positive endothelial cells were first distributed in the nerve fiber layer from P3. Afterward the vascular branches sprouted and penetrated deeply into the retina. The endothelial cells positive for GSIB4 and the pericytes in the microvessels were additionally immunoreactive for nestin. Interestingly, the presumed migrating microglial cells showing only GSIB4 reactivity preceded the microvessels throughout the neuroblast layer during vascular sprouting and extension. These findings may suggest that nestin expression represents the proliferation and movement potential of the neural progenitor cells as well as the progenitor cells of the endothelial cell and the pericyte during retinal development. Thus, Muller glial cells might be potential neural progenitor cells of the retina, and the retinal microvasculature established by both the endothelial and the pericyte progenitor cells via vasculogenesis along microglia migrating routes sustains its angiogenic potential.
Bromodeoxyuridine ; Carisoprodol ; Endothelial Cells ; Foot ; Griffonia ; Humans ; Infant, Newborn ; Intermediate Filament Proteins ; Lectins ; Microglia ; Microvessels ; Nerve Fibers ; Nerve Tissue Proteins ; Neurogenesis ; Neuroglia ; Pericytes ; Plant Lectins ; Retina ; Retinal Vessels ; Retinaldehyde ; Stem Cells

PURPOSE: To report the treatment results of mass excision and cryotherapy in a case of bilateral conjunctival amyloidosis. CASE SUMMARY: A 72-year-old man with conjunctival mass and foreign body sensations in both eyes visited our clinic. He was previously diagnosed with conjunctival lymphoma after conjunctival biopsy at another hospital. A yellow-pink colored mass was observed in the bulbar conjunctiva. A repeated conjunctival biopsy revealed the mass to be amyloid, consistent with the cervical lymph node biopsy results, and the diagnosis was changed to primary systemic amyloidosis. The patient was treated with melphalan and prednisolone; however, the ocular pain, symblepharon, and conjunctival mass progressed. A 360 degree conjunctivoperiotomy, mass excision, and repeated cryotherapy were performed in the more severely affected left eye. The patient was followed for one year, and there were no complications or progression of the conjunctival lesion. CONCLUSIONS: Conjunctival amyloidosis requires local pathologic confirmation as well as a systemic work-up. If surgical removal is necessary despite systemic treatment, mass excision and cryotherapy may be effective.
Aged ; Amyloid ; Amyloidosis ; Biopsy ; Conjunctiva ; Cryotherapy ; Eye ; Foreign Bodies ; Humans ; Lymph Nodes ; Lymphoma ; Melphalan ; Sensation

It has been previously reported that parvalbumin expression was downregulated in AII amacrine cells, while upregulated in a subset of cone bipolar cells electrically synapse with AII amacrine cell in the streptozotocin-induced diabetic rat retina. In the present study, we aimed to trace biochemical changes of pre-synaptic neurons to AII amacrine cells in rat retina following diabetic injury. Diabetic condition was induced by streptozotocin injection into Sprague-Dawley rats aged of 8 weeks. The experimental term of induced diabetes was set at 1, 4, 12 and 24 weeks. Changes of pre-synaptic neurons were evaluated by immunohistochemistry and Western blot analysis with anti-protein kinase C (PKC)-alpha and anti-tyrosine hydroxylase (TH) antibodies. Rod bipolar cells immunolocalized with PKC-alpha antibody extended their enlarged axon terminals into stratum 5 of the inner plexiform layer. In later diabetes, the axon was shorten and its terminals of rod bipolar cell are slightly enlarged. The protein levels of PKC-alpha were slightly increased along with the duration of diabetes. TH immunoreactive neurons are morphologically classified into two subtypes of amacrine cells in the inner nuclear layer: one (type 1) has large soma with long and primary dendrites, classified with dopaminergic, and the other (type 2) has small soma with dendritic arborization. In the outermost inner plexiform layer, ring-like structures being composed of type 1 cell processes were densely distributed. In diabetic retina, the intensity of TH immunoreactivity in type 1 neurons was reduced. In accordance with morphological changes, the protein levels of TH were reduced during diabetes. These results demonstrate that TH immunoreactive dopaminergic amacrine cells are more susceptible to diabetic injury than the rod bipolar cells in the rat retina and may suggest that downregulation of parvalbumin expression in AII amacrine cells of diabetic retina is mainly due to dysfunction of pre-synaptic dopaminergic amacrine cells.
Amacrine Cells* ; Animals ; Antibodies ; Axons ; Blotting, Western ; Carisoprodol ; Dendrites ; Down-Regulation ; Immunohistochemistry ; Neurons* ; Phosphotransferases ; Presynaptic Terminals ; Rats* ; Rats, Sprague-Dawley ; Retina* ; Streptozocin ; Synapses