Search

A 62-year-old man was transported to the emergency medical center because of blunt chest trauma combined with multiple trauma after a car accident.He complained of severe back pain.Contrast-enhanced computed tomography revealed left hemopneumothorax with multiple left rib fractures,a scapular fracture,lung contusion,liver injury,right renal injury,and acute aortic dissection.Although open surgical repair and endovascular stent grafting were considered,primarily nonoperative manage-ment of the thoracic aortic injury under blood pressure control was selected because of the multiple trauma,type B aortic dissection,and oral administration of two antiplatelet drugs.The patient’s hemodynamic and respiratory conditions remained stable in the intensive care unit,and the aortic dissection improved.We herein report a rare case of blunt thoracic aortic injury with oral administra-tion of antiplatelet drugs resulting in multiple trauma and acute aortic dissection treated nonoperatively.

The salamander Hynobius yatsui from southwestern Japan was formerly regarded as a small-sized group of H. naevius, but has recently been resurrected as a distinct species. We investigated the phylogeography of H. yatsui from Kyushu Island using partial sequences of the mitochondrial cytochrome b gene. We detected 49 haplotypes in 181 individuals from 24 localities covering the entire geographic distribution of this species on Kyushu. These haplotypes were grouped into two lineages, a northern lineage from northern and central regions, and a southern lineage from the southern region; no haplotypes were shared between the lineages. We surmise that the divergence of the two lineages was induced by volcanic activity that started in the Beppu-Shimabara Graben, between the areas occupied by these two lineages. From the results of a nested clade phylogeographical analysis, we surmise that the high intrapopulation genetic variation observed in the non-volcanic Kyushu Mountains was generated by alternation of contiguous range expansion or long-distance dispersal, and isolation. The current distribution and the observed complicated genetic structures of H. yatsui in Kyushu seem to have been affected first by volcanic activities since the late Pliocene, but subsequent climatic oscillations during the Pleistocene may also have some effects, although it is impossible at this time to differentiate the effects of these two factors.

A 61-year-old man with an aneurysm of the common and deep femoral arteries underwent successful vascular reconstruction.The patient presented with localized pain and a rapidly enlarging pulsatile mass in the femoral triangle.A graft was placed from the left common femoral artery to the left superficial and deep femoral arteries.No ischemic symptoms or thrombosis developed postoperatively.Successful reconstruction with a graft is rare in this situation,with less than 30 cases reported in Japan to date.This type of aneurysm is characterized by rapid enlargement and severe atherosclerotic changes.Ischemic complications may occur after surgical treatment of a ruptured deep femoral artery aneurysm.We recommend reconstruction using the saphenous vein or a vascular prosthesis,as there have been some reports of patients requiring leg amputation following ligation of the deep femoral artery.