An Uncommon Cause of Shock: Acute Thrombosis of the Inferior Vena Cava.

Background: Obstructive shock is an uncommon presentation to the emergency department (ED) and is most often caused by an acute pulmonary embolism. A very rare cause of obstructive shock is extensive deep venous thrombosis, otherwise known as phlegmasia cerulea dolens. We present a case of obstructive shock caused by placement of an inferior vena cava filter complicated by acute occlusion with extensive deep venous thrombosis.

Sns and Kirre, the Drosophila orthologs of Nephrin and Neph1, direct adhesion, fusion and formation of a slit diaphragm-like structure in insect nephrocytes.

The Immunoglobulin superfamily (IgSF) proteins Neph1 and Nephrin are co-expressed within podocytes in the kidney glomerulus, where they localize to the slit diaphragm (SD) and contribute to filtration between blood and urine. Herein, we demonstrate that their Drosophila orthologs Kirre (Duf) and Sns are co-expressed within binucleate garland cell nephrocytes (GCNs) that contribute to detoxification of the insect hemolymph by uptake of molecules through an SD-like nephrocyte diaphragm (ND) into labyrinthine channels that are active sites of endocytosis. The functions of Kirre and Sns in the embryonic musculature, to mediate adhesion and fusion between myoblasts to form multinucleate muscle fibers, have been conserved in the GCNs, where they contribute to adhesion of GCNs in the ;garland' and to their fusion into binucleate cells.