• Title/Summary/Keyword: Vena cava, inferior

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Posterior Transvertebral Extension Osteotomy - A Case Report - (후방 추체 경유 신전 절골술 - 증 례 보 고 -)

  • Jung, Ho;Kim, Yong-Seog;Park, Moon-Sun;Ha, Ho-Gyun;Lee, Jong-Sun;Kim, Ju-Seung
    • Journal of Korean Neurosurgical Society
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    • v.29 no.9
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    • pp.1262-1266
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    • 2000
  • Objective : Flat back syndrome constitutes a syndrome complex characterized by the loss of normal lumbar lordosis. Various techniques of correction for flat back syndrome have been reported. Posterior extension osteotomy has certain drawbacks. Forceful hyperextension of the spine may result in vascular complications such as rupture of the aorta or the inferior vena cava and stretching of superior mesenteric artery, and pseudoarthrosis. We describe a rationale and technique of transvertebral posterior extension osteotomy to avoid complications of posterior extension osteotomy and to achieve an correction of 30 degrees of flat back syndrome. Method : A 63-year-old woman with degenerative lumbar kyphosis presented with low back pain, thigh pain, knee pain and walking difficulty. Transpedicular fixation from L1 vertebra to S1 vertebra was accomplished for lumbar degenerative kyphosis. After 6 months, the patient presented with flat back syndrome. A second operation was performed with transvertebral posterior extension osteotomy. Result : With short segemental fusion, early bone fusion and correction of 30 degrees were achieved. Conclusion : Transvertebral posterior extension osteotomy provide an 30-60 degrees of correction of flat back syndrome. This technique is considered to be good method for the revision of lumbar degenerative kyphosis.

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The Iliac Fossa Transplant as an Acute Rejection Model in Porcine Kidney Transplantation: a Tool for the Safety Study of the Stem Cell- induced Humanized Tissue (돼지 장기이식에서 급성거부반응 연구에 효과적인 엉덩오목이식 동물모델: 줄기세포유래 Humanized 조직의 안전성 평가모델)

  • Kwak, Ho-Hyun;Nam, Hyun-Suk;Woo, Heung-Myong
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.63-70
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    • 2011
  • To consider the iliac fossa as the vascular anastomosis site of kidney transplantation for the short-term study of acute rejection in pigs. Twelve domestic pigs weighing 39~48 kg underwent heterotopic renal allgraft transplantation. The experimental animals were divided into 2 groups in terms of renal vascular anastomosis site; the external iliac artery and vein were used in iliac fossa model (n = 6), the abdominal aorta and the caudal vena cava inferior to the kidney were used in abdominal cavity model (n = 6). Renal function was evaluated by daily measurement of plasma creatinine and BUN concentrations. The experiments' health including postoperative complications was also assessed daily for 8 days after transplantation. After euthanazation gross and histopathologic analysis was performed. All six pigs in iliac fossa model developed neuropraxia and lameness of the ipsilateral pelvic limb. However, no necrosis was observed in any pigs. In the abdominal cavity model, durations of both the surgical operation and the vascular anastomosis were significantly longer than those in the iliac fossa model. Furthermore, ischemia injury of the transplanted kidney was increased in abdominal cavity model, which induced accelerated-acute immune response from day 4 after transplantation. Despite of pelvic limb complication, the iliac fossa model showed more advantages including not only less ischemia time related to easy vascular anastomosis, but also less immune response during the acute rejection period. The results indicate that the iliac fossa model may be appropriate to the study of acute rejection in porcine kidney transplantation.

A Case of Scimitar Syndrome (Adult Form) (성인형 Scimitar 증후군 1예)

  • Kim, Woo-Gyu;Kim, Jeong-Kyung;Jeon, Seong-Hee;Lim, Dal-Soo;Min, Cheol-Hong;Park, Hun-Sik;Lim, Byung-Sung;Hong, Suk-Keun;Hwang, Hweung-Kon;Kim, Mi-Young
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.259-264
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    • 1999
  • The scimitar syndrome, a rare complex anomaly, is defined as an anomalous right pulmonary venous drainage, partial or complete, to the inferior vena cava. The shape of the Turkish curved sword (scimitar) has provided the name of this syndrome. Additional characteristics of this syndrome such as hypoplasia of the right lung and of the right pulmonary arterial tree, anomalous arterial supply of the right lung from the aorta, dextrocardia and bronchial anomalies are common. Recently we experienced a case of scimitar syndrome (adult form) in a 19-year-old woman patient, so we report the case with a brief review of the literature.

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Hepatocellular Carcinoma with Right Atrial Invasion Detected by PET/CT (우심방에 침범한 간세포암을 PET/CT로 진단한 1예)

  • Kim, Ji-Hoon;Kim, Eun-Sil;Yu, Ji-Won;Ahn, Seok-Jin;Jung, Jun-Oh;Kim, So-Yon;Kim, Young-Jung
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.5
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    • pp.414-418
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    • 2008
  • The role of positron emission tomography (PET) with F-18 fluorodeoxyglucose (F-18 FDG) in the diagnosis of hepatocellulcar carcinoma (HCC) has been limited because of a variable FDG uptake in HCC. However, the usefulness of PET/CT for detecting extrahepatic metastasis and monitoring of the treatment response in HCC has been reported. A 55-year-old man with a hepatitis B surface antigen-positive, was admitted to our hospital due to dyspnea, general weakness and body weight loss for one month. Chest X-ray showed multiple reticulo-nodular densities on both lower lung fields, which implies metastatic lesions. F-18 FDG PET/CT revealed consecutively intense hypermetabolic mass in right hepatic lobe, inferior vena cava and right atrium. We report a case of HCC with IVC and right atrium invasion identified by F-18 FDG PET/CT.

Effects of Ethanol Administration on Glutathione and Lipid Peroxide Levels in Rat Liver and Cerebellum (에탄을 공급이 흰쥐 조직중의 Glutathione 및 지질산화 수준에 미치는 영향)

  • 이정원
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.20 no.4
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    • pp.285-292
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    • 1991
  • The effects of acute and chronic ethanol administration on hepatic and cerebellar glutathione (GSH) statuses and lipid peroxide levels in rats were investigated. In the liver, chronic ethanol feeding (6.9 g/kg, per day) as 10% (v/v) drinking water for 4 weeks produced a slight decrease of total GSH and an increase in the ratio of GSSG/total GSH without change of GSSG (oxidized GSH). Lipid peroxide level however was not modified. Many other studies have shown the acute ethanol loading effect in the rat liver, that is moderate decrease of total GSH and elevation of lipid peroxide level. Relating to this, it was observed that total GSH in the plasma obtained from post. hepatic inferior vena cava was increased by acute ethanol injection (50 mmol/kg, i.p.). This increased hepatic efflux of GSH into blood, in addition to the promoted antioxidative utilization of GSH, could be suggested as one of the possible reasons for the decrease of hepatic GSH induced by ethanol load. In the cerebellum, acute ethanol load did not change the total GSH and GSSG, but increased the lipid peroxidation rate. In the chronic, neither GSH pattern nor lipid peroxidation rate was changed.

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Blunt Abdominal Trauma in Children (소아 복부 외상에 관한 임상적 고찰)

  • Kim, Dong-Hyun;Seo, Sang-Hyuk;Lee, Nan-Joo;Chun, Yong-Soon
    • Advances in pediatric surgery
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    • v.13 no.2
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    • pp.119-126
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    • 2007
  • Trauma is one of the leading causes of death in children. Abdominal trauma is about 10 % of all pediatric trauma. This study describes the sex and age distribution, injury mechanism, site of intraabdominal injury, management and mortality of children aged 16 years or less who suffered abdominal trauma. The hospital records of 63 patients treated for abdominal injury between March 1997 and February 2007 at the department of surgery, Inje University Pusan Paik Hospital, were analyzed retrospectively. The peak age of incidence was between 2 and 10 years (78%) and this report showed male predominance(2.7:1). The most common mechanism of blunt abdominal trauma was pedestrian traffic accident (49%). The most common injured organ was liver. More than Grade IV injury of liver and spleen comprised of 4(12%) and 5(24%), respectively. Fourteen cases (22%) had multiple organ injuries. Forty nine cases (78%) were managed nonoperatively. Three patients (4.8%) died, who had Grade IV liver injury, Grade IV spleen injury, and liver and spleen injury with combined inferior vena cava injury, respectively. All of the three mortality cases had operative management. In conclusion, the liver or spleen injury which was more than Grade 4 might lead to mortality in spite of operation, although many cases could be improved by nonoperative management.

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A Case of Acute Lung Injury Complicated by Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma (간세포암의 간동맥 화학색전술 후 발생한 급성 폐손상 1예)

  • Cho, Se-Haeng;Kim, Joo-Hang;Kim, Byung-Soo;Jang, Joon
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.781-786
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    • 1995
  • Transcatheter arterial chemoembolization(TACE) was performed in a 61 year old male patient with hepatocellular carcinoma with 10 cc of Lipiodol and 50 mg of doxorubicin. Three days later, he complained of dyspnea and dry cough. The arterial blood gas study revealed moderate hypoxemia and hypocarbia. The chest PA showed acute pulmonary edema with bilateral pleural effusion. To rule out the possibilities of acute respiratory failure caused by infection, pulmonary embolism or congestive heart failure, we performed several laboratory studies. The blood and sputum culture studies revealed negative results for bacterial growth. The echocardiogram was normal. The abdominal CT scan and MR imaging revealed no thrombus or mass lesion in the inferior vena cava. So we concluded pulmonary oil embolism induced by lipiodol as the cause of acute lung injury. Four weeks later, clinical symptoms and chest x-ray were markedly improved with conservative care. We report a case of acute lung injury after TACE with lipiodol and doxorubicin, with review of literatures.

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An Experimental Study on the Heterotopic Canine Heart Transplantation: Pathologic Observation (동종 심장이식의 병리조직학적 연구)

  • 손광현;서경필;이영균
    • Journal of Chest Surgery
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    • v.2 no.2
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    • pp.155-166
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    • 1969
  • Heterotopic abdominal homograft of canine heart was carried out in 20 pairs of dogs. Of these 12 cases were subjected as a control and 8 were subjected to immunosuppressive group. The dosage of immunosuppressive agent was 5mg/kg/day of Imuran [Azathioprine] for 3 days preoperatively, 10mg/kg on operative day and 5mg/kg/day postoperatively. For reducing the metabolic demand, the donor heart was preserved in 4degree heparinized saline solution for approximately I4 minutes. In the most of the cases, transplantation was performed with the technique of end-to-side aorto-aortic anastomosis and end-to-side pulmonary artery-inferior vena cava anastomosis at the infrarenal portion. Five out of 20 grafted dogs were survived more than one day. The longest survived 18 days in the control group and survive more than 60 days in the treated group. The survival cases were 3 out of 8[37. 5%] in the group of dogs treated with lmuran and 2`out of 12 [16.6%] in the group of non-treated. A prominent gross findings of the grafted heart was a minimal to moderate degree of dilatation of the heart with or without thrombosis in the cardiac chambers and/or anastomotic site. The case number 10, 15, and 19 showed moderate hypertrophy in grossly. The microscopic findings were as follows; 1. There were early hypersensitive histologic reactions such as interstitial edema, cellular infiltrations and early degenerative changes in the myocardium in the cases of 3 hour survival. 2. In the cases of more than 6 hours survival, organizing thrombosis of myocardial vessels, vasculitis,myocardial necrosis and lymphocyte, plasma cell, round cell infiltrations were noted. In the cases of more than 12 hours survival, the degree of these histologic changes especially in the non-treated group were more intensified than in the treated. 3. In the cases which survived more than one day, so called homograft specific histologic changes were milder in the immunosuppressive group compared with the control. 4. All the host hearts showed no evidence of pathologic findings histologically. Among the homologous canine cardiac transplantation tissue reaction, was milder and suvival time longer in the group treated with immunosuppressive drug.

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Anemia of Chronic Liver Diseases (만성(慢性) 간질환(肝疾患)의 빈혈상(貧血像))

  • Shin, Hyun-Chung;Lee, Jhung-Sang;Koh, Chang-Soon;Lee, Mun-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.5 no.2
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    • pp.41-56
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    • 1971
  • The pathogenetic mechanisms of anemia in patients with chronic liver disease were observed. Seventeen patients with moderate to advanced hepatic diseass were studied by various methods. Only patients without previous blood loss were included: 14 had cirrhosis, 2 had active chronic hepatitis, and one had inferior vena cava obstruction with associated liver cirrhosis. The followings were the results: 1. The anemia based on red blood cell count, Hb., and Ht. was found in 76.5-78.6% of the patients. 2. Red cell indices indicated that normo-macrocytic and normochromic anemia was present is the majority of the patients. 3. No evidence of megaloblastic anemia was found on the basis of the morphological examinations. 4. Serum iron, TIBC, % saturation and iron content in the bone marrow indicated that iron deficiency anemia was present in about half of the patients. 5. In the view of the erythrocyte dynamics, primary increase in the red cell destruction was ascribed to the cause of the anemia. 6. Decrease in the red cell survival time was not correlated with MCV, % saturation and S.L. ratio. Also, hemoglobin level was not correlated with MCV, % saturation and $T_{50}Cr$. Therefore, multiple causes may be involved in the pathogenesis of the anemia. 7. Anemia as determined by the red cell volume was found in only 60% of the patients. It may be possible that hemodilutional anemia is present.

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Experimental Applications of in situ Liver Perfusion Machinery for the Study of Liver Disease

  • Choi, Won-Mook;Eun, Hyuk Soo;Lee, Young-Sun;Kim, Sun Jun;Kim, Myung-Ho;Lee, Jun-Hee;Shim, Young-Ri;Kim, Hee-Hoon;Kim, Ye Eun;Yi, Hyon-Seung;Jeong, Won-Il
    • Molecules and Cells
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    • v.42 no.1
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    • pp.45-55
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    • 2019
  • The liver is involved in a wide range of activities in vertebrates and some other animals, including metabolism, protein synthesis, detoxification, and the immune system. Until now, various methods have been devised to study liver diseases; however, each method has its own limitations. In situ liver perfusion machinery, originally developed in rats, has been successfully adapted to mice, enabling the study of liver diseases. Here we describe the protocol, which is a simple but widely applicable method for investigating the liver diseases. The liver is perfused in situ by cannulation of the portal vein and suprahepatic inferior vena cava (IVC), with antegrade closed circuit circulation completed by clamping the infrahepatic IVC. In situ liver perfusion can be utilized to evaluate immune cell migration and function, hemodynamics and related cellular reactions in each type of hepatic cells, and the metabolism of toxic or other compounds by changing the composition of the circulating media. In situ liver perfusion method maintains liver function and cell viability for up to 2 h. This study also describes an optional protocol using density-gradient centrifugation for the separation of different types of hepatic cells, allowing the determination of changes in each cell type. In summary, this method of in situ liver perfusion will be useful for studying liver diseases as a complement to other established methods.