We encountered with four child patients infected with a new type of influenza virus. All the cases were complicated by severe dyspnea. This study was to review the clinical picture of the influenza, and some problems that confronted us in the course of treatment. The four patients had not been vaccinated. Three of them had a history of bronchial asthma. Two developed a fever and dyspnea all at once, and the other two had acute dyspnea in less than nine hours after the attack of fever. Antiviral agents were totally useless for preventing the disease from worsening. The clinical features were exacerbated asthma, pneumonia, air leak, and plastic bronchitis. Two children were mechanically ventilated. All the patients were given corticosteroids in addition to antiviral drugs (the methylprednisolone pulse therapy given to three patients). Two patients were administered with sivelestat. All the patients recovered their illness. There was no incidence of nosocomial infestion. Keeping watch for any change in the condition of the respiratory organs is needed in the infantile case of a new type of influenza regardless of whether or not the patient has a history of bronchial asthma. The new influenza may suddenly become worse. It is almost impossible to contain the virus with antiviral drugs. Early vaccination is of cardinal importance before influenza spreads around the world in seasonal epidemics.

A 55-year-old man was admitted with a thoracic aortic aneurysm causing wheezing. Computed tomography and angiography revealed a large distal aortic saccular aneurysm, occupying the retrotracheal space and compressing the trachea. There has been only one report of this type of aneurysm. This patient needed emergency intubation because of severe dyspnea caused by premedication for surgery. Replacement of the distal arch was performed via left posterolateral thoracotomy. Profound hypothermia was used during open proximal anastomosis, which helped to make this procedure safe and simple. This patient recovered uneventfully.

Methods: This study included 50 patients with CSM and 39 with C-OPLL who underwent multi-segment laminoplasty. Decreased CL was defined as the difference between preoperative and 2-year postoperative neutral C2–7 Cobb angles. Radiographic parameters included preoperative neutral C2–7 Cobb angles, C2–7 sagittal vertical axis (SVA), T1 slope (T1S), dynamic extension reserve (DER), and range of motion. The radiographic risk factors were investigated for decreased CL in CSM and C-OPLL. Additionally, the Japanese Orthopedic Association (JOA) score was assessed preoperatively and 2 years postoperatively. Results: C2–7 SVA (p =0.018) and DER (p =0.002) were significantly correlated with decreased CL in CSM, while C2–7 Cobb angle (p =0.012) and C2–7 SVA (p =0.028) were correlated with decreased CL in C-OPLL. Multiple linear regression analysis revealed that greater C2–7 SVA (B =0.22, p =0.026) and small DER (B =−0.53, p =0.002) were significantly associated with decreased CL in CSM. By contrast, greater C2–7 SVA (B =0.36, p =0.031) was significantly associated with decreased CL in C-OPLL. The JOA score significantly improved in both CSM and C-OPLL (p <0.001). Conclusions C2–7 SVA was associated with a postoperative decreased CL in both CSM and C-OPLL, but DER was only associated with decreased CL in CSM. Risk factors for decreased CL slightly differed depending on the etiology of the condition.