Hiroshi Shigematsu - Academia.edu (original) (raw)

Papers by Hiroshi Shigematsu

Journal of Vascular Surgery, 1999

Two patients who had aortopulmonary fistula of postoperative origin with hemoptysis underwent suc... more Two patients who had aortopulmonary fistula of postoperative origin with hemoptysis underwent successful repair by means of an endovascular stent graft procedure. One patient had undergone repeated thoracotomies two times, and the other one time to repair anastomotic aneurysms of the descending aorta after surgery for Takayasu's arteritis. A self-expanding stainless steel stent covered with a Dacron graft was inserted

Journal of Vascular Surgery, 2005

Objective: We prospectively studied the clinical implication of plasma level of soluble fibrin mo... more Objective: We prospectively studied the clinical implication of plasma level of soluble fibrin monomer (FM)-fibrinogen complex, a recently established molecular marker reflecting thrombin activity, in patients with abdominal aortic aneurysm (AAA) undergoing elective aortic repair. Methods: The study included 49 patients who underwent elective aneurysm repair using a gelatin-sealed or nonimpregnated Dacron prosthesis. Plasma level of soluble FM-fibrinogen complex was measured before surgery and on days 1, 3, 5, 7, and 10 postoperatively by latex agglutination assay utilizing monoclonal antibody IF-43. Plasma levels of thrombin-antithrombin complex (TAT), D-dimer, ␣ 2 -plasmin inhibitor-plasmin complex (PIC), and fibrinogen were also evaluated. Results: The preoperative level of soluble FM-fibrinogen complex showed variation in the degree of hemostatic activation, with fair correlations with TAT (r ‫؍‬ 0.509, P < .001), D-dimer (r ‫؍‬ 0.521, P < .001), and PIC (r ‫؍‬ 0.579, P < .001). The patients with greater intraoperative blood loss ‫؍>(‬ 800 mL) showed a significantly elevated plasma level of soluble FM-fibrinogen complex preoperatively compared with those with less intraoperative blood loss (P ‫؍‬ .009). Its postoperative fluctuation showed a similar pattern to that of TAT, reflecting the time course of coagulation activity. Gelatin impregnation of the Dacron vascular graft did not seem to influence the postoperative systemic coagulation mechanism.

Journal of Vascular Surgery - J VASC SURG, 2005

Objective: Surgical treatment of arterial lesions associated with Behçet disease (BD) is often co... more Objective: Surgical treatment of arterial lesions associated with Behçet disease (BD) is often complicated by graft occlusion and recurrence of aneurysms. The purpose of this study was to clarify the long-term outcome of surgical intervention for arterial involvement in BD. Methods: Ten patients with BD (9 men, 1 woman) who underwent surgical treatment for arterial aneurysms between 1980 and 2004 were included in the study. The age of patients at the first operation ranged from 36 to 69 years (mean, 50.4 ؎ 9.0 years). The mean period between the onset of BD and that of arterial manifestations was 8.0 ؎ 5.0 years. We retrospectively reviewed their postoperative courses, including survival, graft occlusion, formation of anastomotic false aneurysms, and the development of aneurysms at different sites. The Kaplan-Meier method was used to calculate the chronologic incidence of complications after surgery. Results: The mean follow-up period was 133 ؎ 92 months, ranging from 5 to 285 months. One patient died of rupture of a dissecting aortic aneurysm after undergoing several surgical interventions for multiple aneurysms. There were five graft occlusions among 21 grafts. The cumulative primary graft patency rate in the infrainguinal region was 83.9% at 3 years. Five anastomotic false aneurysms formed among 49 anastomoses between grafts and host arteries. The overall cumulative incidence of formation of anastomotic pseudoaneurysm was 12.9% at 5 and 10 years. All of them formed within 18 months after surgery. Development of new aneurysms in different arteries was observed in two patients.

Cardiovascular Surgery, 2001

Purpose: This study was a retrospective review of 11 limbs of 10 patients with popliteal artery e... more Purpose: This study was a retrospective review of 11 limbs of 10 patients with popliteal artery entrapment syndrome (PAES) treated surgically in a 20-yr period.

The American Journal of Surgery, 1999

To determine the influence of the site affected by thrombi on the subsequent venous physiology, w... more To determine the influence of the site affected by thrombi on the subsequent venous physiology, we examined patients with postthrombotic syndrome (PTS) with respect to ambulatory venous function using near-infrared spectroscopy (NIRS). Fifty-one limbs of 45 patients, for whom more than 1 year had passed since an acute episode of deep vein thrombosis, were studied. Seventeen limbs were asymptomatic, 27 had mild symptoms (edema only), and 7 showed severe symptoms (skin changes). The mean duration of PTS was 8.2 years. All of the patients underwent a treadmill walking test with simultaneous NIRS. Deoxygenated hemoglobin was continuously measured during exercise. The ambulatory venous retention index (AVRI) obtained from the serial deoxygenated hemoglobin changes was calculated in each patient. The location of thrombi at the onset of deep vein thrombosis was identified by venography. The calculated AVRI was apparently related to the clinical symptoms of PTS. The limbs initially involved with popliteal vein thrombosis showed significantly higher AVRI values than those without popliteal vein thrombosis. The clinical severity of PTS is correlated well with the degree of venous retention during exercise. Initial involvement of the popliteal vein is an important factor determining subsequent venous hemodynamics in patients with PTS.

Surgery Today, 2000

We describe herein the case of a patient with severe liver failure in whom an abdominal aortic an... more We describe herein the case of a patient with severe liver failure in whom an abdominal aortic aneurysm (AAA) extending to the right iliac artery was diagnosed. Because the risk of performing a standard open repair was considered too high in this patient, the aneurysm was uneventfully repaired using a technique of transfemoral endovascular stent-grafting with femorofemoral bypass and occlusion of the left common and right internal iliac arteries. Unfortunately, multiorgan failure associated with adult respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (DIC) suddenly developed on postoperative day (POD) 2 and the patient died on POD 9. Thus, although endovascular stent-grafting is generally assumed to be less invasive and therefore feasible for high-risk patients, patients with severe liver dysfunction may not be suitable candidates.

Molecular and Cellular Biology, 2000

Sphingosine-1-phosphate (S1P) is a bioactive lysophospholipid that induces a variety of biologica... more Sphingosine-1-phosphate (S1P) is a bioactive lysophospholipid that induces a variety of biological responses in diverse cell types. Many, if not all, of these responses are mediated by members of the EDG (endothelial differentiation gene) family G protein-coupled receptors EDG1, EDG3, and EDG5 (AGR16). Among prominent activities of S1P is the regulation of cell motility; S1P stimulates or inhibits cell motility depending on cell types. In the present study, we provide evidence for EDG subtype-specific, contrasting regulation of cell motility and cellular Rac activity.

Gene Therapy, 2001

Adenovirus-mediated ex vivo gene transfer of basic fibroblast growth factor (bFGF), a new strateg... more Adenovirus-mediated ex vivo gene transfer of basic fibroblast growth factor (bFGF), a new strategy for the treatment of chronic vascular occlusive disease, was examined in a rabbit model of hind limb ischemia. The left femoral artery was completely excised to induce an ischemic state in the hind limb of male rabbits. Simultaneously, a skin section was resected from the wound, and host fibroblasts were cultured. The cultured fibroblasts were infected with adenovirus vector containing modified human bFGF cDNA with the secretory signal sequence (AxCAMAssbFGF) or LacZ cDNA (AxCALacZ). At 21 days after femoral artery excision, the gene-transduced fibroblasts were administered through the left internal iliac artery. The fibroblasts significantly accumu-

European Journal of Vascular and Endovascular Surgery, 2000

Background: aortic aneurysm is a rare but life-threatening cardiovascular complication in patient... more Background: aortic aneurysm is a rare but life-threatening cardiovascular complication in patients with systemic lupus erythematosus (SLE). The purpose of this study was to clarify the characteristic clinical features and the pathological mechanism of aneurysmal formation in these patients. Methods: among 429 patients operated on for abdominal aortic aneurysm (AAA) during the past 10 years, five cases with SLE were treated surgically. Their clinical data were reviewed, and the resected aneurysmal wall of the five patients was also examined histologically. Results: the mean age of the patients with SLE was 55 years, which was statistically younger than that of the other patients (mean 77 years, s.d. 7.9, p<0.05).

Clinical Science, 2001

Two spatially resolved oximeters, NIRO-300 and OM-200, were compared with regard to the measureme... more Two spatially resolved oximeters, NIRO-300 and OM-200, were compared with regard to the measurement of oxygen saturation values in two forearm muscle groups at rest and during arterial occlusion in nine healthy volunteers. There was a significant correlation between the muscle oxygen saturation values obtained at rest using the two oximeters (n=33, r(2)=0.43, P<0.0001), whereas these values were significantly different during arterial occlusion. Thus, although there was good agreement between muscle oxygen saturation values measured using the two oximeters, the operating range of the tissue oximeters should be recognized and indicated.

Circulation Journal, 2007

Biochemical and Biophysical Research Communications, 1999

AGR16/H218/EDG5 and EDG1 are functional receptors for lysosphingolipids, whereas EDG2 and EGD4 ar... more AGR16/H218/EDG5 and EDG1 are functional receptors for lysosphingolipids, whereas EDG2 and EGD4 are receptors for lysophosphatidic acid (LPA). The present study demonstrates that EDG3, the yet poorly defined member of the EDG family G protein-coupled receptors, shows identical agonist specificity, but distinct signaling characteristics, compared to AGR16 and EDG1. Overexpression of EDG3 conferred a specific [32P]S1P binding, which was displaced by S1P and sphingosylphosphorylcholine (SPC), but not by LPA or other related lipids. In cells overexpressing EDG3, S1P induced inositol phosphate production and [Ca2+]i increase in a manner only partially sensitive to pertussis toxin (PTX), which was similar to the case of AGR16, but quite different from the case of EDG1, in which the S1P-induced responses were totally abolished by PTX. EDG3 also mediated activation of mitogen-activated protein kinase (MAPK) in PTX-sensitive and Ras-dependent manners, as in the cases of EDG1 and AGR16, although EDG3 and EDG1 were more effectively coupled to activation of MAPK, compared to AGR16. Additionally, EDG3 mediated a decrease in cellular cyclic AMP content, like EDG1, but contrasting with AGR16 which mediated an increase in cyclic AMP. These and previous results establish that EDG1, AGR16 and EDG3 comprise the lysosphingolipid receptor subfamily, each showing distinct signaling characteristics.

The American Journal of Cardiology, 2009

Although the presence of coronary heart disease (CHD) was the major determinant of perioperative ... more Although the presence of coronary heart disease (CHD) was the major determinant of perioperative mortality and long-term prognosis in patients with aortic aneurysm (AA) and peripheral artery disease (PAD), the prevalence and severity of CHD in patients with individual vascular diseases was unknown. Adenosine triphosphate-loading myocardial single-photon emission computed tomography therefore was performed in 788 patients with vascular diseases of the aorta and peripheral arteries, with AA in 500, PAD localized in the lower-limb arteries in 183, and combined AA and PAD in 105. Patients with known CHD, such as those with previous myocardial infarction or revascularization procedures, were excluded. Myocardial single-photon emission computed tomography was analyzed using a 20-segment model, and summed stress scores and summed difference scores were calculated. Stress-induced myocardial ischemia was defined as a summed difference score >2. The presence of myocardial ischemia was highest in patients with combined PAD and AA (73%), followed by PAD (55%; p ‫؍‬ 0.005), and the lowest in patients with AA (37%; p <0.0001). Summed stress score was also the highest in patients with combined PAD and AA (11.6 ؎ 9.9), followed by PAD (7.8 ؎ 8.8; p <0.0001), and the lowest in patients with AA (4.0 ؎ 6.2; p <0.0001 for both). Similarly, summed difference score was the highest in patients with combined PAD and AA (6.4 ؎ 6.1), followed by PAD (4.4 ؎ 5.7; p ‫؍‬ 0.001) and AA (2.3 ؎ 4.0; p <0.0001 for both). In conclusion, the prevalence of CHD in patients with PAD was >50%, and although myocardial ischemia was observed in only 1 ⁄3 of patients with AA, its prevalence not only doubled, but also indicated extensive myocardial ischemia when combined with PAD. Thus, cardiac evaluation was particularly important in patients with combined AA and PAD.

European Journal of Vascular and Endovascular Surgery, 2007