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1.
Stem Cell Res ; 14(2): 165-76, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25644021

RESUMEN

Identification of pivotal factors potentially present in the in situ environment and capable of influencing the function of CD34(+) cells, which can be used for autologous cell therapy, is of paramount interest. SHh is one of the morphogens essential for embryonic vascular development as well as postnatal neovascularization, and the activation of SHh signaling with angiogenic and vascular differentiation responses in CD34(+) cells by SHh treatment differed depending on the G-CSF treatment or the background disease. SHh enhanced the migration, proliferation, adhesion, and EPC colony forming capacities of G-CSF mobilized CD34(+) cells, increasing the vasculogenic/angiogenic potential for neovascularization. An increase in the differentiation potential of CD34(+) cells toward vascular lineages was demonstrated with SHh treatment involving TGFß signaling pathway. The SHh-activated G-CSF mobilized CD34(+) cells directly contributed to vascular regeneration while non-activated CD34(+) cells showed a lower regenerative capacity in a mouse ischemic hindlimb model. SHh signaling regulates human CD34(+) cell fate and function, and may potentiate the therapeutic effect of G-CSF mobilized CD34(+) cells on ischemic diseases.


Asunto(s)
Antígenos CD34/sangre , Proteínas Hedgehog/metabolismo , Adulto , Animales , Diferenciación Celular/fisiología , Factor Estimulante de Colonias de Granulocitos , Miembro Posterior/irrigación sanguínea , Humanos , Isquemia/sangre , Isquemia/metabolismo , Masculino , Ratones , Ratones Desnudos , Proteínas Recombinantes/química , Transducción de Señal , Proteínas Smad/metabolismo , Factores de Crecimiento Transformadores/metabolismo
2.
Surg Today ; 41(8): 1054-61, 2011 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-21773893

RESUMEN

PURPOSE: We reviewed our experience with homemade stent grafts in the repair of a variety of thoracic aortic lesions. The objective of this study was to assess the early and mid-term outcomes of this therapy. METHODS: From 1999 to 2007, homemade stent grafts were inserted in 88 patients with an atherosclerotic aneurysm, dissection, pseudoaneurysm, trauma, or rupture in the thoracic aorta. The endoprostheses were stainless steel Z-stents covered by a polyester graft, and were custom-designed for each patient. RESULTS: Placement of stent grafts was technically successful in 81 of the 88 patients (92%). Within 30 days after treatment, 3 patients died, 3 had a cerebral infarction, and 3 had onset of paraplegia or paraparesis. Primary endoleaks were observed in 8 patients (9%). During the mean follow-up period of 32 ± 26 months, 7 patients had persistent endoleaks and 7 had stent-graft migration. The aneurysm-related mortality rate was 7%. The rate of freedom from open-surgery conversion at 32 months was 89.0%. CONCLUSIONS: Our early experience with elective and emergency thoracic endovascular aortic repair using homemade stent grafts provided therapeutic benefits to high-risk patients. Endoleaks and stent-graft migrations were the factors most commonly responsible for secondary intervention in the mid-term period. Careful follow-up of patients treated with this approach is needed to avoid major complications in the long term.


Asunto(s)
Aorta Torácica , Enfermedades de la Aorta/cirugía , Implantación de Prótesis Vascular , Prótesis Vascular , Procedimientos Endovasculares , Stents , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Enfermedades de la Aorta/etiología , Enfermedades de la Aorta/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tereftalatos Polietilenos , Diseño de Prótesis , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento , Adulto Joven
3.
Kyobu Geka ; 64(1): 9-14, 2011 Jan.
Artículo en Japonés | MEDLINE | ID: mdl-21229672

RESUMEN

We reviewed our experience with homemade stent-grafts in the repair of thoracic aortic lesions. The objective of this study was to assess the long-term outcomes of this therapy. From 1999 to 2008, homemade stent-grafts were inserted in 94 patients with various thoracic diseases. The endoprostheses were stainless steel Z-stents covered with polyester graft and were custom designed for each patient. Placement of the stent-grafts was technically successful in 85 of the 94 patients (90%). Within 30 days after the treatment, 4 patients died, 3 had cerebral infarction, and 3 had the onset of paraplegia or paraparesis. Primary endoleaks were observed in 10 patients (11%). During the mean follow-up period of 43 +/- 29 months, 10 patients had endoleaks and 8 had stent-graft migration. The aneurysm-related mortality rate was 12%. Our early outcomes of elective and emergency thoracic endovascular aortic repair with homemade stent-grafts demonstrated their therapeutic effectiveness in high-risk patients with various thoracic diseases. Endoleaks and migration were, however, the factors most responsible for secondary intervention in the mid-term period. Careful follow-up of the treated patients is needed to avoid the major complication in the long-term period.


Asunto(s)
Aorta Torácica , Stents , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Enfermedades de la Aorta/cirugía , Enfermedades de la Aorta/terapia , Procedimientos Endovasculares , Diseño de Equipo , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , Injerto Vascular
4.
Vasc Endovascular Surg ; 44(8): 668-73, 2010 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-20724287

RESUMEN

OBJECTIVES: The purpose of this study was to evaluate and compare our recent clinical experience with temporary inferior vena cava (IVC) filters (TF) and retrievable IVC filters (RF). MATERIALS AND METHODS: Patients who received TF or RF implantation between October 2002 and May 2009 were studied. The early clinical outcomes between the 2 groups were compared. RESULTS: Nonpermanent IVC filters were placed in 119 patients (34 in TF and 85 in RF). Retrieval of RF and removal of TF were successful in 98.7% and 100%, respectively. The incidence of filter-related complications for TF was significantly higher than for RF (26.5% vs 3.5%; P = .0004). However, no symptomatic pulmonary embolism (PE) was observed during filter placement. CONCLUSION: TF and RF provided similar protection from PE. We prefer RF because they can be left in permanently if it is impossible to remove or retrieve the filter for some reason.


Asunto(s)
Extremidad Inferior/irrigación sanguínea , Embolia Pulmonar/prevención & control , Filtros de Vena Cava , Tromboembolia Venosa/prevención & control , Trombosis de la Vena/terapia , Adulto , Anciano , Anciano de 80 o más Años , Distribución de Chi-Cuadrado , Remoción de Dispositivos , Femenino , Humanos , Japón , Masculino , Persona de Mediana Edad , Diseño de Prótesis , Embolia Pulmonar/etiología , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento , Filtros de Vena Cava/efectos adversos , Tromboembolia Venosa/etiología , Trombosis de la Vena/complicaciones , Adulto Joven
5.
Ann Vasc Surg ; 24(7): 952.e13-6, 2010 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-20599351

RESUMEN

A 49-year-old man was referred to our hospital at 10 days after the onset of sudden intermittent claudication of the right lower limb and with right lower abdominal pain. Diagnosis by computed tomography scan and pelvic angiography was dissection from the common iliac artery to peripheral external iliac artery with thrombosed false lumen. Replacement of the common and external iliac artery was performed using a 10-mm Dacron prosthesis. A pathological examination of the right common iliac artery revealed an arterial disorder caused by fibromuscular dysplasia.


Asunto(s)
Disección Aórtica/etiología , Aneurisma Ilíaco/etiología , Dolor Abdominal/etiología , Disección Aórtica/diagnóstico por imagen , Disección Aórtica/patología , Disección Aórtica/cirugía , Implantación de Prótesis Vascular , Displasia Fibromuscular/complicaciones , Displasia Fibromuscular/diagnóstico por imagen , Displasia Fibromuscular/patología , Displasia Fibromuscular/cirugía , Humanos , Aneurisma Ilíaco/diagnóstico por imagen , Aneurisma Ilíaco/patología , Aneurisma Ilíaco/cirugía , Claudicación Intermitente/etiología , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
6.
Asian Cardiovasc Thorac Ann ; 17(5): 505-9, 2009 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-19917794

RESUMEN

Venous thromboembolism is the most preventable illness among patients in hospital. We prepared guidelines for the prophylaxis of venous thromboembolism, based on previous experience of perioperative risk factors. The aim of this study was to evaluate the effectiveness of these guidelines. All 1,467 patients who underwent surgery for thoracic or cardiovascular disease between April 2002 and July 2004, before the prophylactic guidelines were implemented, were assigned to group A. Another 1,389 patients who had surgery between August 2004 and December 2006, after the guidelines had been implemented, formed group B. The incidences of venous thromboembolism perioperatively in the 2 groups were compared. Six (0.4%) patients in group A developed deep vein thrombosis or pulmonary embolism, whereas no patient in group B experienced thromboembolism. The difference between groups was significant, so we consider our guidelines for venous thromboembolism prevention in the perioperative period to be clinically useful.


Asunto(s)
Anticoagulantes/uso terapéutico , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Aparatos de Compresión Neumática Intermitente , Medias de Compresión , Procedimientos Quirúrgicos Torácicos/efectos adversos , Tromboembolia Venosa/prevención & control , Adulto , Anciano , Terapia Combinada , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Guías de Práctica Clínica como Asunto , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento , Tromboembolia Venosa/epidemiología , Tromboembolia Venosa/etiología
7.
Surg Today ; 39(9): 764-9, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19779772

RESUMEN

PURPOSE: To evaluate the recent clinical experience with nonpermanent inferior vena cava (IVC) filter placement preoperatively, especially with regard to patients who had deep venous thrombosis (DVT) due to compression by a tumor or an aneurysm. METHODS: Preoperative prophylactic IVC filter placement was performed between October 2002 and March 2008 in 48 of 83 patients who underwent IVC filter placement. IVC filter placement was performed preoperatively in 35 of the 48 patients due to DVT located distally in an iliac vein or due to IVC compression by a tumor or aneurysm. This study examined the early and mid-term outcomes resulting from nonpermanent IVC filter placement. RESULTS: The mean implantation period was 11.1 +/- 9.3 days (range, 3-56 days). Three patients (8.6%) experienced minor complications during the IVC filter placement. A thrombus was captured in the filter in 4 patients (8.8%). One patient in whom the filter was left as a permanent filter died during the follow-up period. No patient experienced any pulmonary embolus during the follow-up period. CONCLUSION: Nonpermanent IVC filter insertion is perioperatively useful in surgical procedures that eliminate the compression of the vein by an excision of either the tumor or aneurysm compressing the vein.


Asunto(s)
Embolia Pulmonar/prevención & control , Filtros de Vena Cava , Insuficiencia Venosa/complicaciones , Trombosis de la Vena/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Anticoagulantes/uso terapéutico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuidados Preoperatorios , Embolia Pulmonar/etiología , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Insuficiencia Venosa/diagnóstico por imagen , Trombosis de la Vena/diagnóstico por imagen
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