The Tohoku journal of experimental medicine
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Tohoku J. Exp. Med. · Sep 2009
ReviewExtracorporeal shock wave therapy as a new and non-invasive angiogenic strategy.
Ischemic heart disease is the leading cause of death and the number of refractory severe patients is increasing. Therefore, it is crucial to develop new therapeutic strategies for severe ischemic heart disease. We found that a low-energy shock wave (SW) (about 10% of energy density that used for urolithiasis) effectively increases the expression of vascular endothelial growth factor (VEGF) in cultured endothelial cells. ⋯ The SW therapy was also effective to ameliorate LV remodeling after acute myocardial infarction in pigs and to enhance angiogenesis in hindlimb ischemia in rabbits. Based on these animal studies, we are also conducting clinical studies in patients with acute myocardial infarction and those with peripheral artery disease. Thus, our extracorporeal cardiac SW therapy is an effective, safe, and non-invasive angiogenic strategy in cardiovascular medicine and its indication is now rapidly expanding.
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Tohoku J. Exp. Med. · Sep 2009
Elevated risk of motor vehicle accident for male drivers with obstructive sleep apnea syndrome in the Tokyo metropolitan area.
Previous studies have suggested that patients with obstructive sleep apnea syndrome (OSAS) are at an increased risk of motor vehicle accidents (MVAs). This study is the first systematic investigation of MVA risk among Japanese drivers with obstructive sleep apnea syndrome (OSAS). We investigated the rate of MVAs in the preceding 5 years and dozing off at the wheel in Japanese male OSAS drivers (n = 616, mean [S. ⋯ The MVA rate among OSAS patients in the research area was significantly higher than that among the controls. Subjective excessive daytime sleepiness and severity of OSAS are independently associated with the occurrence of MVA. In conclusion, early diagnosis and treatment of OSAS drivers especially with serious respiratory disorder should be made to prevent multiple MVAs.