Type B intramural hematoma (IMH) is not considered to be a life-threatening condition, and medical treatment is the first treatment choice. We report 2 cases of ruptured type B intramural hematoma. Total arch replacement was performed via median sternotomy, which is not a common surgical strategy for type B dissection. Case 1 : a 77-year-old woman was transferred to our hospital with chest and back pain. CT revealed type B IMH with a large hematoma in the anterior mediastinum. She underwent total arch replacement, but she died of respiratory failure on the 167th postoperative day. Case 2 : a 60-year-old man was transferred to our hospital with chest and back pain. CT revealed a type B IMH with a large hematoma on the anterior side of the arch. He underwent total arch replacement, but died of sepsis on the 13th postoperative day. We had 2 rare cases of ruptured type B IMH. In both cases, postoperative courses were problematic. However, median sternotomy could be an approach for ruptured type B dissection in some cases.

The teleost fish has been widely used in creating neurodegenerative models. Here we describe the teleost medaka fish Parkinson's disease (PD) models we developed using toxin treatment and genetic engineering. 1-Methyl-4-phenyl-1,2,3,4-tetrahydropyridine (MPTP), 6-hydroxydopamine (6-OHDA), proteasome inhibitors, lysosome inhibitors and tunicamycin treatment in our model fish replicated some salient features of PD: selective dopamine cell loss and reduced spontaneous movement with the last three toxins producing inclusion bodies ubiquitously in the brain. Despite the ubiquitous distribution of the inclusion bodies, the middle diencephalic dopaminergic neurons were particularly vulnerable to these toxins, supporting the idea that this dopamine cluster is similar to the human substantia nigra. PTEN-induced putative kinase 1 (PINK1) homozygous mutants also showed reduced spontaneous swimming movements. These data indicate that medaka fish can serve as a new model animal of PD. In this review we summarize our previous data and discuss future prospects.
Animals ; Brain ; Dopamine ; Dopaminergic Neurons ; Genetic Engineering ; Humans ; Inclusion Bodies ; Lysosomes ; Oryzias ; Oxidopamine ; Parkinson Disease ; Phosphotransferases ; Proteasome Inhibitors ; Protein Kinases ; Substantia Nigra ; Swimming ; Tunicamycin