The purpose of this study was to examine the relationship between muscle oxygenation kinetics and tolerance to fatigue (Fr) on short-term maximal isometric knee extension exercise for healthy endurance-trained women. The decline rate of Tissue Oxygenation Index (TOI) at the onset of exercise had a significant negative correlation to Fr (r=-0.76, p<0.05). The half-time of TOI recovery tended to have a positive correlation to Fr (r=0.74, p=0.056). The subjects with higher localized tolerance to fatigue showed greater deoxygenation at the onset of exercise and faster reoxygenation at recovery.

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Objectives: We administered a multidisciplinary approach utilizing a combination of various treatments, in addition to revascularization, for critical limb ischemia (CLI). We herein report our treatments’ protocols and outcomes of this multidisciplinary approach in patients with CLI. Patients and Methods: Between January 2007 and September 2012, we treated 48 limbs of CLI by multidisciplinary treatments. Results: We administered the multidisciplinary treatments as follows: 18 limbs were treated with bypass surgery, 17 limbs were treated with endovascular treatment and 15 limbs were treated with hybrid treatment. As an additional therapy for revascularization; 16 limbs were treated with negative pressure wound therapy, 22 limbs were treated with maggot debridement therapy, 17 limbs were treated with hyperbaric oxygen therapy, three limbs were treated with low-density lipoprotein apheresis, seven limbs were treated with free tissue transfer and 17 limbs were treated with skin grafting. The limb salvage rate was 79%, and the 1-, 2- and 3-year amputation-free survival rates were 82.3%, 75.0% and 68.2%, respectively. Conclusions: Limb salvage might be achieved with multidisciplinary treatment for CLI, even when the patient has severe comorbidities. Such treatments should be considered in patients with extensive tissue loss before amputation is performed.

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A 38-year-old woman was found to have low plasma renin activity and a high plasma aldosterone concentration. The diagnosis of primary aldosteronism with a double inferior vena cava and a multiple renal arteries was noted. This case is reported here for the reviewer’s consideration.

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