Different Characteristics and Interleukin-6 Ratios of Scattering-Type Aortic Plaques.

Background Cholesterol crystals (CCs) are related to innate inflammation in spontaneously ruptured aortic plaques (SRAPs), and variability exists in the CCs and interleukin (IL)-6 ratio in SRAPs. Methods The prevalence of scattering-type ruptures that glittered against the light of angioscopic fibers (puff-chandelier ruptures) and those that did not (puff ruptures) was analyzed in 848 patients with suspected coronary artery disease. Overall, 177 puff-chandelier ruptures and 105 puff ruptures were sampled using nonobstructive general angioscopy (NOGA). The sampled plaques were analyzed by direct detection of CCs with polarized light microscopy. The characteristics of the plaque fragments from puff and puff-chandelier ruptures were compared. The Interleukin-6 (IL-6) ratios were calculated for 100 puff-chandelier ruptures and 100 puff ruptures. Results CCs were detected in 54% of puff-chandelier ruptures and 20% of puff ruptures. The longer and shorter dimensions of the puff ruptures were smaller than those of the puff-chandelier ruptures. CCs were more prevalent in puff chandeliers than in puff ruptures (54% vs. 20%, respectively; p<0.0001). The number of CCs was higher in puff chandeliers than in puff ruptures with CCs (median 12,727 (interquartile range (IQR) 3,636-25,909)/10 mL vs. median 3,182 ( IQR 909-9,318)/10 mL) in CC-positive samples (p=0.0120). The IL-6 ratio of puff-chandelier ruptures was higher than that of puff ruptures (p=0.0014). Conclusions Examination of plaque fragments from puff-chandelier and puff ruptures revealed a higher prevalence of CCs in puff-chandelier ruptures compared to puff ruptures. Puff chandeliers exhibited a significantly greater number of CCs, suggesting a potential correlation with inflammatory levels. The IL-6 ratio was also higher in puff-chandelier ruptures. Direct detection of CCs and hematoxylin and eosin staining for SRAPs demonstrated variations in CC degree and dimensions between puff-chandelier and puff ruptures. Puff-chandelier ruptures exhibited more CCs associated with innate inflammation and larger fragments than puff ruptures. NOGA proved effective in detecting diverse characteristics and inflammation levels, as indicated by IL-6, in scattering-type SRAPs.

Detection of macrophages engulfing cholesterol crystals and docosahexaenoic acid from spontaneous ruptured aortic plaque.

We visualized macrophages engulfing cholesterol crystals from spontaneously ruptured aortic plaques sampled by angioscopy. Docosahexaenoic acid cholesterol ester (DHA-CE) was demonstrated by imaging mass spectrometry. DHA-CE is reported to be produced by macrophages against inflammation. Activities of macrophages against atherosclerosis inside plaques was shown from spontaneously ruptured aortic plaques in situ. Learning objectives: Activities of macrophages such as engulfing cholesterol crystals and producing docosahexaenoic acid cholesterol ester were shown from spontaneously ruptured aortic plaques in situ.

A novel initial wiring technique for chronic total occlusion of the superficial femoral artery using the structural features of a polymer jacket guidewire.

BACKGROUND: To evaluate the efficacy of the GLadIus MG drilLINg technique (GLIMGLIN), a novel initial wiring technique using the Gladius MG™ structural features, for crossing the superficial femoral artery (SFA) with chronic total occlusion (CTO). METHODS: This retrospective, single-center study enrolled 27 symptomatic patients (mean age 77.4 ± 8.5 years; 20 men) with de novo SFA CTO (mean CTO length 16.1 ± 8.9 cm) who underwent GLIMGLIN as the initial wiring between January 2020 and December 2021. The success of GLIMGLIN was defined when the wire crossing was completed using a Gladius MG™ and a microcatheter without any additional devices and techniques. RESULTS: The success rate of GLIMGLIN was 48.1%. Intravascular ultrasound findings showed complete true lumen passage in the GLIMGLIN success group. Compared to the failure group, the proximal (6.3 ± 0.8 vs. 5.5 ± 0.9 mm, p = 0.02) and distal (5.9 ± 0.5 vs. 5.4 ± 0.6 mm, p = 0.02) reference vessel diameters were significantly larger, and the rate of calcium angle > 180° was significantly lower (30.8 vs. 71.4%, p = 0.04) in the success group. No significant difference was shown in the CTO length between two groups. Total wiring time, total procedure time, and fluoroscopic time were significantly shorter in the success group. CONCLUSIONS: GLIMGLIN may enable operators to perform CTO wiring easily and efficiently in selected cases.

Cytopathological evaluation of potential malignancy of duodenal gastrinoma using aspiration smears from two patients' resected tumors (NET G1, NET G2): A case report.

Sporadic gastrin-producing neuroendocrine tumors (NETs) of the duodenum present with either Zollinger-Ellison syndrome or unspecific syndromes. Ki-67 scoring in cytopathology is an alternative approach for establishing the gastrinoma grade. Although the majority of NETs, including gastrinomas, occur in the duodenum, most research regarding the Ki-67 index is focused on tumors of pancreatic origin. To the best of our knowledge, there is no study on the Ki-67 index for cytological analysis of duodenal gastrinoma. The current report presents two cases of a 56-year-old man and a 66-year-old woman with NET G1 and G2 gastrinoma, respectively, arising in the duodenal bulb. The present report focused on the differences in nuclear pleomorphism and Ki-67 index between these two cases.

Large polypoid angiomyofibroblastoma of the vulva: report of a case.

We report a case of angiomyofibroblastoma which arose in the vulva of a 46-year-old woman. The tumor formed a large pedunculated polypoid mass, measuring 14 cm in maximal dimension, which hung down from the right labium majus. It consisted of a dense or loose proliferation of fibroblastic and myofibroblastic cells on an edematous background, and the tumor cells occasionally exhibited an increased cellularity around well-developed, medium-sized or small blood vessels. In small areas, conglomerates of capillaries exhibited an appearance resembling that of capillary hemangioma. Tumor cells were immunoreactive for vimentin, desmin, estrogen receptor, and progesterone receptor, but not for α-smooth muscle actin, CD34, CD10, S-100 protein, calretinin, podoplanin, or cytokeratin. Angiomyofibroblastoma usually appears as a small subcutaneous nodule, and the formation of a large pedunculated polypoid mass is rare. The differential diagnosis from aggressive angiomyxoma and other mesenchymal tumors which preferentially involve the vulvo-vaginal region was briefly discussed.

Solid-state reduction of silica nanoparticles via oxygen abstraction from SiO4 units by polyolefins under mechanical stressing.

Metal oxides with an oxidation number lower than the highest often exhibit attractive functional properties. However, conventional chemical or thermal reduction of the stable oxides is often laborious and cannot be stopped at an appropriate level of reduction. Therefore, we here try to explore non-conventional reduction processes in a solid-state without external heating. Unique features of reduction processes of SiO2 toward suboxides, SiO x (1 ≤ x < 2), were made possible by milling fumed silica nanoparticles with polyolefins (POL), i.e., polypropylene (PP) or polyethylene (PE) and a fluorine-containing one, polyvinylidene difluoride (PVDF). We mainly examined the electronic and coordination states of Si by Si2p XPS spectra and 29Si MAS NMR, respectively. They significantly differ from a similar commercial product obtained via a thermal route. Judging from the chemical shift of 29Si MAS NMR as a criterion of the degree of reduction of SiO2, the function of POL as a reductant is in the order PP ≈ PE > PVDF. Since the present solid-state reaction is free from the formation of unstable gaseous SiO as an intermediate, the products are free from the Si component in a Q0 state close to that of metallic Si. From these results we conclude that the present silicon suboxides obtained by co-milling silica with POL are closer to those defined as a random bonding model of SiO, than a random mixture model, the former being unachievable by a thermal process. The main mechanism of the present solid-state reduction is the oxygen abstraction from the SiO4 units by the polarized POL, with its simultaneous oxidative decomposition up to the state of carbon. The reaction process is simple and scalable so that it may offer a new affordable fabrication method of silicon suboxides.

Manifestation of J wave induced by acetylcholine applied for a coronary spasm provocation test in a patient with aborted sudden cardiac death.

A 51-year-old man with a resuscitation episode was referred to our hospital. Coronary angiography revealed a focal spasm overlapped with organic stenosis where a bare metal stent was implanted. Acetylcholine (ACh) provocation test did not induce chest pain. It revealed no discernible ST-T changes but unmasked a J wave at the end of the QRS complex, which was associated with short-coupled repetitive premature ventricular beats. A J wave reportedly appears immediately before the onset of ventricular fibrillation caused by vasospastic angina. However, a J wave observed newly after a coronary spasm provocation test using ACh without ST-T changes is informative when considering the mechanisms of the J wave.