Background: Type 1 diabetes mellitus induced by immune-checkpoint inhibitors (ICI-T1DM) is a rare critical entity. However, the etiology of ICI-T1DM remains unclear. Methods: In order to elucidate risk factors for ICI-T1DM, we evaluated the clinical course and immunological status of patients with ICI-T1DM who had been diagnosed during 2016 to 2021. Results: Seven of 871 (0.8%, six men and one woman) patients developed ICI-T1DM. We revealed that the allele frequencies of human leukocyte antigen (HLA)-DPA1*02:02 and DPB1*05:01 were significantly higher in the patients with ICI-T1DM In comparison to the controls who received ICI (11/14 vs. 10/26, P=0.022; 11/14 vs. 7/26, P=0.0027, respectively). HLA-DRB1*04:05, which has been found to be a T1DM susceptibility allele in Asians, was also observed as a high-risk allele for ICI-T1DM. The significance of the HLA-DPB1*05:01 and DRB1*04:05 alleles was confirmed by an analysis of four additional patients. The absolute/relative neutrophil count, neutrophils-lymphocyte ratio, and neutrophil-eosinophil ratio increased, and the absolute lymphocyte count and absolute/relative eosinophil count decreased at the onset as compared with 6 weeks before. In two patients, alterations in cytokines and chemokines were found at the onset. Conclusion Novel high-risk HLA alleles and haplotypes were identified in ICI-T1DM, and peripheral blood factors may be utilized as biomarkers.

Knitted Polyester prosthetic grafts can cause long-term dilatations and formation of anastomotic or non-anastomotic aneurysms, and rupture in result. We experienced a case of anastomotic pseudoaneurysm and recurrent non-anastomotic dilatation of the ascending aorta-abdominal aorta bypass by Cooley Double Velour Knitted Dacron (CDVKD) graft for a patient with atypical coarctation of the aorta (Takayasu Aortitis, type III), which case needed treatment two times over 30 years after the initial operation. The first additional treatment was Thoracic Endovascular Aortic Repair (TEVAR) for non-anastomotic aneurysm was done as 1st operation. Thirty-two years after the initial operation, the second treatment was a hybrid operation consisting of 4 procedures: bilateral axillo-external iliac bypass, taking down of the CDVKD graft at the proximal anastomotic site, endovascular repair (EVAR) with modified Double D Technique, and coil packing at the distal anastomotic site of the CDVKD graft. The patient was discharged at 37-POD. No complication and no endoleak has occurred in the 2.5 years since the operation.

Among the less reported complications after thoracic endovascular aortic repair (TEVAR) is type II endoleak (T2EL). The intercostal and bronchial artery are known as feeder vessels to T2EL after TEVAR. We experienced two cases of successful treatment of percutaneous transarterial feeder vessels embolization via right costocervical trunk approach for patients with persistent T2EL and sac enlargement of an arch aneurysm after TEVAR. The costocervical trunk route is possible for key vessels to construct a collateral pathway to feeder vessels of the endoleak nidus of T2EL after TEVAR procedures for aortic arch aneurysm. A preembolizational Catheter-Directed CT angiogram (CTA) can be helpful to prevent harmful complications (e.g., spinal cord infarction).