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T Nishibe

Publications and source records attributed to T Nishibe.

At least 19 recordsLinked to original sources
PubMed2006

Presence of prostacyclin receptor in arteriosclerotic human femoral artery.

AIM: Prostacyclin, which is mainly synthesized by vascular endothelial cells, exerts antiplatelet and smooth-muscle-relaxant effects, thereby maintaining cardiovascular homeostasis. Prostacyclin analogues have been clinically proven to improve ischemic symptoms and prevent the occurrence of vascular events in the lower extremities of patients with arteriosclerosis obliterans. We examined the presence of prostacyclin receptor (IP receptor) in an arteriosclerotic human femoral artery. METHODS: Specimens of the femoral artery were obtained at the time of limb amputation from an 83-year-old woman. Atherosclerotic lesions and associated changes such as calcification were evident. The specimens were stained with hematoxylin and eosin, and processed for immunohistochemistry. RESULTS: A monolayer of cells was observed on the luminal side of the femoral artery. Single immunohistochemistry showed the presence of the IP receptors on cells of the luminal side of the femoral artery. Triple-immunofluorescence staining revealed colocalization of IP-receptor-positive cells and cells positive for von Willebrand factor, a marker of vascular endothelial cells. CONCLUSIONS: We investigated the presence of the IP receptor in the human femoral artery immunohistochemically, and demonstrated their strong expression in endothelial cells. This finding suggests that prostacyclin or prostacyclin analogues may act on their receptors on endothelial cells in patients with arteriosclerosis obliterans.

Aged, 80 and over↗
PubMed2006

False aneurysm formation at proximal and distal ends of a stent graft: a rare complication in the repair of endovascular thoracic aortic aneurysm.

This case report demonstrates a rare complication of false aneurysm formation at the proximal and distal ends of a stent graft that was placed in the descending thoracic aorta to repair an atherosclerotic aneurysm with a fibrotic, solid aortic wall. This complication can develop not only in penetrating aortic ulcers and aortic dissections but also in atherosclerotic aneurysms.

Aged↗
PubMed2006

Relationship between air-plethysmographic venous function and clinical severity in primary varicose veins.

AIM: The role of air plethysmography (APG) in the diagnosis of chronic venous insufficiency has not been well established. The purpose of this study was to elucidate the relationship between APG parameters and clinical severity in patients with chronic venous insufficiency. METHODS: Two hundred and ninety-four limbs in 154 patients with primary varicose veins were evaluated by APG. Limbs were categorized according to the clinical classification of chronic venous disease suggested by the Ad Hoc Committee on Reporting Standards in Venous Disease of the North American Chapter of the Society for Vascular Surgery and International Society for Cardiovascular Surgery (SVS/ ISCVS). RESULTS: The venous filling index (VFI) was significantly higher in classes 2, 3, 4, and 5+6 than in class 0 or 1, and did not differ among classes 2, 3, 4, 5+6. The ejection fraction did not differ significantly among the 6 classes, and the residual volume fraction was significantly higher in classes 2, 3, 5+6 than in class 0. CONCLUSIONS: APG is a reasonable method for distinguishing the presence or absence of chronic venous insufficiency, but it cannot discriminate the clinical severity. Among APG parameters, the VFI is the most useful diagnostic parameter in the evaluation of chronic venous insufficiency.

Adult↗
PubMed2005

Long-term results of treatments for varicose veins due to greater saphenous vein insufficiency.

AIM: The purpose of this study was to determine the long-term recurrence rates of greater saphenous vein (GSV) insufficiency after treatments for primary varicose veins, and to elucidate risk factors for recurrence. METHODS: This was a multicenter retrospective analysis of 376 limbs of 296 patients treated for primary varicose veins due to GSV insufficiency from January 1996 to December 1997. The recurrence-free rates after stripping surgery, saphenofemoral ligation, and sclerotherapy were estimated. The risk factors for the recurrence of primary varicose veins were estimated by multiple regression analysis. RESULTS: The follow-up period was 3.1+/-1.3 (mean+/-SD) years. The recurrence-free rates at 4 years after stripping, saphenofemoral ligation and sclerotherapy were 80.7%, 64.5%, and 51.3%, respectively. The saphenofemoral ligation group and sclerotherapy group had significantly higher recurrence rates than the stripping group (P=0.002, P<0.001, respectively). There was no difference in recurrence rates between the saphenofemoral ligation group and sclerotherapy group (P=0.074). Logistic regression analysis revealed that being female (P<0.029) and treatment without stripping (P<0.001) increased the recurrence rate. CONCLUSIONS: Stripping surgery may be the treatment of first choice for patients with varicose veins due to GSV insufficiency. Patients who have not received stripping surgery and female patients require closer follow-up.

Aged↗
PubMed2004

Abdominal aortic aneurysm with left-sided inferior vena cava. Report of a case.

The combination of abdominal aortic aneurysms and congenital anomalies of the inferior vena cava and its tributaries, such as double inferior vena cava, left-sided inferior vena cava, circumaortic renal collar, and retroaortic renal vein, are very rare but of clinical importance to vascular surgeons since these conditions can increase the difficulty of aneurysm resection as well as the risk of venous injury and subsequent excessive bleeding. This report describes a case of an abdominal aortic aneurysm with a left-sided inferior vena cava, and reviews of the incidence, diagnosis, and treatment of these conditions.

Aged↗
PubMed2003

Autologous transplantation of peripheral blood endothelial progenitor cells (CD34+) for therapeutic angiogenesis in patients with critical limb ischemia.

AIM: Intramuscular injection of endothelial progenitor cells (EPCs) may constitute an alternative treatment strategy for patients with critical limb ischemia (CLI). We performed transplantations of EPCs (CD34(+)) extracted from peripheral blood in patients with CLI. The objective of this report is to present the method and early results of intramuscular autologous peripheral blood CD34(+) cell transplantation in the ischemic limb. METHODS: CD34(+) cell transplantation was performed in 2 limbs of 2 patients with CLI, in cases in which it was not possible to perform surgical or percutaneous revascularization. The patients received a granulocyte colony-stimulating factor (G-CSF) prior to the treatment. CD34(+) cells were retrieved from peripheral blood and injected directly into the muscle of the ischemic limb. RESULTS: CD34(+) cells retrieved in patient 1 were 1 x 10(5)/ml and in patient 2 were 1.6 x 10(5)/ml. Transcutaneous oxygen pressure in the foot increased and clinical symptoms improved. Newly visible collateral blood vessels were directly documented by angiography. CONCLUSION: Satisfactory clinical improvement was achieved by using peripheral blood EPCs (CD34(+)) in the patients with CLI. No complications arose following the intramuscular administration of peripheral blood CD34(+) cells.

Aged↗
PubMed2002

Popliteal venous aneurysms: involvement of tibial nerve in aneurysmal wall.

Primary popliteal venous aneurysms are very rare vascular abnormalities, with 50 cases reported in the English literature. Thromboembolic complications are common in popliteal venous aneurysms. Since medical treatment has been proved inadequate, surgical repair is recommended with a minimum time delay. However, it involves some risk because of the complex anatomy of the popliteal space. We report on a case of popliteal venous aneurysm, in which the tibial nerve was involved in the aneurysmal wall and was injured by surgical repair.

Adult↗
PubMed2002

Successful endovascular stent-grafting for thoracic aortic aneurysms in systemic lupus erithematosus. Report of 2 cases and review of the literature.

Systemic lupus erythematosus (SLE) is frequently associated with cardiovascular manifestations but rarely complicated with aortic disease, and surgical treatment is often complicated with later anastomotic dehiscence. We report successful endovascular stent-graft placement (EVSGP) as an alternative to conventional treatment of the aortic aneurysm in patients with SLE and review of the literature. Clinical cases included a 58-year-old woman with a saccular aneurysm of the distal aortic arch and a 52-year-old woman who had the aortic dissection in the whole descending thoracic aorta. Both patients underwent placement of the stent-graft in the diseased aorta through the iliac artery and received steroid perioperatively. Mortality was compared between surgical and medical treatment in the reported 39 cases of SLE associated with aortic aneurysm. Both patients were successfully treated by EVSGP and no inflammatory signs were seen after the procedure. There were no recurrence in the short follow-up period (up to 23 and 15 months after the procedure). In review of the literature, operative mortality (13.6%) was superior to that in patients receiving medical treatment only (53.3%), but two of 19 operative survivors died of rupture afterward. EVSGP can be a useful alternative to conventional treatment of the aortic aneurysm in patients with SLE, although it lacks the support of long-term follow-up data currently.

Adrenal Cortex Hormones↗
PubMed2002

Prosthetic grafts for above-knee femoropopliteal bypass. A multicenter retrospective study of 564 grafts.

BACKGROUND: Many prosthetic grafts including expanded polytetrafluoroethylene (ePTFE) and polyethylene terephthalate (Dacron) have recently been used for above-knee femoropopliteal bypass. The purpose of this study was to identify the factors affecting patency performance and patient survival. METHODS: A multicenter retrospective analysis of 496 patients who received 564 grafts between 1990 and 1999 (325 ePTFE and 239 Dacron). Follow-up extended to 114.5 months, with a mean of 30.8 months (+/-25.9 months). RESULTS: The overall primary patency rate for all grafts was 71.4% at 5 years, 73.7% for ePTFE, and 68.9% for Dacron grafts. The secondary patency rates at 5 years were 84.1% for ePTFE, and 83.8% for Dacron. No significant differences were found. The logistic regression analysis revealed that younger age at operation and smoking history were correlated with decreased primary patency rate. The patency rates were unaffected by postoperative administration of oral anticoagulants or antiplatelet agents, although pharmacotherapy contributed to the improvement of survival rates. Renal failure, cerebral infarction and Dacron decreased survival rate. CONCLUSIONS: We conclude that the patency performances of prosthetic grafts are satisfying. However, the choice of prosthetic grafts for younger patients or patients with a smoking history need to be carefully considered. Cerebral infarction, chronic renal failure and Dacron grafts may decrease the survival rate. The operative indications should be determined carefully in these cases. The administration of beraprost sodium is recommended for postoperative pharmacotherapy.

Aged↗
PubMed2002

A rare case of atherosclerotic popliteal artery aneurysm in a young adult.

Popliteal artery aneurysms are not so clinically frequent but are the most common peripheral aneurysms. They usually affect older men aged over 60 and are caused by atherosclerosis. Whenever they occur in younger men, other more unusual etiologies such as trauma, infection, inflammatory arteritis or popliteal entrapment are responsible. In this paper we present the case of a young male with an atherosclerotic popliteal artery aneurysm without a history of penetrating trauma or other possible etiologies.

Adult↗
PubMed2002

Albumin-coated knitted Dacron aortic prosthses. Study of postoperative inflammatory reactions.

BACKGROUND: The purpose of this study was to investigate the postoperative inflammatory reactions to albumin-coated Dacron grafts (ACGs), which are used in the repair of abdominal aortic aneurysm (AAA). METHODS EXPERIMENTAL DESIGN: a retrospective study with a follow-up period of 14 days. SETTING: University hospital. PATIENTS: 50 patients admitted for elective AAA repair from January 1997 to January 2000. INTERVENTIONS: each patient underwent AAA repair with an ACG (Bard, albumin-coated Dacron graft). MEASURES: the white blood cell (WBC) count, plasma C-reactive protein (CRP) concentration, and body temperature (BT) were determined. The preoperative data, the highest values of the postoperative data, and the values 2 weeks postsurgery were analyzed. RESULTS: The BT, CRP, and WBC increased and peaked at the 1st week postsurgery and then decreased gradually. The BT and WBC levels returned to normal within 2 weeks. The CRP level continued to show slightly elevated values in the 2nd week, but it was not significantly different compared to the preoperative data. CONCLUSIONS: The use of an albumin-impregnated prosthesis for the reconstruction of AAA is biocompatible, since no significant increases in inflammatory reactions are observed in the 2nd week postsurgery.

Aged↗
PubMed2002

Combined spinal and epidural anesthesia for abdominal aortic aneurysm surgery in patients with severe chronic pulmonary obstructive disease.

BACKGROUND: The presence of chronic obstructive pulmonary disease (COPD) should not be considered a contraindication to operation but should rather identify those patients that require special preoperative and postoperative pulmonary care. The purpose of this paper is to report our experience in the use of combined spinal and epidural anesthesia (CSEA) for open AAA repair in such patients. METHODS: From April 1997 to November 1998, three patients with severe COPD underwent elective open infrarenal AAA repair under CSEA. All the patients satisfied one or more of the following criteria: a room air PaO2 =or<60 mmHg, PaCO2 =or>45 mmHg, FEV1 =or<50% of predicted, and/or FVC =or<75% of predicted, and one of them was on home oxygen preoperatively. Preoperative preparation of the patients consisted of breathing exercises with incentive espirometry, elimination of underlaying pulmonary infections and usage of bronchodilator therapy. RESULTS: All the patients tolerated surgery safely. None of them developed postoperative complications, including pneumonia and other respiratory conditions. No significant changes in room air arterial blood gas or pulmonary function was recognized before and after surgery. CONCLUSIONS: CSE anesthesia is a viable anesthetic option for conventional AAA surgery in patients with severe COPD since it can preserve spontaneous breathing and provide additional respiratory benefits over general anesthesia.

Aged↗
PubMed2002

Induction of angiotensin converting enzyme in neointima after intravascular stent placement.

BACKGROUND: To investigate the morphological changes of the arterial wall and the expression of angiotensin converting enzyme (ACE) in the arterial wall after stent placement in a canine model. METHODS: Seventeen mongrel dogs underwent stent placement (Gianturco's Z stent) in the aorta. Six animals were sacrificed at 4 weeks after stent implantation, and the other 5 animals at 12 weeks. The normal aorta was harvested from 6 dogs. The specimens were stained with hematoxylin-eosin (H&E) as well as by immunohistochemistry (smooth muscle specific a-actin, and ACE). Histomorphometric analysis was performed using the sections stained with H&E and smooth muscle specific a-actin. RESULTS: The total intimal area was significantly increased at all time points as compared with the control aorta. The a-actin positive intimal area was also significantly increased at all time points as compared with the control aorta. In the control aorta, luminal endothelial cells as well as a-actin positive medial cells occasionally exhibited faint cytoplasmic staining for ACE. In the 4- and 12-week stented aorta, a-actin positive cells in the neointima and media as well as macrophages in the adventitia stained strongly positive for ACE. CONCLUSIONS: ACE was induced in the neointima after stent placement of the canine aorta. Considering its multiple biological actions, ACE may be associated with the pathogenesis of neointimal hyperplasia after stent placement.

Actins↗
PubMed2001

Oncostatin M promotes biphasic tissue factor expression in smooth muscle cells: evidence for Erk-1/2 activation.

Tissue factor (TF), a transmembrane glycoprotein, initiates the extrinsic coagulation cascade. TF is known to play a major role in mediating thrombosis and thrombotic episodes associated with the progression of atherosclerosis. Macrophages at inflammatory sites, such as atherosclerotic lesions, release numerous cytokines that are capable of modulating TF expression. This study examined the role of oncostatin M (OSM), a macrophage/ T-lymphocyte-restricted cytokine, in the expression of TF in vascular smooth muscle cells (SMCs). It is reported here that OSM stimulated a biphasic and sustained pattern of TF messenger RNA (mRNA). The effect of OSM on TF mRNA expression was regulated at the transcriptional level as determined by nuclear run-offs and transient transfection of a TF promoter-reporter gene construct. OSM-induced TF expression was regulated primarily by the transcription factor NF-kappaB. Activation of NF-kappaB by OSM did not require IkappaB-alpha degradation. Inhibition of MEK activity by U0126 prevented OSM-induced TF expression by suppressing NF-kappaB DNA binding activity as determined by gel-shift analysis. Further, inhibition of Erk-1/2 protein by antisense treatment resulted in suppression of TF mRNA expression, indicating a role for Erk-1/2 in modulating NF-kappaB DNA binding activity. These studies suggest that the induced expression of TF by OSM is primarily through the activation of NF-kappaB and that activation of NF-kappaB is regulated in part by the MEK/Erk-1/2 signal transduction pathway. This study indicates that OSM may play a key role in promoting TF expression in SMCs within atherosclerotic lesions.

Blood Coagulation↗
PubMed2001

Effect of cilostazol on endothelial cell denudation and proliferation in canine vein grafts.

The purpose of the present study was to examine the effects of cilostazol on endothelial cell denudation and proliferation in vein grafts used as arterial substitutes. Unilateral aortoiliac bypass was performed using the lateral jugular vein in 20 mongrel dogs. The animals were divided into two groups according to whether or not cilostazol was given. The grafts were removed at intervals of 1 day and 50 days, and the luminal surface was assessed for endothelial cell coverage (%). The denudation of endothelial cells was less extensive in the cilostazol group than in the control group on postoperative day 1. There was significantly more proliferation of endothelial cells in the control group over the course of time than in the cilostazol group. In conclusion, cilostazol significantly prevented early endothelial cell denudation, although it did not appear to stimulate successive endothelial cell proliferation. Therefore, cilostazol may help preserve an intact intima, which would potentially result in the inhibition of intimal hyperplasia.

Animals↗
PubMed2001

Perforated leiomyosarcoma of Meckel's diverticulum: report of a case.

We report herein a case of leiomyosarcoma of Meckel's diverticulum which presented as a rare manifestation of perforation. A previously healthy 63-year-old man was referred to the Tetsujinkai Eniwa hospital following the sudden development of acute abdominal pain. Abdominal computed tomography revealed a solid mass in the pelvic cavity, and an emergency operation was performed under a provisional diagnosis of peritonitis associated with a pelvic tumor. A perforated tumoral mass was found in Meckel's diverticulum. Segmental resection of the ileum, including the tumor-bearing diverticulum, was performed along with regional lymph node dissection. Histologic examination revealed the lesion to be leiomyosarcoma.

Humans↗
PubMed2001

Repair of false para-anastomotic aortic aneurysms using an endovascular stent graft technique in a patient with severe pulmonary disease: report of a case.

Conventional surgery for para-anastomotic aortic aneurysms is technically challenging, and is associated with high morbidity and mortality. This report describes the case of a patient with severe pulmonary diseases in whom false para-anastomotic aortic aneurysms were successfully repaired using an endovascular stent graft technique.

Aged↗