This study aims to test the hypothesis that the effect of excimer laser coronary angioplasty (ELCA) not only vaporizes thrombi and their underlying coronary plaque, it also changes their quality. We ...performed a series of cross-sectional analyses in 52 lesions in 51 patients before and after ELCA with integrated backscatter-intravascular ultrasound (IB-IVUS). The constituent parts of the plaque can be assessed by IB-IVUS (i.e., calcified, fibrous, lipid) according to integrated backscatter values. Minimum lumen diameter, lumen volume and vessel volume expanded after ELCA, while plaque volume did not significantly decrease. There was also a decrease of ‘lipid’ component (35.4–30.3%,
P
< 0.001) and an increase of IB-IVUS-derived ‘fibrous’ part (34.5–38.3%,
P
< 0.001). These results may help in understanding plaque change after ELCA. Excimer laser coronary angioplasty seems to contribute to the modification of coronary plaque composition in addition to debulking it.
The objective was to prepare guidelines to perform the current optimum treatment by organizing effective and efficient treatments of hemangiomas and vascular malformations, confirming the safety, and ...systematizing treatment, employing evidence-based medicine (EBM) techniques and aimed at improvement of the outcomes. Clinical questions (CQs) were decided based on the important clinical issues. For document retrieval, key words for literature searches were set for each CQ and literature published from 1980 to the end of September 2014 was searched in Pubmed, Cochrane Library, and Japana Centra Revuo Medicina (JCRM). The strengths of evidence and recommendations acquired by systematic reviews were determined following the Medical Information Network Distribution System (MINDS) technique. A total of 33 CQs were used to compile recommendations and the subjects included efficacy of resection, sclerotherapy/embolization, drug therapy, laser therapy, radiotherapy, and other conservative treatment, differences in appropriate treatment due to the location of lesions and among symptoms, appropriate timing of treatment and tests, and pathological diagnosis deciding the diagnosis. Thus, the Japanese Clinical Practice Guidelines for Vascular Anomalies 2017 have been prepared as the evidence-based guidelines for the management of vascular anomalies.
The objective was to prepare guidelines to perform the current optimum treatment by organizing effective and efficient treatments of hemangiomas and vascular malformations, confirming the safety, and ...systematizing treatment, employing evidence‐based medicine (EBM) techniques and aimed at improvement of the outcomes. Clinical questions (CQs) were decided based on the important clinical issues. For document retrieval, key words for literature searches were set for each CQ and literature published from 1980 to the end of September 2014 was searched in Pubmed, Cochrane Library, and Japana Centra Revuo Medicina (JCRM). The strengths of evidence and recommendations acquired by systematic reviews were determined following the Medical Information Network Distribution System (MINDS) technique. A total of 33 CQs were used to compile recommendations and the subjects included efficacy of resection, sclerotherapy/embolization, drug therapy, laser therapy, radiotherapy, and other conservative treatment, differences in appropriate treatment due to the location of lesions and among symptoms, appropriate timing of treatment and tests, and pathological diagnosis deciding the diagnosis. Thus, the Japanese Clinical Practice Guidelines for Vascular Anomalies 2017 have been prepared as the evidence‐based guidelines for the management of vascular anomalies.
The objective was to prepare guidelines to perform the current optimum treatment by organizing effective and efficient treatments of hemangiomas and vascular malformations, confirming the safety and ...systematizing treatment, employing evidence‐based medicine techniques and aimed at improvement of the outcomes. Clinical questions (CQ) were decided based on the important clinical issues. For document retrieval, key words for published work searches were set for each CQ, and work published from 1980 to the end of September 2014 was searched in PubMed, Cochrane Library and Japana Centra Revuo Medicina databases. The strengths of evidence and recommendations acquired by systematic reviews were determined following the Medical Information Network Distribution System technique. A total of 33 CQ were used to compile recommendations and the subjects included efficacy of resection, sclerotherapy/embolization, drug therapy, laser therapy, radiotherapy and other conservative treatment, differences in appropriate treatment due to the location of lesions and among symptoms, appropriate timing of treatment and tests, and pathological diagnosis deciding the diagnosis. Thus, the Japanese Clinical Practice Guidelines for Vascular Anomalies 2017 have been prepared as the evidence‐based guidelines for the management of vascular anomalies.
AbstractBackgroundDepending on the size and site of the venous malformation (VM), patients with VM often experience pain and swelling. VMs in the head and neck typically have lower pain rates due to ...complications than VMs in the limbs and trunk. We evaluated the heuristics on VM pain by statistically analyzing data of patients with VM from a multicenter database in Japan. MethodsWe collected data on age, sex, pain, lesion site, lesion depth, and lesion size for 2199 clinical cases with common VMs. We created categories for lesion depth and size and excluded multiple lesion cases that overlapped in these categories. Next, we constructed cross-tabulation tables to analyze the factors that contributed to pain. Finally, we evaluated the risk of pain in patients with VM by performing binomial logistic regression analysis based on age, sex, lesion site, lesion depth, and lesion size. ResultsFor patients with limb and trunk VMs, the most frequent site of pain was the muscle, tendon, and bone, with an incidence of 79%, followed by the skin and subcutis, with an incidence of 43%. For patients with head and neck VMs, the most frequent site of pain was the muscle, tendon, and bone, with an incidence of 28%, followed by the skin and subcutis, with an incidence of 11% ( P < .01). For pain incidence by lesion size, pain most frequently occurred in lesions >10 cm (67%), followed by lesions between 5 cm and 10 cm (56%) and lesions <5 cm (29%). ConclusionsOur study indicated a clear order of factors that contributed to pain: lesion site > lesion depth > lesion size. Age was also an important factor. Infants and children had low pain complication frequencies with limb and trunk VMs. As the patients aged, the pain frequency became higher, reaching 50% at almost 7 years of age.
We previously reported an outbreak in a neurosurgery ward of catheter-associated urinary tract infection with multidrug-resistant (MDR) Pseudomonas aeruginosa strain IMCJ2.S1, carrying the ...6'-N-aminoglycoside acetyltransferase gene aac(6')-Iae. For further epidemiologic studies, 214 clinical isolates of MDR P. aeruginosa showing resistance to imipenem (MIC >= 16 μg/ml), amikacin (MIC >= 64 μg/ml), and ciprofloxacin (MIC >= 4 μg/ml) were collected from 13 hospitals in the same prefecture in Japan. We also collected 70 clinical isolates of P. aeruginosa that were sensitive to one or more of these antibiotics and compared their characteristics with those of the MDR P. aeruginosa isolates. Of the 214 MDR P. aeruginosa isolates, 212 (99%) were serotype O11. We developed a loop-mediated isothermal amplification (LAMP) assay and a slide agglutination test for detection of the aac(6')-Iae gene and the AAC(6')-Iae protein, respectively. Of the 212 MDR P. aeruginosa isolates, 212 (100%) and 207 (98%) were positive in the LAMP assay and in the agglutination test, respectively. Mutations of gyrA and parC genes resulting in amino acid substitutions were detected in 213 of the 214 MDR P. aeruginosa isolates (99%). Of the 214 MDR P. aeruginosa isolates, 212 showed pulsed-field gel electrophoresis patterns with >=70% similarity to that of IMCJ2.S1 and 83 showed a pattern identical to that of IMCJ2.S1, indicating that clonal expansion of MDR P. aeruginosa occurred in community hospitals in this area. The methods developed in this study to detect aac(6')-Iae were rapid and effective in diagnosing infections caused by various MDR P. aeruginosa clones.
Abstract
System x
c
−
was recently described as the most upstream node in a novel form of regulated necrotic cell death, called ferroptosis. In this context, the small molecule erastin was reported ...to target and inhibit system x
c
−
, leading to cysteine starvation, glutathione depletion and consequently ferroptotic cell death. Although the inhibitory effect of erastin towards system x
c
−
is well-documented, nothing is known about its mechanism of action. Therefore, we sought to interrogate in more detail the underlying mechanism of erastin’s pro-ferroptotic effects. When comparing with some well-known inhibitors of system x
c
−
, erastin was the most efficient inhibitor acting at low micromolar concentrations. Notably, only a very short exposure of cells with low erastin concentrations was sufficient to cause a strong and persistent inhibition of system x
c
−
, causing glutathione depletion. These inhibitory effects towards system x
c
−
did not involve cysteine modifications of the transporter. More importantly, short exposure of tumor cells with erastin strongly potentiated the cytotoxic effects of cisplatin to efficiently eradicate tumor cells. Hence, our data suggests that only a very short pre-treatment of erastin suffices to synergize with cisplatin to efficiently induce cancer cell death, findings that might guide us in the design of novel cancer treatment paradigms.
Purpose: The purpose of this study was to evaluate active knee flexion range of motion and hamstring strength following hamstring anterior cruciate ligament (ACL) reconstruction. Type of Study: Case ...control study, consecutive sample. Methods: Seventy-four consecutive patients who had undergone hamstring ACL reconstruction underwent isokinetic muscle strength testing at 2 years post surgery. Measurements of the maximum standing active knee flexion angle with the hip extended were also taken. During isokinetic testing, we evaluated flexion torque at 90° of knee flexion, in addition to the peak flexion torque. We further compared these parameters of muscle strength around the knee for the patients in whom only semitendinosus tendon was harvested as a graft source (ST group), and those from whom the semitendinosus tendon and the gracilis tendon were harvested (ST/G group). Results: Isokinetic testing showed that, in both the ST and ST/G groups, the knee flexor strength of the involved leg was less effectively restored at 90° of knee flexion than at the angle at which the peak torque was generated. Conversely, no significant difference was seen in the side-to-side ratio in either the peak flexion torque or the 90° flexion torque between the groups. The side-to-side ratio in mean maximum standing knee flexion angle was significantly lower in the ST/G group than in the ST group. Conclusions: This study suggests that the loss of knee flexor strength following the harvest of the hamstring tendons may be more significant than has been previously estimated. Furthermore, multiple tendon harvest may affect the range of active knee flexion.
Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 18, No 6 (July-August), 2002: pp 598–602
Although Klippel-Trénaunay syndrome is a mixed vascular malformation characterized by abnormal growth in the extremities, no uniform diagnostic criteria have been established because of the variety ...in its manifestation. Consequently, no anatomical analysis based on a comparison study has been reported. In this study, the authors determine the frequency of various vascular malformations and abnormal growth and assess any statistical relationship between vascular malformation type/location and abnormal growth in terms of length and girth.
Thirty-five patients with Klippel-Trénaunay syndrome satisfying the criteria proposed by Oduber et al. in 2008 were enrolled. The type and location of the vascular malformation and abnormal circumferential growth were assessed by magnetic resonance imaging and ultrasonography. Bone girth was assessed by axial magnetic resonance imaging/computed tomography. Plain radiographs of the long bones were used to measure growth in length.
The spectrum of vascular types was similar to that in previous reports. There was no significant association between leg length and vascular malformation type or location. Leg bone circumferential hypoplasia was observed in 50 percent of cases and was significantly related to the presence of intramuscular lesions. A single venous malformation in the subcutaneous tissue was significantly associated with the presence of subcutaneous hypertrophy. Patients with intramuscular lymphatic malformations had a significantly higher frequency of muscle hypoplasia.
The type and location of certain vascular malformations were significantly associated with abnormal subcutaneous tissue, muscle, and bone growth.
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