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  • The aortic dissections in 35 patients (80%) were found after acute chest pain and subsequent emergency surgery. Seven patients displayed Takayasu aortitis, according to patient age (<65 years) and established clinical criteria,18 and presented typical clinical signs, including dyspnea, <a href="">Sitaxentan fever, or decreased pulse in the extremities. Four patients with Takayasu aortitis showed TAA, and two showed diffuse sclerosis of the aorta. Five patients received corticosteroids preoperatively. These cases were confirmed based on light microscopic features such as patchy medial laminar necrosis rimmed by macrophages and occasional giant cells. Infectious aortitis was identified in three patients (one patient with fungus and two patients with bacteria) based on serologic date and pathologic findings of massive suppurative changes, such as granulation tissue with infiltration of neutrophils. We were unable to identify patients with isolated aortitis in this series, even in the large category Paclitaxel price of aortitis of the ascending aorta.18?and?19 Isolated aortitis often causes aneurysmal shape due to thinning of the aortic wall caused by inflammatory changes, as histopathologically characterized by patchy areas of medial necrosis associated with infiltration of lymphocytes, plasmacytes, and histiocytes.19 All histologic analyses in this study were performed by two pathologists (S.K and Y.Z) who were blinded to the clinical features of the samples. For each patient, the medical record was reviewed retrospectively and the following data were recorded: age, gender, medical history, and preoperative diagnosis. We examined whether the patient had a history of cardiovascular, autoimmune, or pancreatic disease (autoimmune pancreatitis).9 History of allergic disorders, such as bronchial asthma and drug allergy, was also examined because associations between IgG4-SD and allergic reactions have been suggested.20 All patients with TAA and Takayasu aortitis were under preoperative surveillance for 6 months to 2 years. Infectious aortitis was observed for 1 to 3 weeks preoperatively. For all except the 44 patients with aortic dissection, preoperative serologic findings for white blood cell (WBC) count and C-reactive protein (CRP) level were available ��1 month before operation. In 35 patients with aortic dissection, preoperative serologic data did not reflect the long-term immune status because the patients first entered our hospitals in a state of rapid dissection requiring emergency surgery. All patients underwent radiologic examination, such as angiography, computed tomography, or magnetic resonance imaging. Maximum luminal diameter of the aneurysm was calculated on radiologic imaging in each patient. Location of the aortic lesion was classified into ascending or descending thoracic aorta, or aortic arch.

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