著者

Yuichi Fujii Junko Soga Shuji Nakamura Takayuki Hidaka Takaki Hata Naomi Idei Noritaka Fujimura Kenji Nishioka Kazuaki Chayama Yasuki Kihara Yukihito Higashi

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.74, no.8, pp.1684-1688, 2010 (Released:2010-07-23)

参考文献数

22

被引用文献数

9 20

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Background: A corkscrew collateral appearance on angiography is one of the diagnostic criteria for Buerger's disease. The purpose of the present study was to classify the angiographic findings of corkscrew collaterals and to evaluate the relationship between corkscrew collateral type and the severity of Buerger's disease. Methods and Results: Corkscrew collaterals were assessed on digital subtraction angiography in lower extremities of 28 patients with Buerger's disease (55 limbs). The corkscrew sign was classified into 4 types by size and pattern as follows: type I, artery diameter >2 mm, large helical sign; type II, diameter >1.5 mm and ≤2 mm, medium helical sign; type III, diameter ≥1 mm and ≤1.5 mm, small helical sign; and type IV, diameter <1 mm, tiny helical sign. The prevalence of ischemic ulcers was significantly higher in patients with types III and IV corkscrew collaterals than in patients with types I and II corkscrew collaterals either below or above the knee. Multiple regression analysis indicated that types III and IV below the knee are independent predictors of risk of ischemic ulcers. Conclusions: The prevalence of ischemic ulcers is significantly higher in patients who have small corkscrew patterns in distal segments of limb collaterals than in patients who have large corkscrew collaterals.  (Circ J 2010; 74: 1684 - 1688)

著者

Tatsuya Maruhashi Masahiko Ogawa Yasuo Fukunaga Daisaku Kitaura Masato Kajikawa Shinji Kishimoto Yuji Takaeko Takayuki Yamaji Takahiro Harada Yu Hashimoto Yiming Han Aya Mizobuchi Farina Mohamad Yusoff Kazuaki Chayama Ayumu Nakashima Chikara Goto Kenichi Yoshimura Yukiko Nakano Yukihito Higashi

出版者

Japan Society for Vascular Failure

雑誌

Vascular Failure (ISSN:24324477)

巻号頁・発行日

vol.6, no.1, pp.14-19, 2022-12-25 (Released:2023-02-14)

参考文献数

15

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Background: Sleep apnea is an independent risk factor for motor vehicle accidents. We investigated the prevalence of sleep-disordered breathing (SDB) among commercial motor vehicle drivers in a transport company. Methods: Among 355 drivers in a transport company, 345 commercial motor vehicle drivers (mean age: 47.0±8.8 years, range: 21-71 years) underwent unattended out-of-center sleep testing using a type IV portable sleep monitor between September 2019 and November 2019.Results: The prevalence of oxygen desaturation index 3% (ODI3) score ≥15 was 17.7%. The prevalence of moderate-to-severe SDB, defined as respiratory event index (REI) score ≥15, was 31.9%. The prevalence of Epworth Sleepiness Scale (ESS) score ≥11 was 15.3%. There was no significant correlation between the ESS score and ODI3 (ρ=−0.05, P=0.40) or REI (ρ=−0.03, P=0.65) score. Multivariate analysis revealed that age (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1.02-1.09, P=0.002), body mass index (OR: 1.14, 95% CI: 1.05-1.23, P<0.001), and daily alcohol intake (OR: 1.98, 95% CI: 1.10-3.55, P=0.02) were significantly associated with moderate-to-severe SDB in drivers. The ESS score was not significantly associated with moderate-to-severe SDB (OR: 0.98, 95% CI: 0.93-1.05, P=0.70).Conclusions: Objective screening tests for sleep apnea such as unattended out-of-center sleep testing may be necessary to improve the health and safety of commercial motor vehicle drivers, especially middle-aged obese male drivers having daily alcohol intake.

著者

Shintaro Sagami Yoshitaka Ueno Shinji Tanaka Kenta Nagai Ryohei Hayashi Kazuaki Chayama

出版者

一般社団法人 日本内科学会

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.54, no.17, pp.2167-2172, 2015 (Released:2015-09-01)

参考文献数

21

被引用文献数

11

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A 52-year-old woman with ulcerative colitis was admitted to our hospital for an ulcerative colitis flare-up under salazosulfapyridine therapy. The symptoms improved with high-dose corticosteroids. After prednisolone was tapered to 10 mg, the frequency of diarrhea increased. The diarrhea was accompanied by joint pain and a skin ulcer with abscess formation, which was diagnosed to be pyoderma gangrenosum. The patient was started on adalimumab. A positive response to the adalimumab therapy was observed after 2 weeks, during which time the ulcerative skin lesion healed completely, however, colonic mucosal healing was achieved at 2 months. Therefore, adalimumab appears to be an effective therapeutic option for patients with ulcerative colitis-associated pyoderma gangrenosum.

著者

Akira Sato Michio Sata Kenji Ikeda Takashi Kumada Namiki Izumi Yasuhiro Asahina Yukio Osaki Kazuaki Chayama Shuichi Kaneko Akito Sakai Morikazu Onji Yoichi Hiasa Takumi Omura Itaru Ozeki Osamu Yokosuka Shuichiro Shiina Mariko Itsubo Shuhei Nishiguchi Katsuharu Hirano Tatsuya Ide Shotaro Sakisaka Takahiro Yamasaki Isao Hidaka Masatoshi Tanaka Soo Ryang Kim Takafumi Ichida

出版者

一般社団法人 日本内科学会

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.52, no.24, pp.2701-2706, 2013 (Released:2013-12-15)

参考文献数

32

被引用文献数

4 14

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Objective We attempted to elucidate the clinical features of chronic hepatitis C patients who develop hepatocellular carcinoma (HCC) after achieving a sustained viral response (SVR) to interferon (IFN) therapy. Methods The clinical features of 130 patients at 19 hospitals who developed HCC after obtaining an SVR were retrospectively reviewed. Results Overall, 107 (82%) of the 130 patients were men, with 92 (71%) being ≥60 years of age and 76, 38 and 16 developing HCC within 5, 5-10 and 10-16.9 years after IFN therapy, respectively. Before receiving IFN therapy, 92 (71%) patients had cirrhosis and/or a low platelet count (<15×104 cells/μL). Lower albumin (<3.9 g/dL) and higher alpha fetoprotein (AFP) (≥10 ng/mL) levels were identified in a multivariate analysis to be independent variables of the development of HCC within five years after IFN therapy. Among 4,542 SVR patients, HCC occurred in 109 (2.4%) during a 5.5-year follow-up period, thus resulting in an occurrence rate of 4.6% for men and 0.6% for women. Conclusion SVR patients with lower albumin or higher AFP levels require careful assessments to prevent early HCC development after IFN therapy. HCC occurrence within >10 years of IFN therapy is not uncommon, and the risk factors remain uncertain, thus suggesting that all SVR patients should undergo long-term follow-up examinations for HCC development.