Efficient Suppression of Abdominal Aortic Aneurysm Expansion in Rats through Systemic Administration of Statin-Loaded Nanomedicine.

Abdominal aortic aneurysm (AAA) is a life-threatening disease. However, no systemically injectable drug has been approved for AAA treatment due to low bioavailability. Polymeric micelles are nanomedicines that have the potential to improve therapeutic efficacy by selectively delivering drugs into disease sites, and research has mainly focused on cancer treatments. Here, we developed a statin-loaded polymeric micelle to treat AAAs in rat models. The micelle showed medicinal efficacy by preventing aortic aneurysm expansion in a dose-dependent manner. Furthermore, the micelle-injected group showed decreased macrophage infiltration and decreased matrix metalloproteinase-9 activity in cases of AAA.

[Technique of Arterial Anastomosis].

The important point in vascular anastomosis is anastomosis with a secure suture and prevention of thrombosis. Uncertainty in sutures can cause bleeding from the anastomotic site and post operative pseudoaneurysm formation. In addition, the failure of the antithrombotic function causes early occlusion of the anastomotic site due to thrombus formation, causing intimal thickening and causing stenosis of the anastomotic site. Vascular anastomosis must be performed with attention to the property and site of the blood vessel, the method of graft formation, and the procedure of suturing. Training is required for fast and accurate sutures, and it is also important to conduct off the job training to efficiently improve your proficiency.

[Purtscher's retinopathy following blunt chest compression].

Following chest or abdominal injury, acute blurring of vision occurs without direct eye injury. This disease is known as Purtscher's retinopathy. A 74-year-old man suffered blunt chest injury by air bag inflation at traffic accident. Next morning, he suddenly complained of visual abnormality. An ophthalmoscopy revealed multiple cotton-wool exudation and retinal edema. He was diagnosed as Purtscher's retinopathy. The symptoms of soft exudation and retinal edema gradually resolved. The visual acuity gradually improved, but not reached to the previous level. We must be aware of this retinopathy, since this is rare but sometimes sight-threatening condition.

Specific Features of Patients Under 40 Years Old With Small-to-Medium-Sized Arterial Deterioration.

Background: Arterial deterioration is mostly caused by atherosclerosis, which progresses with age. However, we have observed serious backgrounds or etiologies in younger patients with non-atherosclerotic diseases and deterioration of small-to-medium-sized arterial lesions. Therefore, we aimed to identify the specific features of patients aged <40 years with deterioration of small-to-medium-sized arteries. Methods: We selected patients who were admitted to our department from 1995 to 2019 with deterioration of small-to-medium-sized arteries (aneurysms, dissection, rupture, or arterial injury/damage) and focused on the cohort aged <40 years. We examined the backgrounds or etiologies of the patients including genetic and inflammatory diseases, which might have caused the arterial deterioration. Results: Consequently, more than half (54.1%) of the patients aged <40 years had non-atherosclerotic comorbid diseases. However, the number of deteriorated arterial lesions was higher in patients aged <40 years than in patients aged ≥40 years (3.13 vs. 1.33 lesion/patient; P = 0.011). Furthermore, the data analysis of patients with multiple arterial lesions (≥3) revealed that the younger population tended to have more specific backgrounds or etiologies, notably Ehlers-Danlos syndrome and Behçet's disease. There were no differences in the all-cause mortality and cardiovascular disease-related mortality between patients aged <40 and ≥40 years (P = 0.89 and 0.29, respectively). Conclusions: Over 50% of patients aged <40 years with deterioration of small-to-medium-sized arteries had non-atherosclerotic, specific clinical backgrounds or etiologies, including genetic and inflammatory diseases. In addition, they exhibited more arterial lesions than older patients.