Single-Center Contemporary Clinical Outcomes after Endovascular Treatment in Patients with De Novo Femoropopliteal Lesions between 2017 and 2019

Background: Drug-coated balloons (DCBs) and drug-eluting stents (DES) were available for treating femoropopliteal disease since 2017 and 2019. However, there are few reports to investigate whether approval of DCB and DES improved primary patency in clinical practice. Materials and Methods: We divided consecutive 407 patients into 2017 (n=93), 2018 (n=128), and 2019 (n=186) groups, undergoing endovascular therapy (EVT) for de novo femoropopliteal lesions in our hospital. We retrospectively compared clinical characteristics, procedure, and one-year patency between the three groups. Results: Baseline characteristics were not different except for the lower rate of popliteal lesions in 2017 (p=0.030). Use of DCB increased from 7.5% in 2017 to 38.7% in 2019, and use of DES from 0.0% in 2018 to 24.2% in 2019. One-year primary patency increased significantly both from 2017 to 2018 (62.7% vs. 70.8%, p=0.036) and from 2018 to 2019 (70.8% vs. 80.5%, p=0.025). Cox proportional multivariate analysis revealed that restenosis was independently associated with advanced age (p=0.036) and hemodialysis (p=0.003). Conversely, use of paclitaxel-based devices (p\u3c0.001) and larger diameter of finalized devices (p=0.005) were protective factors against restenosis. Conclusion: One-year primary patency after EVT in femoropopliteal lesions was improved annually by utilizing DCB and DES, individually

Indocyanine green angiography findings in initial acute pretreatment Vogt-Koyanagi-Harada disease in Japanese patients

Purpose: Indocyanine green angiography (IA) is a highly sensitive method to evaluate choroidal inflammatory lesions. We present standardized IA findings of initial acute Vogt-Koyanagi-Harada (VKH) disease in Japanese patients before therapeutical intervention. Methods: Medical records of patients with VKH disease at Tokyo Medical and Dental University Hospital and Miyata Eye Hospital were retrospectively analyzed. We analyzed six IA signs: choroidal perfusion inhomogeneity, early hyperfluorescent stromal vessels, hypofluorescent dark dots (HDDs), fuzzy or lost pattern of large stromal vessels, disc hyperfluorescence, and diffuse late choroidal hyperfluorescence. Results: Ten patients from the two hospitals were studied. The most constant findings present in all eyes were early hyperfluorescent stromal vessels, HDDs, and either fuzzy or lost pattern of large stromal vessels. Disc hyperfluorescence was present in 18 eyes. Choroidal perfusion inhomogeneity was seen in six patients, and diffuse late choroidal hyperfluorescence was seen to a certain degree in all eyes. Conclusions: Four of the analyzed signs, including early hyperfluorescent stromal vessels, HDDs, fuzzy or lost pattern of large stromal vessels, and disc hyperfluorescence were consistent findings in Japanese VKH patients. Because the primary lesion is situated in the choroid, IA is the method of choice to monitor disease activity in VKH diseas

Polymorphous Low-Grade Adenocarcinoma Arising at the Retromolar Region: A Rare Case of High-Grade Malignancy

Polymorphous low-grade adenocarcinoma (PLGA) is an entity under the subclassification of adenocarcinoma from salivary glands. We report here a rare case of PLGA with suspected metastases to a regional lymph node and the liver, confirmed by magnetic resonance imaging and computed tomography. An 88-year-old Japanese woman complaining of pain in the left mandible, specifically in the gingiva upon swallowing, was referred to our clinical department in July 2003. The pain in the left mandibular gingiva had been noted 10 months before the first medical examination. Oral examination revealed a 38 × 30 mm mass forming from the left retromolar region to the glossopalatal arch with ulcer. An incisional biopsy of the mass revealed PLGA. Histopathologically, tumor cells presenting mild atypia showed tubular and cribriform structures. Immunohistochemically, the Ki-67 labeling index showed 31% suggesting a potential high-grade malignancy of tumor cells

A patient with octopus pot-shaped cardial cancer that metastasized to multiple organs

A 71-year-old male was admitted for abdominal fullness. The condition rapidly deteriorated in a short period (3weeks), and the patient died. Autopsy revealed a protruding lesion measuring about 3 cm with erosion measuring 5mmin diameter immediately below the esophago-gastric conjugation site, suggesting primary cardial undifferentiated adenocarcinoma. In the primary focus, changes on the mucosal surface were almost normal. However, below the mucosa, infiltration of cancer cells was observed in an approximately 3 cm area along the gastric wall. Simultaneously, the site of infiltration was markedly increased in deep areas. Extra serous infiltration was observed. The morphology was special, and resembled an octopus pot, a trap used to catch octopuses in Japan, with a narrow top and a broad base. In our patient, metastatic lesions were detected in multiple organs, including the stomach

Nuclear factor (erythroid derived 2)-like 2 activation increases exercise endurance capacity via redox modulation in skeletal muscles

Sulforaphane (SFN) plays an important role in preventing oxidative stress by activating the nuclear factor (erythroid derived 2)-like 2 (Nrf2) signalling pathway. SFN may improve exercise endurance capacity by counteracting oxidative stress-induced damage during exercise. We assessed running ability based on an exhaustive treadmill test (progressive-continuous all-out) and examined the expression of markers for oxidative stress and muscle damage. Twelve- to 13-week-old Male wild-type mice (Nrf2+/+) and Nrf2-null mice (Nrf2−/−) on C57BL/6J background were intraperitoneally injected with SFN or vehicle prior to the test. The running distance of SFN-injected Nrf2+/+ mice was significantly greater compared with that of uninjected mice. Enhanced running capacity was accompanied by upregulation of Nrf2 signalling and downstream genes. Marker of oxidative stress in SFN-injected Nrf2+/+ mice were lower than those in uninjected mice following the test. SFN produced greater protection against muscle damage during exhaustive exercise conditions in Nrf2+/+ mice than in Nrf2−/− mice. SFN-induced Nrf2 upregulation, and its antioxidative effects, might play critical roles in attenuating muscle fatigue via reduction of oxidative stress caused by exhaustive exercise. This in turn leads to enhanced exercise endurance capacity. These results provide new insights into SFN-induced upregulation of Nrf2 and its role in improving exercise performance

Pre-Angioplasty Instantaneous Wave-Free Ratio Pullback Predicts Hemodynamic Outcome In Humans With Coronary Artery Disease: Primary Results of the International Multicenter iFR GRADIENT Registry.

The authors sought to evaluate the accuracy of instantaneous wave-Free Ratio (iFR) pullback measurements to predict post-percutaneous coronary intervention (PCI) physiological outcomes, and to quantify how often iFR pullback alters PCI strategy in real-world clinical settings.This article is freely available via Open Access. Please click on the Additional Link above to access the full-text via the publisher's site