Cervical aortic arch is an unusual malformation. Cervical aortic arch with aneurysm formation is very rare. We report a case of cervical aortic arch associated with a saccular aneurysm in a 59-year-old Japanese man. The aneurysm protruded caudally and was located between the left common carotid and left subclavian arteries. Cardiopulmonary bypass and deep hypothermic circulatory arrest was applied as adjunct methods. A Dacron graft was sutured just distal to the left common carotid artery, with the patient in the Trendelenburg position. The proximal site was left open while oxygen-saturated venous blood was supplied in a retrograde manner to perfuse the lower body during occlusion of the descending aorta. Distal anastomosis to the descending aorta was performed during rewarming. The left subclavian artery was reconstructed by using a branch of the graft. This procedure is simple and useful for distal arch operations, especially in patients with Haughton D type aneurysms.

Our results suggest that Streptococcal infection may play an important role in the pathogenesis of IgAN by stimulating IgA production through TGF-beta synthesis.

Generation of cytotoxic T lymphocytes (CTL) in vitro and tumor-rejection responses by sensitization of semi-syngeneic mice with tumor-antigen-reconstituted liposomes were investigated. Liposomes were prepared from a crude butanol extract (CBE) of BALBRVD leukemia cells and egg phosphatidylcholine (PC): 1,2-dimyristoylamido-1,2-deoxyphosphatidylcholine (DDPC) (3:2) or dimyristoylphosphatidylcholine (DMPC):DDPC (1:4). Inter-membrane protein transfer (IMPT) liposomes were prepared by incubating BALBRVD cells with DMPC:DDPC (1:4) liposomes. Sensitization of male CB6F1 mice with CBE or IMPT liposomes induced a level of cytotoxicity similar to that on sensitization with mitomycin-C(MMC)-treated BALBRVD against BALBRVD target cells after in vitro sensitization with the tumor cells. Sensitization with CBE alone resulted in only marginal cytotoxicity. The cytotoxic effector cells induced by either mode of sensitization were CD8+ T-cells whose recognition was Kd-restricted. No difference in specificity was observed with the different modes of sensitization. Two in vivo immunizations with CBE or with CBE liposomes at a dose of 25 micrograms of protein (equivalent to 2.5 x 10(7) cells) cause moderate inhibition of BALBRVD tumor growth in male CB6F1 mice and immunization with IMPT liposomes at a dose of 1 microgram of protein result in efficient protection.

An asymptomatic 59-year-old man was admitted with an initial suspicion of mediastinal tumor. He was diagnosed as having a left-sided cervical aortic arch (Haughton type D) with arch aneurysm by using contrast-enhanced CT and angiography. The arch aneurysm was surgically removed. This is the 20th reported case of cervical aortic arch with aneurysm formation.