Pathological findings of late stent thrombosis after paclitaxel-eluting stent implantation for superficial femoral artery disease

AbstractA 76-year-old man presented with right critical limb ischemia. An angiography revealed right SFA occlusion. Therefore, two paclitaxel-eluting stents (Zilver PTXs 6.0mm×120mm stents; Cook Medical, Bloomington, Indiana) were placed, which promoted good blood flow. Follow-up angiography at 6 months also showed no restenosis. However, 10 months later, the patient suddenly visited with acute-onset pain in the right leg. Computed tomography showed the acute occlusion at the stented SFA. Eventually, above-knee amputation was performed due to the poor general condition and progressive limb ischemia. As the pathological finding, heterogeneous neointima formation at the stented site was mainly found. Although neointimal layer consisting of smooth muscle cell (SMC) was partly observed, necrotic tissue was evident in the remaining portion. At the necrotic tissue site, the majority of the components of the material covered by the stent strut were fibrin deposits. The findings of regenerative endothelial cells were not observed at the luminal surface. Nuclei of medial SMCs were also lost between the arterial media and the stent strut.Late stent thrombosis after paclitaxel-eluting stenting for SFA lesion has not been sufficiently evaluated. Here, we report a case of late stent thrombosis with a review including pathological findings.<Learning objective: We reported that a 76-year-old man received paclitaxel-eluting stent for femoropopliteal disease. Ten months later, stent thrombosis was occurred and above-knee amputation was performed. As the pathological finding, heterogeneous neointima formation was mainly found and the regenerative endothelial cells were not observed. Our report suggested that delayed healing and uncovered strut caused by paclitaxel-exposure resulted in late stent thrombosis.

Required clothing ventilation for different body regions in relation to local sweat rates

Required clothing ventilation for different body regions in relation to local sweat rate

The effects of exercise and passive heating on the sweat glands ion reabsorption rates

The sweat glands maximum ion reabsorption rates were investigated (n = 12, 21.7 ± 3.0 years, 59.4 ± 9.8 kg, 166.9 ± 10.4 cm and 47.1 ± 7.5 mL/kg/min) during two separate endogenous protocols; cycling at 30% (LEX) and 60% VO2max(MEX) and one exogenous trial; passive heating (PH) (43°C water lower leg immersion) in 27°C, 50%RH. Oesophageal temperature (Tes), skin temperature (Tsk), and forearm, chest and lower back sweat rate (SR) and galvanic skin conductance (GSC) were measured. Salivary aldosterone was measured pre-and postheating (n = 3). Using the ∆SR threshold for an increasing ∆GSC to identify maximum sweat ion reabsorption rate revealed higher reabsorption rates during MEX compared to PH (mean of all regions: 0.63 ± 0.28 vs. 0.44 ± 0.3 mg/cm2/min, P  0.05). Aldosterone increased more during MEX (72.8 ± 36.6 pg/mL) compared to PH (39.2 ± 17.5 pg/mL) and LEX (1.8 ± 9.7 pg/mL). The back had a higher threshold than the forearm (P  0.05) (mean of all conditions; 0.64 ± 0.33, 0.42 ± 0.25, 0.54 ± 0.3 mg/cm2/min, respectively). Although the differences between conditions may be influenced by thermal or nonthermal mechanism, our results indicate a possibility that the sweat glands maximum ion reabsorption rates may be different between exercise and passive heating without mediating skin regional differences

Regional microclimate humidity of clothing during light work as a result of the interaction between local sweat production and ventilation

Purpose – The aim of this study is to explore the influence of the clothing ventilation in three body regions on the humidity of the local clothing microclimates under five work-shirts immediately after the onset of sweating in light exercise. Design/methodology/approach – The clothing microclimate ventilations were measured at chest, back and upper arm using a manikin. Separate wear trials were performed to determine the sweat production and the humidity of the clothing microclimate at the same locations as where the ventilation was measured during light exercise. Findings – Every shirt shows the greatest value of ventilation index (VI) for the chest and the smallest one for the upper arm. The values of VI differ remarkably at the chest among the five shirts. Comfort sensation became gradually worse as the time passed after starting exercise. There was no significant difference among the clothing conditions in mean values of rectal temperature, local skin temperatures, microclimate temperatures, microclimate relative humidities and local sweat rates at three regions over 10?min after the onset of sweating. A relationship was observed between the ratio of the mean moisture concentration in the clothing microclimate to the mean sweat rate at the chest and the back and the VI. Originality/value – The results suggest that clothing ventilation should be measured in different body regions in response to sweat rates in corresponding regions

Do nitric oxide synthase and cyclooxygenase contribute to sweating response during passive heating in endurance‐trained athletes?

The aim of our study was to determine if habitual endurance training can influence the relative contribution of nitric oxide synthase (NOS) and cyclooxygenase (COX) in the regulation of sweating during a passive heat stress in young adults. Ten trained athletes and nine untrained counterparts were passively heated until oral temperature (as estimated by sublingual temperature, Tor) increased by 1.5°C above baseline resting. Forearm sweat rate (ventilated capsule) was measured at three skin sites continuously perfused with either lactated Ringer\u27s solution (Control), 10 mmol/L NG‐nitro‐L‐arginine methyl ester (L‐NAME, non‐selective NOS inhibitor), or 10 mmol/L ketorolac (Ketorolac, non‐selective COX inhibitor) via intradermal microdialysis. Sweat rate was averaged for each 0.3°C increase in Tor. Sweat rate at the L‐NAME site was lower than Control following a 0.9 and 1.2°C increase in Tor in both groups (all P ≤ 0.05). Relative to the Control site, NOS‐inhibition reduced sweating similarly between the groups (P = 0.51). Sweat rate at the Ketorolac site was not different from the Control at any levels of Tor in both groups (P > 0.05). Nevertheless, a greater sweat rate was measured at the end of heating in the trained as compared to the untrained individuals (P ≤ 0.05). We show that NOS contributes similarly to sweating in both trained and untrained individuals during a passive heat stress. Further, no effect of COX on sweating was measured for either group. The greater sweat production observed in endurance‐trained athletes is likely mediated by factors other than NOS‐ and COX‐dependent mechanisms

The influence of local skin temperature on the sweat glands maximum ion reabsorption rate

PURPOSE: Changes in mean skin temperature (Tsk) have been shown to modify the maximum rate of sweat ion reabsorption. This study aims to extend this knowledge by investigating if modifications could also be caused by local Tsk. METHODS: The influence of local Tsk on the sweat gland maximum ion reabsorption rates was investigated in ten healthy volunteers (three female and seven male; 20.8 ± 1.2 years, 60.4 ± 7.7 kg, 169.4 ± 10.4 cm) during passive heating (water-perfused suit and lower leg water immersion). In two separate trials, in a randomized order, one forearm was always manipulated to 33 °C (Neutral), whilst the other was manipulated to either 30 °C (Cool) or 36 °C (Warm) using water-perfused patches. Oesophageal temperature (Tes), forearm Tsk, sweat rate (SR), galvanic skin conductance (GSC) and salivary aldosterone concentrations were measured. The sweat gland maximum ion reabsorption rates were identified using the ∆SR threshold for an increasing ∆GSC. RESULTS: Thermal [Tes and body temperature (Tb)] and non-thermal responses (aldosterone) were similar across all conditions (p > 0.05). A temperature-dependent response for the sweat gland maximum ion reabsorption rates was evident between 30 °C (0.18 ± 0.10 mg/cm2/min) and 36 °C (0.28 ± 0.14 mg/cm2/min, d = 0.88, p  0.05. CONCLUSION: The data indicate that small variations in local Tsk may not affect the sweat gland maximum ion reabsorption rates but when the local Tsk increases by > 6 °C, ion reabsorption rates also increase

Three cases of myxofibroma.

Myxofibroma is a rare tumor. Three cases of myxofibroma, each of which developed at the right mandibular ramus, mandibular anterior tooth region, are presented. Myxofibroma developing in the mandibular ramus region is rare, and there has been only one case reported so far in Japan.</p

Regional microclimate humidity of clothing during light work as a result of the interaction between local sweat production and ventilation

金沢大学教育学部Purpose - The aim of this study is to explore the influence of the clothing ventilation in three body regions on the humidity of the local clothing microclimates under five work-shirts immediately after the onset of sweating in light exercise. Design/methodology/approach - The clothing microclimate ventilations were measured at chest, back and upper arm using a manikin. Separate wear trials were performed to determine the sweat production and the humidity of the clothing microclimate at the same locations as where the ventilation was measured during light exercise. Findings - Every shirt shows the greatest value of ventilation index (VI) for the chest and the smallest one for the upper arm. The values of VI differ remarkably at the chest among the five shirts. Comfort sensation became gradually worse as the time passed after starting exercise. There was no significant difference among the clothing conditions in mean values of rectal temperature, local skin temperatures, microclimate temperatures, microclimate relative humidities and local sweat rates at three regions over 10 min after the onset of sweating. A relationship was observed between the ratio of the mean moisture concentration in the clothing microclimate to the mean sweat rate at the chest and the back and the VI. Originality/value - The results suggest that clothing ventilation should be measured in different body regions in response to sweat rates in corresponding regions. © Emerald Group Publishing Limited