T he bone marrow derived endothelial progenitor cells (EPCs) are considered to originate from haematopoietic stem cells, which are positive for CD34.1 Human CD34 expressing cells (CD34 + cells) injected into nude mice and rats undergoing neovascularisation caused by hindlimb ischaemia are incorporated into the neovasculature and express endothelial antigens. We recently reported that transplantation of autologous bone marrow cells, including CD34+ cells, improved ischaemia in patients with critical limb ischaemia.2 Moreover, increased neovascularisation by bone marrow derived CD34+ cells was shown to improve cardiac function.Recently, a mobilisation of EPCs into circulation from bone marrow was reported in patients with acute myocardial infarction and acute coronary syndrome, 3 4 but little is known about the regulation of EPC mobilisation in patients with stable coronary artery disease (CAD). In the present study, we investigated the number of circulating CD34+ cells in patients with CAD and the influence of atherosclerotic risk factors on this number. METHODSThirty four patients (mean (SEM) age 62.5 (1.7) years) with angiographically documented stable CAD, and 36 healthy control subjects (mean (SEM) age 53.6 (2.0) years) without any evidence of CAD by history and physical examination, were enrolled in the present study. Risk factors for CAD were defined as: a history of hypertension for more than one year that required the initiation of antihypertensive treatment; a history of smoking more than one pack per year and currently smoking; hyperlipidaemia, defined as total cholesterol concentrations exceeding 5.70 mmol/l; and diabetes mellitus, defined as the need for oral anti-diabetic drug treatment or insulin use. The study protocol was approved by the ethics committee of Jichi Medical School, and informed consent was obtained from all patients and control subjects.The number of CD34 + cells in white blood cells (WBCs) was quantified by FACScan (Becton-Dickinson). In brief, WBCs were stained with a fluorescein isothiocyanate conjugated anti-CD34 monoclonal antibody (BectonDickinson, Franklin Lakes, New Jersey, USA). The samples were subjected to a two dimensional side scatter fluorescence dot plot analysis. After appropriate gating, the number of CD34 + cells with low cytoplasmic granularity (low sideward scatter) was quantified and expressed as the number of cells per 10 3 WBCs. Values were expressed as mean (SEM). Significance was evaluated using unpaired Student's t test for comparisons between two means. The interaction between the number of CD34 + cells and risk factors was examined by multivariate analysis using the multiple stepwise logistic regression model. Differences of p , 0.05 were considered significant. RESULTS The number of CD34+ cells in the peripheral blood of patients with CAD and control subjects was determined by flow cytometry. As shown in fig 1, circulating CD34 + cells were significantly reduced, by approximately 30%, in patients with CAD compared with age matched control subjects.We then...

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Circulating EPCs are significantly reduced in hemodialysis patients, which might be related to impaired neovascularization and cardiovascular disease in these patients.

A 49-year-old man was admitted for primary cardiac angiosarcoma with a cardiac tamponade. Transthoracic echocardiography and contrast-enhanced computed tomography scan demonstrated a large mass in the right atrium and thickening of the right ventricular wall. 18F-labeled deoxyglucose (FDG) positron emission tomography (PET) scan showed increased FDG uptake in the mediastinum and over the heart. The patient responded to combination therapy with docetaxel and radiotherapy and tolerated the treatment well, except for radiation esophagitis, which required a soft diet and resolved 1 month after treatment. This combination therapy resulted in a minimal response with slight regression in the tumor size, but FDG-PET initially showed an increase in FDG uptake by the tumor that was no longer seen after combination therapy. There is no evidence of progression or metastasis even at 12 months after diagnosis.

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