著者

Ayumu Fujioka Kenji Yanishi Arito Yukawa Kojiro Imai Isao Yokota Kei Fujikawa Ayumu Yamada Akari Naito Keisuke Shoji Hirofumi Kawamata Yukihito Higashi Tomoaki Ishigami Ken-ichiro Sasaki Syuhei Tara Koichiro Kuwahara Satoshi Teramukai Satoaki Matoba

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0046, (Released:2023-03-10)

参考文献数

24

被引用文献数

4

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Background: Thromboangiitis obliterans (TAO) can lead to the development of critical limb-threatening ischemia (CLTI). Despite conventional treatments, such as smoking cessation or revascularization, young patients (<50 years) still require limb amputation. Therapeutic angiogenesis using bone marrow-derived mononuclear cell (BM-MNC) implantation has been tested and shown to have reasonable efficacy in CLTI. In this multicenter prospective clinical trial, we evaluated the safety and efficacy of BM-MNC implantation in CLTI patients with TAO.Methods and Results: We enrolled 22 CLTI patients with skin perfusion pressure (SPP) <30 mmHg. The primary endpoint of this trial is the recovery of SPP in the treated limb after a 180-day follow-up period. Secondary endpoints include the pain scale score and transcutaneous oxygen pressure (TcPO2). One patient dropped out during follow-up, leaving 21 patients (mean age 48 years, 90.5% male, Fontaine Class IV) for analysis. BM-MNC implantation caused no serious adverse events and increased SPP by 1.5-fold compared with baseline. Surprisingly, this effect was sustained over the longer term at 180 days. Secondary endpoints also supported the efficacy of this novel therapy in relieving pain and increasing TcPO2. Major amputation-free and overall survival probabilities at 3 years among all enrolled patients were high (95.5% and 89.5%, respectively).Conclusions: BM-MNC implantation showed safety and significant efficacy in CLTI patients with TAO.

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

Shinobu Sugihara Ichiro Hisatome Masanari Kuwabara Koichiro Niwa Nani Maharani Masahiko Kato Kazuhide Ogino Toshihiro Hamada Haruaki Ninomiya Yukihito Higashi Kimiyoshi Ichida Kazuhiro Yamamoto

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.79, no.5, pp.1125-1132, 2015-04-24 (Released:2015-04-24)

参考文献数

41

被引用文献数

24 82

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Background:Uric acid (UA) serves as an antioxidant in vascular endothelial cells. UA transporter 1 (URAT1) encoded by SLC22A12 is expressed in the kidney and vessels and its loss of function causes hypouricemia. The purpose of this study was to examine whether there is any endothelial dysfunction in patients with hypouricemia.Methods and Results:Twenty-six patients with hypouricemia (<2.5 mg/dl) and 13 healthy control subjects were enrolled. Endothelial function was evaluated using flow-mediated dilation (FMD). mRNA of UA transporters expressed in cultured human umbilical endothelial cells (HUVEC) was detected on RT-PCR. There was a positive correlation between FMD and serum UA in the hypouricemia group. URAT1 loss-of-function mutations were found in the genome of 21 of 26 patients with hypouricemia, and not in the other 5. In the hypouricemia groups, serum UA in homozygous and compound heterozygous patients was significantly lower than in other groups, suggesting that severity of URAT1 dysfunction may influence the severity of hypouricemia. Thirteen of 16 hypouricemia subjects with homozygous and compound heterozygote mutations had SUA <0.8 mg/dl and their FMD was lower than in other groups. HUVEC do not express mRNA of URAT1, suggesting the null role of URAT1 in endothelial function.Conclusions:Depletion of UA due to SLC22A12/URAT1 loss-of-function mutations causes endothelial dysfunction in hypouricemia patients. (Circ J 2015; 79: 1125–1132)

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

Shinobu Sugihara Ichiro Hisatome Masanari Kuwabara Koichiro Niwa Nani Maharani Masahiko Kato Kazuhide Ogino Toshihiro Hamada Haruaki Ninomiya Yukihito Higashi Kimiyoshi Ichida Kazuhiro Yamamoto

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-14-1267, (Released:2015-02-23)

参考文献数

41

被引用文献数

10 82

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Background:Uric acid (UA) serves as an antioxidant in vascular endothelial cells. UA transporter 1 (URAT1) encoded by SLC22A12 is expressed in the kidney and vessels and its loss of function causes hypouricemia. The purpose of this study was to examine whether there is any endothelial dysfunction in patients with hypouricemia.Methods and Results:Twenty-six patients with hypouricemia (<2.5 mg/dl) and 13 healthy control subjects were enrolled. Endothelial function was evaluated using flow-mediated dilation (FMD). mRNA of UA transporters expressed in cultured human umbilical endothelial cells (HUVEC) was detected on RT-PCR. There was a positive correlation between FMD and serum UA in the hypouricemia group. URAT1 loss-of-function mutations were found in the genome of 21 of 26 patients with hypouricemia, and not in the other 5. In the hypouricemia groups, serum UA in homozygous and compound heterozygous patients was significantly lower than in other groups, suggesting that severity of URAT1 dysfunction may influence the severity of hypouricemia. Thirteen of 16 hypouricemia subjects with homozygous and compound heterozygote mutations had SUA <0.8 mg/dl and their FMD was lower than in other groups. HUVEC do not express mRNA of URAT1, suggesting the null role of URAT1 in endothelial function.Conclusions:Depletion of UA due to SLC22A12/URAT1 loss-of-function mutations causes endothelial dysfunction in hypouricemia patients.