To study the detailed normal ultrasonic anatomy of the pleura and chest wall, high resolution (7.5 MHz) ultrasonograms were obtained from cadaver chest wall specimens and compared with thin section computed tomograms and anatomical specimens. Ultrasonograms show three layers of the intercostal muscles (internal, external and innermost), covered by the "echogenic pleural line." The "echogenic pleural line" is caused by composite echoes from the inner parietal pleura, and the outer endothoracic fascia, with the fatty tissue covering both sides of the fascia, which are located deep to the chest wall muscles. On ultrasonograms, the subpleural fat tissue, when abundant, appeared as an apron-like structure hanging down from the inner surface of the rib (subpleural fat pad), or diffuse fat accumulation mimicking the pleural thickening.

The VeinViewer Vision ® is a near-infrared vascular imaging device that creates a digital image of the superficial vein onto the surface of the skin in real-time using near-infrared imaging technology. It can make puncture of blood vessels easy and hand free, while being clean. The vein, but not an artery, can be demonstrated to a subcutaneous depth of 1 cm. We report our experience of using this device for the examination and treatment of varicose vein. While it is difficult to detect the saphenous vein, superficial varicose veins are comparatively visible. The venous network and filling, which are difficult to visualize with ultrasonography, can be evaluated satisfactorily. Moreover, it is useful to determine the puncture area and to evaluate the effect with sclerotherapy. This unique device can be operated cleanly and non-invasively. Therefore, it is anticipated that it will be further developed and used for various vascular surgical procedures in the future.

KEYWORDS: anti-Mi-2 antibody, anti-transcriptional intermediary factor 1-γ antibody, dermatomyositis, enzyme-linked immunosorbent assay, false positive

We report on a 74-year-old woman with an absence of right superior vena cava in visceroatrial situs solitus who underwent mitral valve plasty for severe mitral regurgitation. Preoperative three-dimensional computed tomography revealed an absent right and persistent left superior vena cava that drained into the right atrium by way of the coronary sinus. Perioperaively, placement of pulmonary artery catheter, site of venous cannulation, and management of associated rhythm abnormalities were great concern. Obtaining the information about this central venous malformation preoperatively, we performed mitral valve plasty without any difficulties related to this anomaly.

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