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Kim J.H.,Chonbuk National University | Hwang S.E.,Daejeon Sun Hospital | Rodriguez-Vazquez J.F.,Complutense University of Madrid | Murakami G.,Iwamizawa Asuka Hospital | Cho B.H.,Chonbuk National University
Anatomy and Cell Biology | Year: 2014

In the embryonic heart, the primitive atrium is considered to receive the bilateral sinus horns including the upper terminal of the inferior vena cava (IVC). To reveal topographical anatomy of the embryonic venous pole of the heart, we examined horizontal serial paraffin sections of 15 human embryos with crown-rump length 9-31 mm, corresponding to a gestational age of 6-7 weeks or Carnegie stage 14-16. The IVC was often fixed to the developing right pulmonary vein by a mesentery-like fibrous tissue. Rather than the terminal portion of the future superior vena cava, the IVC contributed to form a right-sided atrial lumen at the stage. The sinus venosus or its left horn communicated with the IVC in earlier specimens, but in later specimens, the left atrium extended caudally to separate the sinus and IVC. In contrast, the right atrium consistently extended far caudally, even below the sinus horn, along the IVC. A small (or large) attachment between the left (or right) atrium and IVC in adult hearts seemed to be derived from the left (or right) sinus valve. This hypothesis did not contradict with the incorporation theory of the sinus valves into the atrial wall. Variations in topographical anatomy around the IVC, especially of the sinus valves, might not always depend on the stages but partly in individual differences. © 2014. Anatomy&Cell Biology. Source


Hayashi S.,Tokyo Medical University | Kim J.H.,Chonbuk National University | Hwang S.E.,Daejeon Sun Hospital | Shibata S.,Tokyo Medical and Dental University | And 3 more authors.
Folia Morphologica (Poland) | Year: 2014

In the head and neck of human mid-term foetuses, the interface between areas of endochondral ossification and adjacent membranous (intramembranous) ossification is extensive. Using 8 foetal heads at 15-16 weeks, we have demonstrated differences in the matrices and composite cells between these 2 ossification processes, especially in the occipital squama and pterygoid process. Aggrecan-positive cartilage was shown to be invaded by a primitive bony matrix that was negative for aggrecan. At the interface, the periosteum was continuous with the perichondrium without any clear demarcation, but tenascin-c expression was restricted to the periosteum. In contrast, the interface between the epiphysis and shaft of the femur showed no clear localisation of tenascin-c. Versican expression tended to be restricted to the perichondrium. In the pterygoid process, the density of CD34-positive vessels was much higher in endochondral than in membranous ossification. The membranous part of the occipital was considered most likely to contribute to growth of the skull to accommodate the increased volume of the brain, while the membranous part of the pterygoid process seemed to be suitable for extreme flattening under pressure from the pterygoid muscles. Copyright © 2014 Via Medica. Source


Hwang H.P.,Chonbuk National University | Yang J.D.,Chonbuk National University | Bae S.I.,Chonbuk National University | Hwang S.E.,Daejeon Sun Hospital | And 2 more authors.
Yonsei Medical Journal | Year: 2015

Severe portal vein thrombosis (PVT) is often considered a relative contraindication for living donor liver transplantation due to high associated risks and morbidity. Meanwhile, improvement in operative techniques, resulting in higher success rates has removed PVT from the list of contraindications in deceased donor liver transplantation (DDLT). In this report, we describe a surgical technique for DDLT using polytetrafluoroethylene graft from the inferior mesenteric vein for portal inflow in patient with portomesenteric thrombosis. © Yonsei University College of Medicine 2015. Source


Choi B.J.,Catholic University of Korea | Jeong W.J.,Catholic University of Korea | Kim Y.K.,Daejeon Sun Hospital | Kim S.-J.,Catholic University of Korea | Lee S.C.,Catholic University of Korea
International Journal of Surgery | Year: 2015

Background: The aim of this study was to report our initial experience with single-port laparoscopic reversal of Hartmann's procedure (SP-LHR). Methods: Between December 2009 and March 2014, 23 patients underwent single-port laparoscopic reversal of Hartmann's procedure. Single-port laparoscopic surgeries (SPLS) were performed through the preexisting stoma site. A commercially available single port with one 5mm and two 12mm trocars was used with conventional straight and rigid laparoscopic instruments. Patient demographics and operative and postoperative outcomes were analyzed. Results: SP-LHR was successful in 22 patients. No additional incisions for trocars or conversions to open surgery were necessary. In 1 patient, the procedure was aborted. The median operative time and postoperative length of stay were 165min (range, 100-340min) and 8 days (range, 4-31 days), respectively. The median time to the resumption of oral intake was 3 days (range, 1-16 days). No intraoperative complications were noted; there were four postoperative complications including one anastomotic leak. Conclusions: In our experience, SP-LHR via the colostomy site was safe and feasible, and may be considered an additional surgical option for experienced SPLS surgeons in selected patients. © 2015 Surgical Associates Ltd. Source


Arakawa T.,Fumon in Clinic | Hwang S.E.,Daejeon Sun Hospital | Kim J.H.,Chonbuk National University | Wilting J.,University of Gottingen | And 4 more authors.
International Journal of Colorectal Disease | Year: 2016

Purpose and methods: The anal sinuses, small furrows above the pectinate line, sometimes form perianal abscesses in adults. We examined the pattern of fetal growth of the anal sinus and sphincters using 22 mid-term (8–18 weeks) and 6 late-stage (30–38 weeks) fetuses. Results: In mid-term fetuses, the external and internal sphincters gradually increased in thickness, depending on specimen size (from 0.2 to 1.5 mm), whereas the anteroposterior diameter of the anal canal at the epithelial junction was relatively stable (0.5–1.0 mm) irrespective of specimen size. Anal canal diameter increased less than twofold between mid-term and late-stage fetuses, from 0.5–1.0 to almost 2 mm, whereas sphincter thickness increased over tenfold, from 0.2–1.5 to almost 3.5 mm. The anal sinus often showed balloon-like enlargement when the sphincter muscle bundles were tightly packed in mid-term, but not in late-stage fetuses. Conclusions: Large concentric mechanical stress from the sphincters in late-stage fetuses apparently prevented the anal sinus from expanding in a balloon-like manner. Conversely, to avoid anal stenosis, the growing sinuses maintained a luminal space of the anal canal in response to stress from rapidly growing sphincters. The inferiorly extending sinus usually provided temporal double canals separated by a thick column. In the presence of double lumens, anal canal duplication is likely to develop without any abnormalities of the anal epithelium and sphincters. © 2015, Springer-Verlag Berlin Heidelberg. Source

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