Résumé
<p><b>BACKGROUND</b>The zotarolimus-eluting stent has shown larger in-stent late lumen loss compared to sirolimus-eluting stents in previous studies. However, this has not been thoroughly evaluated in ST elevation myocardial infarction.</p><p><b>METHODS</b>This was a prospective, randomized, controlled trial evaluating angiographic outcomes in patients presenting with ST elevation myocardial infarction, treated with zotarolimus-eluting stents or sirolimus-eluting stents. From March 2007 to February 2009, 122 patients were randomized to zotarolimus-eluting stents or sirolimus-eluting stents in a 1:1 fashion. The primary endpoint was 9-month in-stent late lumen loss confirmed by coronary angiography, and secondary endpoints were percent diameter stenosis, binary restenosis rate, major adverse cardiac events (a composite of cardiac death, non-fatal myocardial infarction, and target vessel revascularization), and late-acquired incomplete stent apposition.</p><p><b>RESULTS</b>Angiographic in-stent late lumen loss was significantly higher in the zotarolimus-eluting stent group compared to the sirolimus-eluting stent group ((0.49 ± 0.65) mm vs. (0.10 ± 0.46) mm, P = 0.001). Percent diameter stenosis at 9-month follow-up was also larger in the zotarolimus-eluting stent group ((30.0 ± 17.9)% vs. (17.6 ± 14.0)%, P < 0.001). In-segment analysis showed similar findings. There were no significant differences in binary restenosis rate, major adverse cardiac events, and late-acquired incomplete stent apposition.</p><p><b>CONCLUSIONS</b>Compared to sirolimus-eluting stents, the zotarolimus-eluting stent is associated with significantly higher in-stent late lumen loss at 9-month angiographic follow-up in the treatment of ST elevation myocardial infarction. Although there was no significant difference in 1-year clinical outcomes, the clinical implication of increased late lumen loss should be further studied.</p>
Sujets)
Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Angioplastie coronaire par ballonnet , Méthodes , Endoprothèses à élution de substances , Infarctus du myocarde , Thérapeutique , Sirolimus , Utilisations thérapeutiques , Résultat thérapeutiqueRésumé
Osmidrosis develops in many young people due to the apocrine gland becoming active after the adolescent period and can cause difficulty in social activities and personal relationships. We compared 2 surgical treatment methods for osmidrosis, superficial suction and subdermal excision, to determine how many of apocrine glands could be removed and examine if a significant difference was present in treatment outcome. The subjects used for the present study included 62 patients of whom 46 patients underwent subdermal excision and 16, superficial suction. We counted the total number of apocrine glands in tissue samples obtained using those 2 methods, fixed in formalin and treated with usual histologic treatment. We calculated the number of apocrine glands per unit area by measuring the axillary area of the surgery site determined before surgery. The patients who underwent surgery using those 2 methods were divided into satisfactory group and unsatisfactory group by evaluating the results subjectively and objectively after surgery. The satisfactory rate was 95.7% in 46 patients who underwent subdermal excision and 81.25% in 16 patients who underwent superficial suction. An average of 127.82 apocrine glands/ cm2 were removed through subdermal excision and 72.71 apocrine glands/cm2, through superficial suction. We determined that more apocrine glands were removed with a statistical significance using subdermal excision. However, considering the result that 81.25% satisfactory rate was seen despite 57% of apocrine glands being removed with superficial suction compared with subdermal excision, superficial suction would be also effective in reducing the number of apocrine glands to below a threshold.