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Ekinci Y, Erbahçeci F, Düger T. The effect of different taping techniques on transtibial amputation walking parameters: A case report. Prosthet Orthot Int 2024:00006479-990000000-00207. [PMID: 38170805 DOI: 10.1097/pxr.0000000000000317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 11/17/2023] [Indexed: 01/05/2024]
Abstract
Buerger disease is a nonatherosclerotic, segmental inflammatory disease of the occlusive tract, often involving medium-sized muscular and small-diameter arteries and veins of the extremities. If medical treatment is not successful, amputation is inevitable. The aim of this study was to investigate the effect of different kinesiological taping techniques on walking parameters of transtibial amputee with knee extension limitation. Two different kinesiological taping methods (Kinesio Tape and Dynamic Tape) were applied to the transtibial patient with knee extension limitation. Walking performance of patients was assessed with The Biodex Gait Trainer 2. Gait parameters without tape were as follows: average walking speed 0.38 m/s, average step cycle 0.48 cyl/s, average left step length 50 cm, average right step length 43 cm, coefficient of variation 9% at the left, and coefficient of variation 9% at the right. After applying Kinesio Tape and Dynamic Tape, these values were measured as follows: average walking speed 0.50.56 m/s, average step cycle 0.51.56 cyl/s, average left step length 61-60 cm, average right step length 53-54 cm, coefficient of variation 6%-5% at the left, and coefficient of variation 6%-4% at the right side. Dynamic Tape and Kinesio Tape both had positive effects on active joint motion and walking parameters. Regarding walking speed and step length, Dynamic Tape was found to be more effective than Kinesio Tape. Taping methods applied to amputees have positive effects on range of motion, which in return causes improvements on walking parameters.
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Affiliation(s)
- Yasin Ekinci
- Faculty of Health Sciences, Amasya University, Amasya, Turkey
| | - Fatih Erbahçeci
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Tülin Düger
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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2
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Modaghegh MHS, Kamyar MM, Shafiei A, Shariatmaghani SS, Saremi E, Sadeghipour Kermani F. A comprehensive review of the epidemiology and clinical features of 91 cases with Buerger's disease. Vascular 2023:17085381231175257. [PMID: 37172074 DOI: 10.1177/17085381231175257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
BACKGROUND Thromboangiitis Obliterans (TAO) is a disease of small and medium-sized arteries with an unclear natural course. This study aims to establish a national registry of the disease to gain a better understanding of its epidemiology and clinical course. METHOD This study was a cohort study of 242 patients with a high probability of TAO admitted to Mashhad University of Medical Sciences (MUMS) hospitals from 2000 to 2015. Of these, 91 patients with a confirmed diagnosis were included in the study (90 males and 1 female) with a mean age of 35 ± 7.8 years. RESULTS The most common symptom upon onset of the disease was paresthesia (29.7%), followed by cold sensitivity and paresthesia (93.4%) during the progression of the disease and Raynaud syndrome or vasospasm (93.9%) in the active phase. The right lower limb was the most commonly affected limb (46.2%), and presenting ischemic symptoms in 48.4%.Statistics indicated a positive correlation between the duration of Burger's disease and the number of affected limbs (p = 0.001). There was no effect of disease duration on the likelihood of amputations (p = 0.28). CONCLUSION Some patients may experience mild, subtle symptoms for years before the initial signs and symptoms appear, which can be severe and rapidly progress to the point of requiring amputation.We suggest that the diagnostic criteria for Buerger's disease should be revised in light of the presence of atherosclerosis and its associated risk factors, which present a challenge in terms of diagnosis and treatment. Clinical experience will be of great importance in this regard.
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Affiliation(s)
- Mohammad Hadi Saeed Modaghegh
- Professor of Vascular Surgery, Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Mahdi Kamyar
- Assistant Professor of Vascular Surgery, Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Shafiei
- Assistant Professor of Vascular Surgery, Qom University of Medical Sciences, Qom, Iran
| | - Somayeh Sadat Shariatmaghani
- Assistant Professor of Internal Medicine, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elena Saremi
- Vascular Surgeon, Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Sadeghipour Kermani
- Community and Preventive Medicine, Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Science, Mashhad, Iran
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3
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Carneiro FCF, Almeida BM, Cacione DG. Endovascular treatment for thromboangiitis obliterans (Buerger’s disease). THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2023; 2023:CD014886. [PMCID: PMC9885982 DOI: 10.1002/14651858.cd014886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness and safety of endovascular treatment for thromboangiitis obliterans (Buerger’s disease).
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Affiliation(s)
| | | | - Beatriz M Almeida
- Division of Vascular and Endovascular Surgery, Department of SurgeryUNIFESP – Escola Paulista de MedicinaSão PauloBrazil
| | - Daniel G Cacione
- Division of Vascular and Endovascular Surgery, Department of SurgeryUNIFESP – Escola Paulista de MedicinaSão PauloBrazil
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Nakayama Y, Tabe S, Yamaguchi A, Tsuruya Y, Kobayashi R, Oyama K, Kitano D, Kojima K, Kogawa R, Okumura Y, Ogihara J, Senpuku H, Ogata Y. Identification of Nutritional Factors to Evaluate Periodontal Clinical Parameters in Patients with Systemic Diseases. Nutrients 2023; 15:nu15020365. [PMID: 36678235 PMCID: PMC9866370 DOI: 10.3390/nu15020365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 01/13/2023] Open
Abstract
Nutritional factors reflect the periodontal parameters accompanying periodontal status. In this study, the associations between nutritional factors, blood biochemical items, and clinical parameters were examined in patients with systemic diseases. The study participants were 94 patients with heart disease, dyslipidemia, kidney disease, or diabetes mellitus. Weak negative correlation coefficients were found between nine clinical parameters and ten nutritional factors. Stage, grade, mean probing depth (PD), rate of PD 4−5 mm, rate of PD ≥ 6 mm, mean clinical attachment level (CAL), and the bleeding on probing (BOP) rate were weakly correlated with various nutritional factors. The clinical parameters with coefficients of determinations (R2) > 0.1 were grade, number of teeth, PD, rate of PD 4−5 mm, CAL, and BOP rate. PD was explained by yogurt and cabbage with statistically significant standardized partial regression coefficients (yogurt: −0.2143; cabbage and napa cabbage: −0.2724). The mean CAL was explained by pork, beef, mutton, and dark green vegetables with statistically significant standardized partial regression coefficients (−0.2237 for pork, beef, and mutton; −0.2667 for dark green vegetables). These results raise the possibility that the frequency of intake of various vegetables can be used to evaluate periodontal stabilization in patients with systemic diseases.
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Affiliation(s)
- Yohei Nakayama
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
- Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
- Correspondence: ; Tel.: +81-47-360-9363; Fax: +81-47-360-9364
| | - Shinichi Tabe
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
| | - Arisa Yamaguchi
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
| | - Yuto Tsuruya
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
| | - Ryoki Kobayashi
- Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
- Department of Microbiology and Immunology, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
| | - Katsunori Oyama
- Department of Computer Science, College of Engineering, Nihon University, Fukushima 963-8642, Japan
| | - Daisuke Kitano
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Keisuke Kojima
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Rikitake Kogawa
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Yasuo Okumura
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Jun Ogihara
- Laboratory of Applied Microbiology and Biotechnology, College of Bioresource Sciences, Nihon University, Fujisawa-shi 252-0880, Japan
| | - Hidenobu Senpuku
- Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
- Department of Microbiology and Immunology, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
| | - Yorimasa Ogata
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
- Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
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Wang W, Zhao T, Geng K, Yuan G, Chen Y, Xu Y. Smoking and the Pathophysiology of Peripheral Artery Disease. Front Cardiovasc Med 2021; 8:704106. [PMID: 34513948 PMCID: PMC8429807 DOI: 10.3389/fcvm.2021.704106] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 07/31/2021] [Indexed: 12/15/2022] Open
Abstract
Smoking is one of the most important preventable factors causing peripheral artery disease (PAD). The purpose of this review is to comprehensively analyze and summarize the pathogenesis and clinical characteristics of smoking in PAD based on existing clinical, in vivo, and in vitro studies. Extensive searches and literature reviews have shown that a large amount of data exists on the pathological process underlying the effects of cigarette smoke and its components on PAD through various mechanisms. Cigarette smoke extracts (CSE) induce endothelial cell dysfunction, smooth muscle cell remodeling and macrophage phenotypic transformation through multiple molecular mechanisms. These pathological changes are the molecular basis for the occurrence and development of peripheral vascular diseases. With few discussions on the topic, we will summarize recent insights into the effect of smoking on regulating PAD through multiple pathways and its possible pathogenic mechanism.
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Affiliation(s)
- Weiming Wang
- The State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China.,Department of General Surgery (Vascular Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Key Laboratory of Medical Electrophysiology, Ministry of Education and Medical Electrophysiological Key Laboratory of Sichuan Province, Institute of Cardiovascular Research, Southwest Medical University, Luzhou, China
| | - Tingting Zhao
- The State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Kang Geng
- The State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Gang Yuan
- The State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Yue Chen
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Youhua Xu
- The State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
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Thromboangiitis Obliterans (Buerger's Disease) in an Adolescent Male. J Pediatr Hematol Oncol 2021; 43:e759-e762. [PMID: 32925405 DOI: 10.1097/mph.0000000000001933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 08/12/2020] [Indexed: 11/26/2022]
Abstract
Arterial occlusive disease of the limb is very rare in children. Buerger's disease (BD) is a nonatherosclerotic, segmental inflammatory arteritis affecting the small and medium-sized vessels of the extremities. We report BD in a 16-year-old male presenting with arterial insufficiency of left foot and history of smoking cigarettes and cannabis for 2 years. BD was diagnosed based on history of smoking in combination with clinical, laboratory, and radiologic findings. Pediatric hemato-oncologists should consider BD in the differential diagnosis in adolescents who smoke cigarettes and/or cannabis and present with vascular insufficiency of the hands and/or feet.
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Salehi Ravesh M, Lebenatus A, Bonietzki A, Hensler J, Koktzoglou I, Edelman RR, Graessner J, Jansen O, Both M. High-resolution, non-contrast-enhanced magnetic resonance angiography of the wrist, hand and digital arteries using optimized implementation of Cartesian quiescent interval slice selective (QISS) at 1.5 T. Magn Reson Imaging 2021; 78:58-68. [PMID: 33582146 PMCID: PMC7979532 DOI: 10.1016/j.mri.2021.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/09/2021] [Accepted: 02/09/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE Non-contrast-enhanced (CE) magnetic resonance angiography (MRA) techniques are of considerable interest for diagnosing vascular diseases in the upper extremities owing to the possibility of repeated examinations, sufficient coverage of the measurement volume, and because possible side effects of administering iodine- or gadolinium-based contrast agents and radiation exposure can be avoided. The aim of this study was to investigate the feasibility of an optimized electrocardiogram (ECG) triggered Cartesian quiescent interval slice selective (QISS) technique for MRA of hand arteries. MATERIAL AND METHODS Both hands of 20 healthy volunteers (HVs) were examined using an optimized QISS-MRA pulse sequence at 1.5 Tesla. The wrist and hand arterial trees were divided into 36 segments. Cross-sectional areas (CSA) of all arterial segments were measured. For the technical evaluation of the pulse sequence, the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were computed and six imaging artifacts were graded. Two experienced observers used an ordinal scoring system to assess the image quality of each arterial segment. Interobserver agreement was determined. RESULTS The median CSA was 7.3 mm2 in the ulnar and radial artery, 3.2 mm2 in the four common digital arteries, and 1.5 mm2 in five proper digital arteries. The median SNR and CNR of the third common proper arteries were 45.9 and 20.3, respectively. None of the arterial segments were contaminated by venous enhancement. The image quality of arterial segments for both hands was considered as diagnostic in 87.2% of all 1440 segments. An interobserver agreement of 0.67 for both hands was determined for image quality of arterial segments using a five-grade scoring system. Optimized QISS-MRA allows as the first MRA technique the classification of superficial palmar arch (SPA) and deep palmar arch (DPA) variants. 5 new SPA and 6 new DPA variants could be classified using QISS-MRA in comparison with previous studies using CE computed tomography angiography and using fixed cadaver hands. CONCLUSIONS By using this optimized 2D Cartesian QISS-MRA protocol, contrast agent-free angiography of the wrist and hand arteries provided a high in-plane spatial resolution and an excellent visualization of small digital arteries.
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Affiliation(s)
- Mona Salehi Ravesh
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany.
| | - Annett Lebenatus
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany
| | - Alexandra Bonietzki
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany
| | - Johannes Hensler
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany
| | - Ioannis Koktzoglou
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA; University of Chicago Pritzker School of Medicine, Chicago, IL, USA
| | - Robert R Edelman
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Olav Jansen
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany
| | - Marcus Both
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany
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Para-Clinical and Immunological Evaluation in Buerger's Disease as a Suspected Autoimmune Disease: Case Series. REPORTS OF BIOCHEMISTRY AND MOLECULAR BIOLOGY 2021. [DOI: 10.52547/rbmb.9.4.379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Dsouza RJ, Premkumar P, Samuel V, Kota A, Agarwal S. Patterns of arterial involvement and feasibility of revascularization in thromboangiitis obliterans: a tertiary care centre experience. ANZ J Surg 2020; 90:2506-2509. [PMID: 33176048 DOI: 10.1111/ans.16417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/29/2020] [Accepted: 10/16/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Arterial revascularization is seldom considered as a treatment option in thromboangiitis obliterans (TAO) due to diffuse segmental involvement of medium- and small-sized extremity vessels. Although typical angiographic features include bilaterally symmetrical involvement of infrapopliteal vessels, larger vessels too can be affected. Similarly, there could be distal target vessels feasible for revascularization. This study was conducted to describe the patterns of arterial involvement in TAO and assess the feasibility of revascularization. METHODS The study was approved by the Institutional Review Board and research ethics committee of Christian Medical College, Vellore (IRB no: 12034). A retrospective study was conducted in the Department of Vascular Surgery, Christian Medical College, Vellore, India, between January 2009 and December 2018. There were 329 patients who fulfilled the clinical criteria for TAO of whom 83 had an angiogram done. These 83 patients formed the study cohort. RESULTS Large vessel involvement was seen in 56.6% of patients and 79.5% of patients had at least one or more distal target artery feasible for revascularization. The anterior tibial artery and peroneal artery were the most common target vessels that were patent for revascularization. Of the 22 patients who underwent revascularization (16 bypasses and six angioplasties), the patency rate was 64.8% and the limb salvage rate was 80.9% at the end of 6 months. CONCLUSION The study shows that one-third of our patients with TAO have a distal target artery feasible for revascularization. As most of the affected patients are in the economically productive age group, every attempt should be made to salvage the limb with revascularization for which the use of angiography should be more liberal.
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Affiliation(s)
- Royson J Dsouza
- Department of Vascular Surgery, Christian Medical College Hospital, Vellore, India
| | - Prabhu Premkumar
- Department of Vascular Surgery, Christian Medical College Hospital, Vellore, India
| | - Vimalin Samuel
- Department of Vascular Surgery, Christian Medical College Hospital, Vellore, India
| | - Albert Kota
- Department of Vascular Surgery, Christian Medical College Hospital, Vellore, India
| | - Sunil Agarwal
- Department of Vascular Surgery, Christian Medical College Hospital, Vellore, India
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Almoosawy SA, McGowan M, Hijazi K, Patey R, Bachoo P, Cherukara G. The oral health status of patients with peripheral vascular disorders: A systematic review. Vascular 2020; 29:556-566. [PMID: 33045941 PMCID: PMC8366191 DOI: 10.1177/1708538120963914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives Periodontal disease and tooth loss were found to be associated with several peripheral vascular disorders. Nonetheless, an evaluation of the literature on the broader domains of oral health in individuals with peripheral vascular disorders is lacking. This systematic review aims to collate the current evidence on the oral health status of individuals with peripheral vascular disorders. Methods Five electronic databases were searched for studies assessing oral health parameters in individuals with peripheral vascular disorders. Outcome measures considered were periodontal health, dentition status, caries indices, oral prostheses, oral pathologies and oral hygiene behaviours. The Newcastle-Ottawa scale was used to appraise the quality of the studies. Results From 3025 records identified, 24 studies involving 1232 participants with peripheral vascular disorders were included in this review. In nine studies, periodontitis was significantly more prevalent in peripheral vascular disorders compared to non-peripheral vascular disorders participants. A further six studies reported individuals with peripheral vascular disorders also had significantly fewer teeth and increased rates of edentulism. Only one study reported a higher incidence of dental caries in peripheral vascular disorders participants. Other aspects of oral health such as oral prosthesis, oral pathology and oral hygiene behaviours were seldom assessed. Conclusions The scarcity of studies reporting on broader domains limited our ability to arrive at a conclusion regarding the oral health status of individuals with peripheral vascular disorders. Future studies ought to assess these domains in individuals with peripheral vascular disorders and controls to gain a more complete understanding of oral health and its potential association with peripheral vascular disorders.
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Affiliation(s)
| | - Mhairi McGowan
- Institute of Dentistry, University of Aberdeen, Aberdeen, Scotland, United Kingdom
| | - Karolin Hijazi
- Institute of Dentistry, University of Aberdeen, Aberdeen, Scotland, United Kingdom
| | - Rona Patey
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland, United Kingdom
| | - Paul Bachoo
- Department of Vascular Surgery, Aberdeen Royal Infirmary, Aberdeen, Scotland, United Kingdom
| | - George Cherukara
- Institute of Dentistry, University of Aberdeen, Aberdeen, Scotland, United Kingdom
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Choi B, Jang SY, Kim SK, Kim N, Kim K, Kim DK. The incidence, prevalence, and survival rate of thromboangiitis obliterans in Korea: a retrospective population-based study. Cardiovasc Diagn Ther 2020; 10:1238-1244. [PMID: 33224747 DOI: 10.21037/cdt-20-582] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Few studies used nationwide data to assess the age-standardized prevalence rate, incidence rate, 10-year survival rate, and death risk of thromboangiitis obliterans (TAO; Buerger's disease). Methods Data for 24,392 patients who had newly diagnoses related to TAO (I73.1) from 2006 through 2017 were extracted from the National Health Insurance Service in Korea. The age-standardized prevalence rate, incidence rate, 10-year survival rate, and death risk of TAO were analyzed. Results The mean (standard deviation) age of TAO patients overall was 62.0 (15.7) years; 61.3 (15.4) in males and 63.2 (16.1) in females (P<0.001). The proportion of patients older than 50 years old was about 80% overall. The proportion patients who died of TAO was 28.1%. Overall, the age-standardized prevalence rate of TAO decreased from 11.1 persons per 100,000 persons in 2006 to 8.43 persons in 2017, and overall, the incidence rate of TAO decreased from 6.07 persons in 2006 to 3.38 persons in 2017. The age-standardized prevalence rate and incidence rate in males were higher than that in females. The 10-year survival rate of TAO was about 65% (60.7% in males and 72.5% in females). The adjusted hazard ratio increased significantly with older age, male sex, hypertension, diabetes mellitus, myocardial infarction, heart failure, ischemic stroke, hemorrhagic stroke, chronic kidney disease, and malignant neoplasm. Conclusions The 10-year survival rate of TAO was about 65%. Even though the age-standardized prevalence rate and incidence rate of TAO is decreased during the study period, the adjusted hazard ratio showed significantly increases with age and with male sex after adjustment for comorbidities.
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Affiliation(s)
- Bareun Choi
- Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, 73 Goryeodae-ro Seongbuk-gu, Seoul, Republic of Korea
| | - Shin Yi Jang
- Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, 81 Irwon-ro, Kangnam-gu, Seoul, Republic of Korea
| | - Seong-Kyong Kim
- Departmentof Orthopedic Surgery, Samsung Medical Center, 81 Irwon-ro, Kangnam-gu, Seoul, Republic of Korea
| | - Nari Kim
- Department of Nursing, Samsung Medical Center, 81 Irwon-ro, Kangnam-gu, Seoul, Republic of Korea
| | - Kyeongsug Kim
- Department of Nursing, Samsung Medical Center, 81 Irwon-ro, Kangnam-gu, Seoul, Republic of Korea
| | - Dong Kyu Kim
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, 82 Gugwon-daero, Chungju, Republic of Korea
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Watanabe Y, Miyata T, Shigematsu K, Tanemoto K, Nakaoka Y, Harigai M. Current Trends in Epidemiology and Clinical Features of Thromboangiitis Obliterans in Japan - A Nationwide Survey Using the Medical Support System Database. Circ J 2020; 84:1786-1796. [PMID: 32879220 DOI: 10.1253/circj.cj-19-1165] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The epidemiology and clinical features of thromboangiitis obliterans (TAO) in Japan have not been updated extensively.Methods and Results:This retrospective study used the Japanese Ministry of Health, Labour and Welfare (JMHLW) medical support system database and associated health insurance data. The number of medical financial support recipients registered as TAO patients and estimated prevalence of TAO decreased from fiscal year (FY) 2000 (10,089 and 7.95 [95% confidence interval, CI: 7.79-8.10] per 100,000 population) to FY 2010 (7,147 and 5.58 [95% Cl: 5.45-5.71] per 100,000) and leveled off until 2014. The prevalence of TAO among patients with peripheral arterial occlusive diseases declined from 7.15% (95% Cl: 7.00-7.31) in FY 2008 to 6.12% (95% Cl: 5.98-6.26) in FY 2014. Clinicodemographic features were obtained from 89 new recipients in FY 2013 and 2014: 12 (13%) women, 36 (40%) aged ≥50 years, 26 (29%) had probable onset age ≥50 years, 7 (8%) were non-smokers, and 12 (13%) had arteriosclerosis-related comorbidities. The symptoms were similar regardless of registration age, smoking history, or sex. Although 40 (45%) had digit ulcers, only 12 (13%) fulfilled Shionoya's criteria. They rarely had infrapopliteal lesions combined with upper extremity involvement or phlebitis. CONCLUSIONS The prevalence of TAO has decreased in Japan. In the current diagnosis of TAO, various clinical characteristics including late onset, arteriosclerotic factors, non-smoking, or mild symptoms should be considered.
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Affiliation(s)
| | - Tetsuro Miyata
- Vascular Center, Sanno Hospital and Sanno Medical Center
| | - Kunihiro Shigematsu
- Department of Vascular Surgery, International University of Health and Welfare, Mita Hospital
| | - Kazuo Tanemoto
- Department of Cardiovascular Surgery, Kawasaki Medical School
| | - Yoshikazu Nakaoka
- Department of Vascular Physiology, National Cerebral and Cardiovascular Center Research Institute
| | - Masayoshi Harigai
- Department of Rheumatology, Tokyo Women's Medical University School of Medicine
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Ehteshamfar SM, Afshari JT, Modaghegh MHS, Mahmoudi M, Kazemzadeh GH, Kermani FS. Humoral and cellular immune response to Buerger's disease. Vascular 2020; 28:457-464. [PMID: 32212917 DOI: 10.1177/1708538120910055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Thromboangiitis obliterans is a nonatherosclerotic occlusive disease, affecting small to moderate sized arteries of the upper and lower extremities, leading to progressive inflammation and clot formation. However, the role of humoral and cell-mediated immunity in the development of this disease has not been clearly identified. The present study was intended to investigate the humoral and cellular immune response in patients with Buerger's disease with different disease severity. METHODS In an observational study, 80 male patients with Buerger's disease were included and categorized into three groups (mild, moderate, and severe) based on clinical manifestations. After blood sampling, cellular phenotypes were determined, and erythrocyte sedimentation rate, immunoglobulins (Ig) A, M, G, and E, as well as C3 and C4 components of the complement system and complement hemolytic activity (CH50) were measured. RESULTS The mean age of the patient was 42.85 ± 8.39 years. Pulse abnormality, cold intolerance, and claudication were the most common symptoms. Eleven (13.75%), 46 (57.50%), and 23 (28.75%) patients had mild, moderate, and severe symptoms. Regression analyses showed that the presence of severe symptoms was significantly associated with elevated erythrocyte sedimentation rate and C4 levels (p < 0.05). CONCLUSION Buerger's disease in severe cases was associated with increased erythrocyte sedimentation rate and abnormal C4 levels. The alterations in these inflammatory biomarkers might be due to a secondary inflammatory response to the presence of ulcer or gangrene and the inflammatory process in patients with severe symptoms.
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Affiliation(s)
| | - Jalil Tavakkol Afshari
- Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad-Hadi S Modaghegh
- Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmoud Mahmoudi
- Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gholam Hosein Kazemzadeh
- Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Calmasini FB, Klee N, Webb RC, Priviero F. Impact of Immune System Activation and Vascular Impairment on Male and Female Sexual Dysfunction. Sex Med Rev 2019; 7:604-613. [PMID: 31326360 DOI: 10.1016/j.sxmr.2019.05.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/03/2019] [Accepted: 05/30/2019] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Male and female sexual dysfunction (SD) is considered a multifactorial condition. Numerous studies have shown the involvement of inflammatory processes in this pathological condition. Sexual intercourse requires healthy and functioning vessels to supply the pelvic region in both males and females, generating penile erection and clitoral and vaginal lubrication, respectively. Cardiovascular diseases and associated risk factors may contribute negatively to pelvic blood flow, possibly through immune system activation. AIM The study aimed to address the correlation between vascular inflammation driven by immune system activation and SD in males and females. METHODS A literature review was performed to identify articles addressing male and female SD and vascular inflammation. Key words included "male and female sexual dysfunction," "vascular inflammation," "iliac and pudendal arteries dysfunction," "genitourinary tract," and "blood flow." MAIN OUTCOME MEASURES Management of systemic and local inflammation may be a useful alternative to improve SD and reduce the risk of cardiovascular diseases in the future. RESULTS Increased levels of cytokines and chemokines have been detected in humans and animals with hypertension, obesity, and diabetic conditions. Chronic activation of the innate immune system, especially by pathogen- or damage-associated molecular patterns, and metabolic-related disorders may act as triggers further contributing to an increased inflammatory condition. Due to the reduced size of vessels, SD and retinal vascular impairments have been shown to be predictive factors for cardiovascular diseases. Therefore, considering that blood flow to the genitalia is essential for sexual function, endothelial dysfunction and vascular remodeling, secondary to chronic immune system activation, may be implicated in male and female vasculogenic SD. CONCLUSIONS Several conditions appear to play a role in SD. In the present review, we have identified a role for the immune system in generating vascular and tissue impairments contributing to erectile dysfunction and female SD. Calmasini FB, Klee N, Webb RC, et al. Impact of Immune System Activation and Vascular Impairment on Male and Female Sexual Dysfunction. Sex Med Rev 2019;7:604-613.
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Affiliation(s)
- Fabiano B Calmasini
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA, USA; Deparment of Pharmacology, Faculty of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil.
| | - Nicole Klee
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - R Clinton Webb
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Fernanda Priviero
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA, USA
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Outcomes of endovascular treatment versus bypass surgery for critical limb ischemia in patients with thromboangiitis obliterans. PLoS One 2018; 13:e0205305. [PMID: 30300407 PMCID: PMC6177182 DOI: 10.1371/journal.pone.0205305] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 09/21/2018] [Indexed: 11/23/2022] Open
Abstract
We aimed to compare the clinical outcomes between endovascular treatment and inframalleolar bypass surgery for critical limb ischemia (CLI) in patients with thromboangiitis obliterans (TAO) and to assess the role of bypass surgery in the era of innovative endovascular treatment. Between January 2007 and December 2017, a total of 33 consecutive patients with the diagnosis of TAO presenting with CLI who underwent endovascular treatment (endovascular group, n = 22) or bypass surgery to the pedal or plantar vessels (bypass group, n = 11) were included and analyzed retrospectively. The primary endpoint was defined as a major amputation of the index limb, and the secondary endpoint was defined as graft occlusion, regardless of the number of subsequent procedures. In the bypass group, six patients (55%) had undergone previous failed endovascular procedures and/or arterial bypass surgery to the index limb before inframalleolar bypass, and two patients (18%) received microvascular flap reconstruction after bypass surgery. During the median follow-up period of 32 months (range 1–115 months), there were no significant differences in primary and secondary endpoints between the two groups although the bypass group had a higher Rutherford class than the endovascular group. Kaplan–Meier survival analysis showed that there were similar limb salvage (P = 0.95) and graft patency rates (P = 0.39). In conclusion, endovascular treatment is a valid strategy leading to an acceptable limb salvage rate for TAO patients, and surgical bypass to distal target vessels could play a vital role in cases of previous failed endovascular treatment or extensive soft tissue loss of the foot.
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Huang ZH, Kuo SY, Chiu YH, Chen HC, Lu CC. Treatment of multiple refractory ankle ulcerations in thromboangiitis obliterans: A case report. Medicine (Baltimore) 2018; 97:e10798. [PMID: 29768374 PMCID: PMC5976294 DOI: 10.1097/md.0000000000010798] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Thromboangiitis obliterans (TAOs, or Buerger's disease) present as a non-atherosclerotic segmental occlusive vasculitis within medium- and small-sized blood vessels. TAO frequently occurs in young adults and is associated with cigarette smoking. At present, there are no accurately defined treatments for TAO. PATIENT CONCERNS A 34-year-old Asian woman with a 20-year history of heavy cigarette smoking and recurrent, small, and self-limited lower limb ulcerations since adolescence, presented with persisting unhealed ulcerations on both ankles for 6 months. Her wound healing response was poor following the 2-month administration of colchicine, prednisolone, hydroxychloroquine, and mycophenolic acid. DIAGNOSIS The patient was diagnosed with TAO with hyperimmunoglobulin E and refractory ulcerations on her ankles. INTERVENTIONS The patient received monthly omalizumab (300 mg) and previous medications for 2 months and shifted to omalizumab and colchicine without mycophenolic acid and hydroxychloroquine because of onychomadesis, which was considered to be a possible adverse drug reaction. OUTCOMES The wounds healed almost completely. The administration of omalizumab and colchicine will be continued until they the wounds are fully healed. LESSONS Mycophenolic acid has a limited function in TAO treatment, especially in cases of refractory skin ulcerations. Omalizumab can be a valuable treatment option for patients with TAO and hyperimmunoglobulin E.
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Affiliation(s)
- Zheng-Hao Huang
- Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung
- Division of Rheumatology, Immunology, and Allergy, Department of Internal Medicine, Tri-Service General Hospital; National Defense Medical Center, Taipei, Taiwan
| | - San-Yuan Kuo
- Division of Rheumatology, Immunology, and Allergy, Department of Internal Medicine, Tri-Service General Hospital; National Defense Medical Center, Taipei, Taiwan
| | - Yu-Hsiang Chiu
- Division of Rheumatology, Immunology, and Allergy, Department of Internal Medicine, Tri-Service General Hospital; National Defense Medical Center, Taipei, Taiwan
| | - Hsiang-Cheng Chen
- Division of Rheumatology, Immunology, and Allergy, Department of Internal Medicine, Tri-Service General Hospital; National Defense Medical Center, Taipei, Taiwan
| | - Chun-Chi Lu
- Division of Rheumatology, Immunology, and Allergy, Department of Internal Medicine, Tri-Service General Hospital; National Defense Medical Center, Taipei, Taiwan
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Ye K, Shi H, Qin J, Yin M, Liu X, Li W, Jiang M, Lu X. Outcomes of endovascular recanalization versus autogenous venous bypass for thromboangiitis obliterans patients with critical limb ischemia due to tibioperoneal arterial occlusion. J Vasc Surg 2017; 66:1133-1142.e1. [DOI: 10.1016/j.jvs.2017.03.425] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 03/18/2017] [Indexed: 11/17/2022]
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Systemic vasculitis is associated with a higher risk of lower extremity amputation in patients with severe peripheral arterial occlusive disease: a secondary analysis of a nationwide, population-based health claims database. Rheumatol Int 2017; 37:1847-1852. [PMID: 28951963 DOI: 10.1007/s00296-017-3828-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 09/20/2017] [Indexed: 10/18/2022]
Abstract
Previous research has shown that diabetes mellitus increases the risk of lower extremity amputation in patients with peripheral arterial occlusive disease. However, to our knowledge, no studies have investigated whether systemic autoimmune disease, in particular systemic vasculitis is associated with a higher risk of lower extremity amputation in these patients. To investigate the association between systemic autoimmune disease and lower extremity amputation in patients with severe peripheral arterial occlusive disease based on a secondary analysis of a nationwide, population-based health claims database. Using the inpatient datafile of the Taiwan's National Health Insurance Research Database (NHIRD), we identified 432 patients with severe peripheral arterial occlusive disease that required hospitalization between 2000 and 2012. We also identified patients who had undergone lower extremity amputation and their comorbidities using the same datafile. The risk of lower extremity amputation was assessed using multiple logistic regression analysis, adjusting for age, sex, insured amount, the urbanization level of residence, and the presence of comorbidities. Among patients with severe peripheral arterial occlusive disease, those with systemic vasculitis exhibited a significant higher risk of lower extremity amputation (adjusted odds ratio [aOR] = 6.82, p < 0.001). Diabetes mellitus (aOR = 4.90, p < 0.001) and chronic obstructive pulmonary disease (aOR = 2.87, p = 0.007) were also significantly associated with a higher risk of lower extremity amputation. Among patients with severe peripheral arterial occlusive disease, a significantly higher risk of lower extremity amputation was observed in those with systemic vasculitis.
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Igari K, Kudo T, Toyofuku T, Inoue Y. Endothelial dysfunction in patients with Buerger disease. Vasc Health Risk Manag 2017; 13:317-323. [PMID: 28860792 PMCID: PMC5574590 DOI: 10.2147/vhrm.s139892] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
We evaluated the endothelial function of patients with Buerger disease using peripheral arterial tonometry test, and examined the factors that are significantly correlated with the endothelial dysfunction in these patients. We performed the peripheral arterial tonometry test in 22 patients with Buerger disease. We recorded the patients' characteristics, including ankle brachial pressure index and reactive hyperemia index, which reflect the endothelial dysfunction. We divided the patients with Buerger disease into the conservative treatment and lumbar sympathectomy group. While the reactive hyperemia index was not significantly different between these two groups, the ankle brachial pressure index was significantly different (1.12 versus 0.83, P=0.003). Furthermore, the reactive hyperemia index was significantly correlated with the ankle brachial pressure index value in the patients in the lumbar sympathectomy group (ρ=0.848, P=0.005). Given that patients with Buerger disease show impairment of the sympathetic nervous system, we should consider the after-effects of such an impaired system on the condition of these patients. The patients treated with lumbar sympathectomy might be more appropriate to evaluate their endothelial function by a peripheral arterial tonometry test.
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Affiliation(s)
- Kimihiro Igari
- Division of Vascular and Endovascular Surgery, Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshifumi Kudo
- Division of Vascular and Endovascular Surgery, Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takahiro Toyofuku
- Division of Vascular and Endovascular Surgery, Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshinori Inoue
- Division of Vascular and Endovascular Surgery, Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
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Igari K, Inoue Y, Iwai T. An Experimental Model of Peripheral Vascular Disease Involving the Intravenous Injection of Oral Bacteria. Ann Vasc Dis 2016; 9:267-271. [PMID: 28018496 DOI: 10.3400/avd.oa.16-00092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Accepted: 08/29/2016] [Indexed: 11/13/2022] Open
Abstract
Objective: The purpose of this study was to observe the direct effects of oral bacteria, such as Porphyromonas gingivalis (Pg) and Treponema denticola (Td), on the peripheral vasculature. Materials and Methods: Beagles were directly injected (at various doses) with Pg or Td. Each leg vein was exposed, ligated at proximal and distal sites, and then injected with bacteria diluted with sterile saline. The collected vascular tissue was examined microscopically, and samples of the vascular tissue and blood were cultured and then subjected to the polymerase chain reaction (PCR) in order to detect the bacterial deoxyribonucleic acid (DNA). Results: No genes of the injected bacteria were detected in the Td-inoculated blood or vascular tissue samples collected 2 weeks after the injection. The Pg gene was also not detected in the blood samples collected 4 weeks after the injection although it was detected in the vascular tissue using PCR. Microscopic examinations showed that the inflammatory reactions in the perivascular tissue increased in a bacterial dose-dependent manner, as expected. Conclusion: We observed the direct effects of oral bacteria on vascular tissue. Further studies are needed to investigate the correlations between oral bacteria and systemic diseases. (This article is a translation of Jpn J Phlebol 2015; 26: 41-6.).
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Affiliation(s)
- Kimihiro Igari
- Division of Vascular Surgery, Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshinori Inoue
- Division of Vascular Surgery, Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takehisa Iwai
- Tsukuba Vascular Center, Buerger Disease Research Institute, Moriya, Ibaraki, Japan
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21
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Paraskevas KI. Smoking, Periodontitis, and Buerger Disease. Ann Vasc Surg 2016; 33:265. [PMID: 26965810 DOI: 10.1016/j.avsg.2016.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Accepted: 01/04/2016] [Indexed: 10/22/2022]
Affiliation(s)
- Kosmas I Paraskevas
- Department of Vascular Surgery, Southampton University Hospital, Southampton, UK.
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