[Therapeutic angiogenesis by autologous transplantation of bone-marrow cells in a patient with progressive limb ischemia due to arteriosclerosis obliterans: a case report].

A 78-year-old woman with arteriosclerosis obliterans was admitted with complaints of progressive ischemic change and resting pain of the left leg. She had severe ischemic limb in stage IV of the Fontaine classification. Angiography showed total occlusion of the three main arteries with poor collateral flow at the left crus. Autologous transplantation of bone-marrow mononuclear cell to her left leg was performed to achieve therapeutic angiogenesis. One month later, follow-up angiography showed excellent angiogenesis of collateral vessels at the left crus. Her pain was relieved and leg amputation was not necessary. Recently, the TACT study in Japan showed the efficacy of angiogenesis by autologous bone-marrow transplantation for peripheral artery disease. This case illustrates the efficacy of this therapy.

Efficacy of the Shinki bioclean room for preventing infection in neutropenic patients.

AIM OF THE STUDY: To investigate the effectiveness of a new type of bioclean room named Shinki bioclean room (SBCR) for the prevention of infection during neutropenia after intensive chemotherapy in comparison with a standard laminar air flow room (LAFR). BACKGROUND: Recently, a new industrial technology, wherein a dust-free and aseptic environment is created by circulating air containing nanometre order ultra fine water droplets with abundant negative air ions, has been developed in Japan. METHODS: The air cleanliness of SBCR was examined by measuring airborne particles and microorganisms. Bacteriological samples for environment culture were taken by means of exposed settle-plates. In addition, the frequency of pneumonia and fever higher than 38 degrees C were examined in 34 patients with acute leukaemia who received intensive chemotherapy in SBCR or LAFR. RESULTS: The number of airborne particles (> or = 0.5 microm) was 70 particles/ft3, and that of airborne microorganisms was 0.0 colony forming unit/ft3 in SBCR, and neither bacteria nor fungi were detected. The numbers of colonies of bacteria and fungi on air settle-plates were fewer in the SBCR than in the LAFR regardless of the presence of patients or the nurse entering. The frequency of pneumonia during chemotherapy for acute leukaemia was lower in the SBCR group (0%, 0/19 cases) than in the LAFR group (27%, 4/15 cases) (P=0.0294) and the frequency of fever higher than 38 degrees C also tended to be lower in the SBCR group (53%, 10/19 cases) than in the LAFR group (80%, 12/15 cases) (P=0.0973). CONCLUSION: The SBCR is equal or superior to LAFR in preventing infection during neutropenia. Other advantages for SBCR are a low level of noise (40 dB), easy control of temperature and humidity, and efficient removal of odour. In addition to the quiet and comfortable atmosphere, expected favourable effects of negative air ions may give higher quality of life for patients in SBCR than those in LAFR. Further studies will be needed to examine the safety, benefits and effects of the negative ion exposure.