Laparoscopic liver resection utilizing the ventral avascular area of the inferior vena cava:A retrospective cohort study

BACKGROUND Laparoscopic liver resection(LLR)can be challenging due to the difficulty of establishing a retrohepatic tunnel under laparoscopy.Dissecting the third hepatic hilum before parenchymal transection often leads to significant liver mobilization,tumor compression,and bleeding from the short hepatic veins(SHVs).This study introduces a novel technique utilizing the ventral avascular area of the inferior vena cava(IVC),allowing SHVs to be addressed after parenchymal transection,thereby reducing surgical complexity and improving outcomes in in situ LLR.AIM To introduce and evaluate a novel LLR technique using the ventral avascular area of the IVC and compare its short-term outcomes with conventional methods.METHODS The clinical cohort data of patients with pathologically confirmed hepatocellular carcinoma or intrahepatic cholangiocarcinoma who underwent conventional LLR and novel LLR between July 2021 and July 2023 at the First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed.In novel LLR,we initially separated the caudate lobe from the IVC using dissecting forceps along the ventral avascular area of the IVC.Then,we transected the parenchyma of the left and right caudate lobes from the caudal side to the cephalic side using the avascular area as a marker.Subsequently,we addressed the SHVs and finally dissected the root of the right hepatic vein or left hepatic vein.The short-term postoperative outcomes and oncological results of the two approaches were evaluated and compared.RESULTS A total of 256 patients were included,with 150(58.59%)undergoing conventional LLR and 106(41.41%)undergoing novel LLR.The novel technique resulted in significantly larger tumor resections(6.47±2.96 cm vs 4.01±2.33 cm,P<0.001),shorter operative times(199.57±60.37 minutes vs 262.33±83.90 minutes,P<0.001),less intraoperative blood loss(206.92±37.09 mL vs 363.34±131.27 mL,P<0.001),and greater resection volume(345.11±31.40 mL vs 264.38±31.98 mL,P<0.001)compared to conventional LLR.CONCLUSION This novel technique enhances liver resection outcomes by reducing intraoperative complications such as bleeding and tumor compression.It facilitates a safer,in situ removal of complex liver tumors,even in challenging anatomical locations.Compared to conventional methods,this technique offers significant advantages,including reduced operative time,blood loss,and improved overall surgical efficiency.

Ash removal from inferior coal via ammonium fluoride roasting and simultaneous yield of white carbon black

The quality upgrading and deashing of inferior coal by chemical method still faces great challenges.The dangers of strong acid,strong alkali,waste water and exhaust gas as well as high cost limit its industrial production.This paper systematically investigates the ash reduction and desilicification of two typical inferior coal utilizing ammonium fluoride roasting method.Under the optimal conditions,for fat coal and gas coal,the deashing rates are 69.02%and 54.13%,and the desilicification rates are 92.64%and 90.27%,respectively.The molar dosage of ammonium fluoride remains consistent for both coals;however,the gas coal,characterized by a lower ash and silica content(less than half that of the fat coal),achieves optimum deashing effect at a reduced time and temperature.The majority of silicon in coal transforms into gaseous ammonium fluorosilicate,subsequently preparing nanoscale amorphous silica with a purity of 99.90%through ammonia precipitation.Most of the fluorine in deashed coal are assigned in inorganic minerals,suggesting the possibility of further fluorine and ash removal via flotation.This research provides a green and facile route to deash inferior coal and produce nano-scale white carbon black simultaneously.

Higher Grain-Filling Rate in Inferior Spikelets of Tolerant Rice Genotype Offset Grain Yield Loss under Post-Anthesis High Night Temperatures

Increased nighttime respiratory losses decrease the amount of photoassimilates available for plant growth and yield. We hypothesized that the increased respiratory carbon loss under high night temperatures(HNT) could be compensated for by increased photosynthesis during the day following HNT exposure. Two rice genotypes, Vandana(HNT-sensitive) and Nagina 22(HNT-tolerant), were exposed to HNT(4 ℃ above the control) from flowering to physiological maturity. They were assessed for alterations in the carbon balance of the source(flag leaf) and its subsequent impact on grain filling dynamics and the quality of spatially differentiated sinks(superior and inferior spikelets). Both genotypes exhibited significantly higher night respiration rates. However, only Nagina 22 compensated for the high respiration rates with an increased photosynthetic rate, resulting in a steady production of total dry matter under HNT. Nagina 22 also recorded a higher grain-filling rate, particularly at 5 and 10 d after flowering, with 1.5- and 4.0-fold increases in the translocation of ^(14)C sugars to the superior and inferior spikelets, respectively. The ratio of photosynthetic rate to respiratory rate on a leaf area basis was negatively correlated with spikelet sterility, resulting in a higher filled spikelet number and grain weight per plant, particularly for inferior grains in Nagina 22. Grain quality parameters such as head rice recovery, high-density grains, and gelatinization temperature were maintained in Nagina 22. An increase in the rheological properties of rice flour starch in Nagina 22 under HNT indicated the stability of starch and its ability to reorganize during the cooling process of product formation. Thus, our study showed that sink adjustments between superior and inferior spikelets favored the growth of inferior spikelets, which helped to offset the reduction in grain weight under HNT in the tolerant genotype Nagina 22.

Wetting alternating with partial drying during grain filling increases lysine biosynthesis in inferior rice grain

Lysine content is a criterion of the nutritional quality of rice.Understanding the process of lysine biosynthesis in early-flowering superior grain(SG)and late-flowering inferior grain(IG)of rice would advance breeding and cultivation to improve nutritional quality.However,little information is available on differences in lysine anabolism between SG and IG and the underlying mechanism,and whether and how irrigation regimes affect lysine anabolism in these grains.A japonica rice cultivar was grown in the field and two irrigation regimes,continuous flooding(CF)and wetting alternating with partial drying(WAPD),were imposed from heading to the mature stage.Lysine content and activities of key enzymes of lysine biosynthesis,and levels of brassinosteroids(BRs)were lower in the IG than in the SG at the early grainfilling stage but higher at middle and late grain-filling stages.WAPD increased activities of these key enzymes,BR levels,and contents of lysine and total amino acids in IG,but not SG relative to CF.Application of 2,4-epibrassinolide to rice panicles in CF during early grain filling reproduced the effects of WAPD,but neither treatment altered the activities of enzymes responsible for lysine catabolism in either SG or IG.WAPD and elevated BR levels during grain filling increased lysine biosynthesis in IG.Improvement in lysine biosynthesis in rice should focus on IG.

Pedicled abdominal flap using deep inferior epigastric artery perforators for forearm reconstruction: A case report

BACKGROUND Pedicled abdominal flaps are a widely used surgical technique for forearm reconstruction in patients with soft tissue defects.However,some drawbacks include restricted flap size,partial flap loss,and donor-site morbidity.To address these concerns,we present a case of a pedicled abdominal flap using the deep inferior epigastric artery perforators(DIEP)for forearm reconstruction in a patient with a large soft tissue defect.CASE SUMMARY A 46-year-old male patient was admitted to our hospital with forearm injury caused by a pressing machine.A 15 cm×10 cm soft tissue defect with complete rupture of the ulnar side structures of the forearm was found.One week after orthopedic management of the neurovascular injury and fractures using the first stage of Masquelet technique,the patient was referred to the plastic and recon-structive surgery department for wound coverage.Surgical debridement and negative-pressure wound therapy revealed a 20 cm×15 cm soft tissue defect.A pedicle abdominal flap with the DIEP was used to cover the defect.Three weeks later,the flap was detached from the abdomen,and the abdominal defect was directly closed.Subsequently,the second stage of Masquelet technique was performed at the fracture site at week 10.Finally,all donor and recipient sites healed without complications,such as flap dehiscence,infection,hematoma,or necrosis.Fracture site osteosynthesis was achieved without complications.CONCLUSION Pedicled abdominal flap using the DIEP provides a reliable option for forearm reconstruction in patients with large soft tissue defects.

Massive inferior wall aneurysm presenting with ventricular tachycardia and refractory cardiomyopathy requiring multiple interventions:A case report

BACKGROUND Inferior wall left ventricular aneurysms are rare,they develop after transmural myocardial infarction(MI)and may be associated with poorer prognosis.We present a unique case of a large aneurysm of the inferior wall complicated by ventricular tachycardia(VT)and requiring surgical resection and mitral valve replacement.CASE SUMMARY A 59-year-old male was admitted for VT one month after he had a delayed presentation for an inferior ST-segment elevation MI and was discovered to have a large true inferior wall aneurysm on echocardiography and confirmed on coronary computed tomography(CT)angiography.Due to the sustained VT,concern for aneurysm expansion,and persistent heart failure symptoms,the patient was referred for surgical resection of the aneurysm with patch repair,mitral valve replacement,and automated implantable cardioverter defibrillator insertion with significant improvement in functional and clinical status.CONCLUSION Inferior wall aneurysms are rare and require close monitoring to identify electrical or contractile sequelae.Coronary CT angiography can outline anatomic details and guide surgical intervention to ameliorate life-threatening complications and improve performance status.

Two-stage extraction by partial grinding of impacted mandibular third molar in close proximity to the inferior alveolar nerve

BACKGROUND Extraction of impacted third molars often leads to severe complications caused by damage to the inferior alveolar nerve(IAN).AIM To proposes a method for the partial grinding of an impacted mandibular third molar(IMM3)near the IAN to prevent IAN injury during IMM3 extraction.METHODS Between January 1996 and March 2022,25 patients with IMM3 roots near the IAN were enrolled.The first stage of the operation consisted of grinding a major part of the IMM3 crown with a high-speed turbine dental drill to achieve sufficient space between the mandibular second molar and IMM3.After 6 months,when the root tips were observed to be away from the IAN on X-ray examination,the remaining part of the IMM3 was completely removed.RESULTS All IMM3s were extracted easily without symptoms of IAN injury after extraction.CONCLUSION Partial IMM3 grinding may be a good alternative treatment option to avoid IAN injury in high-risk cases.

Left inferior phrenic arterial malformation mimicking gastric varices: A case report and review of literature

BACKGROUND Gastric submucosal arterial dilation resulting from splenic artery occlusion represents an exceedingly rare etiology of acute upper gastrointestinal bleeding(UGIB).Although endoscopy is a widely utilized diagnostic and therapeutic modality for gastrointestinal bleeding,it has limitations in detecting arterial abnormalities.CASE SUMMARY This report presents a rare case of massive UGIB in a 57-year-old male with a tortuous left inferior phrenic artery accompanied by splenic artery occlusion.“Gastric varices”was identified during the patient's endoscopy one year before hemorrhage.Despite initial hemostasis by endoscopic clipping,the patient experienced massive rebleeding after one month,requiring intervention with transcatheter arterial embolization(TAE)to achieve hemostasis.CONCLUSION This is the first case to report UGIB due to a tortuous left inferior phrenic artery.This case highlights the limitations of endoscopy in identifying arterial abnormalities and emphasizes the potential of TAE as a viable alternative for the management of arterial bleeding in the gastrointestinal tract.

Effect of Weak Noise on the Frequency Tuning of Mouse Inferior Collicular Neurons

In order to study the effect of weak noise on the sound signal extraction of mouse (Mus musculus Km) inferior collicular (IC) neurons from environments,we examined the changes in frequency tuning curves (FTCs) of 32 neurons induced by a weak noise relative to 5 dB below minimum threshold of tone (reMT-5 dB) under free field stimulation conditions.The results were as follows:① There were three types of variations in FTCs,sharpened (34.4%),broadened (18.8%),and unaffected (46.9%),nevertheless,only the alteration of sharpened FTCs was statistically different.② Sharpness of frequency tuning induced by a reMT-5 dB noise was very strong.Q 10 and Q 30 of FTCs were increased by (34.42±17.04)% (P=0.026,n=11) and (46.34±22.88)% (P=0.009,n=7).③ The changes of inverse-slopes (ISs,kHz/dB) between high (IS high) and low (IS low) limbs of FTCs were dissymmetry.The IS high of FTCs decreased markedly (P=0.046,n=7),however,there was little change (P=0.947,n=7) in IS low.Our data revealed for the first time that the weak noise could sharpen frequency tuning and increase the sensitivity on the high frequency of sound signal in IC neurons of mouse.

Comparison of excyclotorsion following graded inferior oblique recession for primary versus secondary inferior oblique overaction

AIM:To compare the changes in excyclotorsion after inferior oblique(IO)recession in patients with primary and secondary inferior oblique overaction(IOOA).METHODS:We retrospectively analyzed the data obtained from patients with IOOA who underwent graded IO recession.The patients were followed up for at least 3 mo after surgery.Fundus photographs were taken preand postoperatively,and the sum of the angles of torsion in both eyes was used to analyze changes in excyclotorsion.Patients were divided into two groups:those diagnosed with primary IOOA were enrolled in the 1’IOOA group,and those diagnosed with secondary IOOA caused by superior oblique palsy(SOP)were enrolled in the 2’IOOA group.Excyclotorsion before and after surgery were compared between the two groups.RESULTS:A total of 78 patients were enrolled in this study:34 eyes in the 1’IOOA group and 44 eyes in the 2’IOOA group.In the 78 patients,torsional angle significantly decreased from 15.31°±7.40°to 12.11°±6.53°after IO recession(P<0.001).Mean preoperative torsional angle was larger in the 2’IOOA group than in the 1’IOOA group(P=0.03).In both groups,excyclotorsion significantly decreased after IO recession(P=0.001 and P<0.001,respectively);however,there was no significant difference in the amounts of changes in excyclotorsion between the two groups.CONCLUSION:Excyclotorsion is significantly larger in secondary IOOA than in primary IOOA,and a significant decrease in the torsional angle occurs after IO recession in both types of IOOA.

Study on Tourism Development in Inferior Tourism Regions of Anhui Province

This study aims to summarize the characteristics of 3 types of inferior tourism regions,so as to contribute to the local tourism development and provide references for the tourism development of other inferior tourism regions.With Anhui Province as an example,this study classifies different types of inferior tourism regions,and figures out the definite counties (cities) to assess their richness of tourism resources and regional development levels by utilizing SPSS and fully analyzing the data after calculating the economic development levels of these counties (cities).For I-class inferior tourism regions,regional cooperation model and brand management model should be adopted to improve their competitiveness,for II-class inferior tourism regions,poverty alleviation model should be adopted and moderate development strategy for III-class inferior tourism regions.

Effectiveness of modified inferior oblique muscle belly transposition for V-pattern exotropia combined with mild to moderate inferior oblique muscle overaction

AIM:To investigate the effectiveness of a modified inferior oblique muscle belly transposition for treatment of V-pattern exotropia combined with mild to moderate inferior oblique muscle overaction.METHODS:Thirteen cases(23 affected eyes)of V-pattern exotropia with inferior oblique muscle overaction(+or++)who underwent the modified inferior oblique muscle belly transposition procedure were retrospectively reviewed.The amount of V-pattern,grade of inferior oblique overaction,degree of vertical strabismus,abnormal head posture,and the fovea-disc angle were evaluated before and after surgery.RESULTS:The V-pattern was corrected in all cases,and the amount of V-pattern reduced by 17.85±5.13 prism diopter(PD)on average(t=16.07,P<0.001).The surgical cure rate for mild to moderate inferior oblique muscle overaction was 87.0%(20/23).The degree of the foveadisc angle has a mean reduction of 5.45°±2.87°(t=3.95,P=0.003)after surgery.The mean vertical deviation in 5 cases with a small-angle hypertropia(5.23±3.06 PD)in the primary position reduced by 3.15±1.86 PD(t=6.10,P<0.001).No serious complications were observed.CONCLUSION:The modified inferior oblique muscle belly transposition procedure can effectively treat mild to moderate inferior oblique overaction and relieve the V-pattern,which is safe and easy to perform.

Vascular anatomy of inferior mesenteric artery in laparoscopic radical resection with the preservation of left colic artery for rectal cancer

AIM To investigate the vascular anatomy of inferior mesenteric artery(IMA) in laparoscopic radical resection with the preservation of left colic artery(LCA) for rectal cancer. METHODS A total of 110 patients with rectal cancer who underwent laparoscopic surgical resection with preservation of the LCA were retrospectively reviewed. A 3 D vascular reconstruction was performed before each surgical procedure to assess the branches of the IMA. During surgery, the relationship among the IMA, LCA, sigmoid artery(SA) andsuperior rectal artery(SRA) was evaluated, and the length from the origin of the IMA to the point of branching into the LCA or common trunk of LCA and SA was measured. The relationship between inferior mesenteric vein(IMV) and LCA was also evaluated.RESULTS Three vascular types were identified in this study. In type A, LCA arose independently from IMA(46.4%, n = 51); in type B, LCA and SA branched from a common trunk of the IMA(23.6%, n = 26); and in type C, LCA, SA, and SRA branched at the same location(30.0%, n = 33). The difference in the length from the origin of IMA to LCA was not statistically significant among the three types. LCA was located under the IMV in 61 cases and above the IMV in 49 cases. CONCLUSION The vascular anatomy of the IMA and IMV is essential for laparoscopic radical resection with preservation of the LCA for rectal cancer. To recognize different branches of the IMA is necessary for the resection of lymph nodes and dissection of vessels.

Changes in Enzyme Activities Involved in Starch Synthesis and Hormone Concentrations in Superior and Inferior Spikelets and Their Association with Grain Filling of Super Rice

The changes in activities of key enzymes involved in sucrose-to-starch conversion and concentrations of hormones in superior and inferior spikelets of super rice were investigated and their association with grain filling was analyzed.Four super rice cultivars,Liangyoupeijiu,IIyou 084,Huaidao 9 and Wujing 15,and two high-yielding and elite check cultivars,Shanyou 63 and Yangfujing 8,were used.The activities of sucrose synthase （SuSase）,adenosine diphosphoglucose pyrophosphorylase （AGPase）,starch synthase （StSase） and starch branching enzyme （SBE）,and the concentrations of zeatin ＋ zeatin riboside （Z ＋ ZR）,indole-3-acetic acid （IAA） and abscisic acid （ABA） in superior and inferior spikelets were determined during the grain filling period and their relationships with grain filling rate were analyzed.Maximum grain filling rate,the time reaching the maximum grain-filling rate,mean grain filling rate and brown rice weight for superior spikelets showed a slight difference between the super and check rice cultivars,but were significantly lower in the super rice than in the check rice for inferior spikelets.Changes of enzyme activities and hormone concentrations in grains exhibited single peak curves during the grain filling period.The peak values and the mean activities of SuSase,AGPase,StSase and SBE were lower in inferior spikelets than in superior ones,as well as the peak values and the mean concentrations of Z ＋ ZR and IAA.However,the peak value and the mean concentration of ABA were significantly higher in inferior spikelets than in superior ones and greater in the super rice than in the check rice.The grain filling rate was positively and significantly correlated with the activities of SuSase,AGPase and StSase and the concentrations of Z ＋ ZR and IAA.The results suggested that the low activities of SuSase,AGPase and StSase and the low concentrations of Z ＋ ZR and IAA might be important physiological reasons for the slow grain filling rate and light grain weight of inferior spikelets in super rice.

Surgical treatment of hepatocellular carcinoma with inferior vena cava tumor thrombus: a new classification for surgical guidance

BACKGROUND: Hepatic resection is the main treatment modality for hepatic tumors. Advances in diagnostic technique, preoperative preparation, surgical technique, and postoperative management increased the success rate. The present study aimed to evaluate hepatectomy and resection of inferior vena cava tumor thrombus (IVCTT) in patients with hepatocellular carcinoma, and the relationship between IVCTT classification and selection of surgical technique. METHODS: We retrospectively reviewed 13 patients with hepatocellular carcinoma who had undergone hepatectomy with IVCTT resection between May 1997 and August 2009. Age, gender, diagnosis, findings of physical examination, results of preoperative laboratory investigations, radiological examination, criteria for resection, postoperative pathological results, incisions, operative technique, intraoperative transfusion, drains, and intraoperative and postoperative complications were evaluated for all patients. RESULTS: Type Ⅰ IVCTT (10 patients) was posterior to the liver and below the diaphragm; type Ⅱ IVCTT (2 patients) was above the diaphragm but still outside the atrium; and type Ⅲ IVCTT (1 patient) was above the diaphragm and in the right atrium. Type Ⅰ was treated by radical hepatectomy and removal of IVCTT with total hepatic vascular exclusion. Type Ⅱ was treated by radical hepatectomy and removal of IVCTT by incision of the diaphragm. Type Ⅲ was treated by hepatectomy and resection of the thrombus from the right atrium under cardiopulmonary bypass. There were no surgical complications and one patient has been survived for 4 years with cancer-free status. The median survival time was 18.2 months, and the 1-and 2-year survival rates were 53.8% and 15.4%, respectively. CONCLUSION: Surgical treatment is safe and feasible for treatment of IVCTT in patients with hepatocellular carcinoma, and surgical resectability can be judged according to the classification of tumor thrombus.

A caval homograft for Budd-Chiari syndrome due to inferior vena cava obstruction

Transjugular intrahepatic portosystemic shunt (TIPS) is the standard treatment of Budd-Chiari syndrome (BCS) non responsive to medical therapy. However, patients with inferior vena cava (IVC) obstruction proximal to the atrium do not benefit from TIPS and a surgical approach is mandatory. We report the case of BCS due to intrapericardial IVC obstruction. We describe a novel surgical approach using a fresh caval homograft. An attempt to balloon dilatation of the IVC obstruction was complicated by right atrial disruption with tamponade and ventricular fibrillation. Lately, the patient successfully underwent a reconstruction of the cavo-atrial continuity by the interposition of a fresh caval homograft, a novel surgical approach never described before for BCS. Further follow-up revealed progressive reduction and resolution of ascites, and overall clinical improvement. IVC obstruction near to the atrium can be surgically approached with a new technique consisting in inferior vena cava resection and replacement with a caval homograft.

A first attempt of inferior vena cava filter successfully guided by a mixed-reality system: a case report

Pulmonary embolism(PE)is one of the fatal heart attacks,and lower limbs deep vein thrombosis(DVT)is the most common reason for PE.Inferior vena cava filter(IVCF)implantation is a most prevention for PE.But it may carry a high risk of injury because of the radiation and contrast agent.Patients with nephrotic syndrome(NS)or some other renal diseases may prone to thrombosis due to the excretion of protein C and protein S overmuch.So,it is necessary to develop a new therapy without contrast agent.Mixed-reality(MR)is a new technology as a guidance of inferior vena cava filter implantation exposed under no X-ray and required no contrast agent.

Manual aspiration thrombectomy for acute and subacute inferior vena cava thrombosis and lower extremity deep venous thrombosis

Deep vein thrombosis(DVT), which can lead to pulmonary embolism(PE), is a major contributor to the global disease burden and is the third most common cardiovascular pathology after coronary artery disease and stroke. Venous thromboembolic disease, which encompasses the disease entities of DVT and PE, affects up to 10 million cases every year and represents a serious and potentially life-threatening condition. Standard anticoagulation therapy alone is ineffective at promoting deep venous system thrombus removal. Many patients develop postthrombotic syndrome(PTS) despite being on adequate anticoagulation therapy. Aggressive therapy for rapid thrombus removal is important to prevent the development of PTS. Besides impeding the onset of PTS, rapid clearance of the thrombus is also required in the treatment of phlegmasia cerulea dolens, an uncommon but life-threatening complication of acute DVT that can lead to arterial insufficiency, compartment syndrome, venous gangrene, and limb amputation. Manual aspiration thrombectomy(MAT) can provide rapid and effective therapy that could be compared to the open surgical thrombectomy approach with minimal risk of morbidity, mortality, or recurrence after surgery. Though many devices have been developed to date for pharmacomechanical thrombolysis, the cost of the treatment using these devices is very expensive. MAT is simple to perform, easy to learn, inexpensive, and rapid. This review will outline and dissect several studies and case reports, sourced from the Pub Med database, on the subject of the use of MAT in treating inferior vena cava thrombosis and lower extremity DVT, including in patients with compression of the iliac vein and phlegmasia cerulea dolens.

Non-buckled vitrectomy for retinal detachment with inferior breaks and proliferative vitreoretinophathy

AIM: To investigate the efficacy of non-buckled vitrectomy with classical endotamponade agents in the treatment of primary retinal detachment (RD) complicated by inferior breaks and proliferative vitreoretinophathy (PVR). METHODS: A retrospective, consecutive and case series study of 40 patients with inferior break RD and PVR >= C1 was conducted. All patients underwent a standard 3-port 20-gauge pars plana vitrectomy (PPV) with gas or silicone oil tamponade without supplementary scleral buckling. The vitreous and all proliferative membrane were completely removed, and retinectomy was performed when necessary. The mean follow-up was 12.5 months. The primary and final anatomic success rate, visual acuity and complications were recorded and analyzed. RESULTS: Primary anatomic success rate was achieved in 35 of 40 eyes (87.5%) and the final anatomic success rate was 100%. The most common cause of redetachment was recurrent PVR. The best-corrected visual acuity (BCVA) at final follow-up was improved in 34 eyes (85%), remained stable in 1 eye (2.5%), and worsened in 5 eyes (12.5%). The mean visual acuity at final follow-up was improved significantly (P=0.000). CONCLUSION: This retrospective study provides evidence that vitrectomy without scleral buckling seemed to be an effective treatment for inferior break RD with PVR. With complete removal of vitreous and proliferative membranes and timing of retinectomy, the inferior breaks which complicated with PVR could be dosed successfully without additional sclera! buckling.

Clinical studies on inferior right hepatic veins

BACKGROUND: Many small veins are called accessory, short hepatic veins in addition to the right, middle and left hepatic veins. The size of these veins varied from a pinhole to 1 cm; the size of inferior right hepatic veins (IRHVs) is thicker than that of short hepatic veins or more than 1 cm. occasionally. Adults have a higher incidence rate of the IRHV. DATA SOURCES: A literature search of the PubMed database was conducted and research articles were reviewed. RESULTS: The size of IRHVs is related to the size of the right hepatic vein, i.e. the larger the diameter of the right hepatic vein, the smaller the diameter of the IRHVs, and vice versa. The IRHVs are divided into superior, medial and inferior groups, separately named the superior, medial and inferior right hepatic veins according to the position of the IRHV entering the inferior vena cava. The superior right hepatic vein mainly drains the superior part of segment VII, and the medial right hepatic vein drains the middle part of segment VII. A thicker IRHV mainly drains segment VI and the inferior part of segment VII and a thinner IRHV drains the inferior part of segment V. CONCLUSIONS: The clinical significance of these studies on IRHVs is varied: (1) Hepatic caudate lobe resection could be introduced after study on the veins of that lobe. (2) It is very important to identify the draining region of the IRHV for guiding hepatic segmentectomy. The postero-inferior area of the right lobe can be preserved along with the hypertrophic IRHV even if the entire main right hepatic vein is resected during segmentectomy of VII and VIII with right hepatic vein resection for patients with primary liver cancer. (3) The ligation of the major hepatic vein for the treatment of juxtahepatic vein injury is recommended because of severe hemorrhagic shock and difficulty in exposure. (4) It is very helpful to decide therapeutic modalities for Budd-Chiari syndrome.