A 66-year-old man underwent replacement of the ascending aortic arch for acute aortic dissection (Stanford type A). During surgery, an ePTFE synthetic graft was anastomosed to the left axillary artery to transmit blood from the extracorporeal circulation. During arch branch reconstruction, the left axillary artery was anastomosed end-to-end to a Dacron synthetic graft and the ePTFE synthetic graft used to transport blood, and the terminal anastomotic site of the ePTFE synthetic graft was used. At about 3 months postoperatively, a bulge was noted below the left clavicle, and it was diagnosed as seroma based on CT and aspiration biopsy findings. His condition did not improve despite repeated paracentesis and drainage. The ePTFE was resected and replaced with a Dacron synthetic graft, resulting in case of his seroma.

Persistent sciatic artery (PSA) is a rare congenital vascular anomaly with an incidence ranging from 0.025 to 0.06% of the general population. We report a 65-year-old male patient with bilateral PSA suffering from intermittent right-calf claudication. Peripheral pulsations could be palpated well at the right common femoral artery but not at the right popliteal artery. His ankle brachial index (ABI) was 0.79 on the right and 0.99 on the left. Computed tomographic (CT) angiography demonstrated that the bilateral PSAs were branched from the internal iliac arteries and the right PSA was completely occluded, whereas aneurysmal change was not evident. Both superficial femoral arteries were incompletely developed. Blood flow to the peroneal artery, anterior and posterior tibial arteries were maintained in both lower legs via a network of collateral arteries. Arterial bypass from right common femoral artery to the above-knee popliteal artery using knitted Dacron graft was performed and postoperative ABI of the right lower limb improved to 1.06. Ten months after the intervention, the patient was then suffered from intermittent left-calf claudication caused by complete occlusion of left PSA, therefore, above-knee femoropopliteal arterial bypass using knitted Dacron graft was performed. PSA is often asymptomatic until a complication develops and the careful monitoring to prevent the risk of thromboembolic and aneurysmal events are recommended.

Objective: In general, antiallergic drugs, steroids, and autonomic drugs are administered for patients with allergic diseases, but the chronic administration of these medicines may occasionally induce side effects. As such, several complementary and alternative medicine (CAM) are used, even though their effectiveness has not been established by a significant amount of evidence. Health food, herbal medicines, herbal tea, and aromatherapy, etc., are used for the treatment of allergic rhinitis (AR) as CAM. Rosmarinic acid is a type of polyphenol, and is reported to have antiallergic, antioxydative and anti-inflammatory properties. Rosmarinic acid is included in Perilla Herbs, which are used in health foods and herbal medicines (Kampo medicines), Rosemary and Lemon balm, which are used as herbal teas and essential oils of aromatherapy. This study was performed to evaluate the effect of rosmarinic acid on AR using AR model rats.
Methods: Six-week-old male Sprague-Dawley rats were sensitized with toluene 2,4-diisocyanate (TDI) to induce AR. Rosmarinic acid (1 mg/kg i.p. or 3 mg/kg i.p.) is administrated for 21 days. On day 22, the symptom of nasal allergy was evaluated by counting the number of sneezes within 10 minutes. Substance P (SP), calcitonin gene-related peptide (CGRP) and nerve growth factor (NGF) in the nasal lavage fluids were also measured.
Result: SP and CGRP take part in the exacerbation of rhinitis symptoms, and are secreted from the nerve ending following nerve stimulation by chemical mediators such as histamine. The administration of Rosmarinic acid had no effect on NGF, but significantly suppressed increases of sneezes, SP and CGRP dose-relatedly. Conclusion: Rosmarinic acid could control the symptom of nasal allergy, and one of the mechanisms was suppressing of the secretion of SP and CGRP.

We have previously reported that the thoracolumbar posterior nerve root shows a tortuous epidural course, based on studies of human fetuses near term. For comparison with the cervical nerve, examinations were conducted using frontal, sagittal and horizontal sections of cervical vertebrae from 22 fetuses at 30–38 weeks of gestation. The cervical nerve root showed a short, straight and lateral course near the zygapophysial joint. Multiple rather than single bundles of the cervical posterior root seemed to account for the majority of sensory nerve fibers innervating the upper extremity. Fasciculation of rootlets was evident near the thoracolumbar spinal cord, whereas it was seen in the dural pocket at the nerve exit from the dural sac although both sites were subdural. As in the thoracolumbar region, the nerve sheath was continuous with the dura mater and independently surrounded each of the anterior and posterior roots. Radicular arteries were few in the cervical region. In 2 of the 22 fetuses (31 weeks and 33 weeks), there was a segmental, unilateral abnormality of nerve rootlet fasciculation where the dorsal root ganglion was located lateral or peripheral to the intervertebral region. Long nerve roots running inferiorly are a necessary adaptation to the delayed and marked growth of the thoracolumbar vertebral column.In children, the cervical nerve roots are likely to be affected by movement or dislocation of the vertebrae. The segmental abnormality of the cervical nerve root may be linked to rare variations in the brachial plexus.