RESUMEN
BACKGROUND: Excess salt intake increases blood pressure (BP). Identifying individuals with excess salt intake is, therefore, important for the prevention of hypertension. AIM: To examine the predictive value of subjective evaluation of salty foods intake for the risk of incident hypertension in a middle-aged population. METHODS: A total of 970 non-hypertensive workers (mean age, 44 ± 6 years) was followed for a maximum period of 4 years, and their BP was measured annually. At baseline, all participants were asked about their subjective frequency of salty foods intake (seldom, sometimes or always), and they were divided into three groups according to their answers. Hypertension was defined as systolic/diastolic BP ≥ 140/90 mmHg or use of antihypertensive medications. RESULTS: There were no significant differences in the 4-year cumulative incident rate of hypertension among the 'seldom', 'sometimes' and 'always' groups (15.8%, 14.3% and 10.3%, respectively, log-rank test P = 0.44). In a multivariate Cox proportional hazards model, age, body mass index and the baseline BP category were independent predictors for developing hypertension, whereas the frequency of salty foods intake was not a predictor (adjusted hazard ratio (95% confidence interval), 0.99 (0.64-1.54) in the 'sometimes' group and 0.64 (0.33-1.28) in the 'always' group as compared with the 'seldom' group). CONCLUSION: The subjective evaluation of salty foods intake did not predict the 4-year risk of incident hypertension in this study population. Further investigations with a longer follow-up period are needed to clarify whether the present insignificant results are maintained for more than 4 years.
Asunto(s)
Ingestión de Alimentos/fisiología , Hipertensión/diagnóstico , Vigilancia de la Población , Autoinforme , Cloruro de Sodio Dietético/administración & dosificación , Cloruro de Sodio Dietético/efectos adversos , Adulto , Ingestión de Alimentos/psicología , Femenino , Estudios de Seguimiento , Humanos , Hipertensión/epidemiología , Hipertensión/psicología , Incidencia , Masculino , Persona de Mediana Edad , Vigilancia de la Población/métodos , Valor Predictivo de las Pruebas , Factores de RiesgoRESUMEN
BACKGROUND: Achieving adequate blood pressure (BP) control often requires more than one antihypertensive agent. The purpose of this study was to determine whether a fixed-dose formulation of losartan (LOS) plus hydrochlorothiazide (HCTZ) (LOS/HCTZ) is effective in achieving a greater BP lowering in patients with uncontrolled hypertension. METHODS: The study was a prospective, multicenter, observational trial exploring the antihypertensive effect of a single tablet of LOS 50 mg/HCTZ 12.5 mg. A total of 228 patients whose BP had previously been treated with more than one antihypertensive agents without having achieved BP goal below 130/80 mmHg enrolled in the study. RESULTS: A significant decrease in systolic and diastolic BP was observed in both clinic and home measurement after switching from the previous treatment to LOS/HCTZ. There was a significant decrease in both B-type natriuretic peptide (BNP) and urinary albumin creatinine (Cr) excretion ratio (ACR), especially in patients with elevated values. In contrast, there was a significant increase in serum Cr concentration in conjunction with a decrease in estimated glomerular filtration rate (eGFR). Overall serum uric acid (UA) concentration increased, whereas in patients with hyperuricemia there was a significant reduction in this value. CONCLUSION: Switching to LOS/HCTZ provides a greater reduction in clinic and home BP in patients with uncontrolled hypertension. This combination therapy may lead to cardio-, reno protection and improve UA metabolism.
Asunto(s)
Antihipertensivos/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Hidroclorotiazida/uso terapéutico , Hipertensión/tratamiento farmacológico , Losartán/uso terapéutico , Adulto , Anciano , Determinación de la Presión Sanguínea , Creatinina/orina , Combinación de Medicamentos , Femenino , Tasa de Filtración Glomerular , Humanos , Hipertensión/metabolismo , Hipertensión/fisiopatología , Hiperuricemia , Japón , Masculino , Persona de Mediana Edad , Péptido Natriurético Encefálico/sangre , Estudios Prospectivos , Resultado del Tratamiento , Ácido Úrico/sangre , Adulto JovenRESUMEN
OBJECTIVES: To determine the effect of macrophage colony-stimulating factor (MCSF) on atherogenesis in patients with coronary artery disease (CAD), we assessed the relation between the plasma concentration of MCSF and the incidence of acute coronary events in patients with CAD. BACKGROUND: Cytokines such as MCSF play a central role in inflammatory and proliferative responses in patients with acute coronary syndromes. However, the effect of MCSF on the clinical course in patients with CAD is still not known. METHODS: We measured the plasma MCSF concentration in 142 patients with documented CAD (62 +/- 9 years) and followed up for a mean period of 14 +/- 6 months. The study included 97 patients with stable angina (SA), 45 patients with unstable angina (UA) and 22 age-matched control subjects. The predictors of coronary events were analyzed by using a Cox proportional hazards model. RESULTS: The mean plasma MCSF concentration in patients with UA was significantly higher than that in patients with SA and in control subjects (981 +/- 277 vs. 693 +/- 223 vs. 680 +/- 158 pg/ml, p < 0.001). The mean plasma MCSF concentration in the 20 patients with coronary events was significantly higher than that in patients without coronary events (1,192 +/- 232 vs. 690 +/- 213 pg/ml, p < 0.001). The predictors of unfavorable outcome were an increased MCSF concentration, the presence of CAD and a low ejection fraction. CONCLUSIONS: These findings suggest that an increased circulating MCSF concentration reflects atherosclerotic progression in patients with CAD and predicts future cardiac events.
Asunto(s)
Angina de Pecho/sangre , Factor Estimulante de Colonias de Macrófagos/sangre , Adulto , Anciano , Anciano de 80 o más Años , Angina de Pecho/diagnóstico por imagen , Angina de Pecho/terapia , Angioplastia Coronaria con Balón , Biomarcadores/sangre , Angiografía Coronaria , Puente de Arteria Coronaria , Progresión de la Enfermedad , Electrocardiografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Modelos de Riesgos Proporcionales , Factores de Riesgo , Volumen SistólicoRESUMEN
STUDY OBJECTIVE: In situ production of reactive oxygen intermediates (singlet oxygen and superoxide) during the photoactivation of rose bengal can induce arrhythmias in the aerobically perfused rat heart. The present study was undertaken (1) to assess whether these effects occur with other photosensitizers; (2) to identify the injurious intermediates; (3) to probe the site of action of these phenomena. DESIGN - The study involved the use of meso-tetra-(4-sulphonatophenyl)-porphine (TPPS), a porphyrin which, in contrast to rose bengal, promotes the production of singlet oxygen alone when illuminated. After 10 min of TPPS free perfusion, rat hearts (n = 6 per group) were perfused aerobically with TPPS (1, 5, 10 or 50 mumol.litre-1) for 25 min; during the last 20 min, the hearts were illuminated (3600 lux). In additional studies, TPPS (50 mumol.litre-1) was washed out before illumination. EXPERIMENTAL MATERIAL: Hearts from 30 male Wistar rats, weighing 220-280 g, were excised and perfused retrogradely. MEASUREMENTS AND MAIN RESULTS: Cardiac function was unaffected with TPPS alone. Upon illumination, electrocardiographic changes (increase in QT interval and/or T wave changes) and arrhythmias developed in a dose dependent manner. At the highest dose, electrocardiographic changes occurred within 7.0(SEM 0.4) s; all hearts exhibited ventricular premature beats and complete atrioventricular block; 67% developed ventricular tachycardia and 17% ventricular fibrillation. During illumination, hearts also exhibited a dose and time dependent decrease in coronary flow. In additional studies, despite the absence of TPPS in the perfusate, all hearts exhibited complete atrioventricular block, 67% developed ventricular premature beats and 33% ventricular tachycardia; none exhibited ventricular fibrillation. CONCLUSIONS: The results suggest that singlet oxygen, as opposed to superoxide, is responsible for the injury which occurs at tissue surfaces to which photosensitizer is bound.
Asunto(s)
Arritmias Cardíacas/inducido químicamente , Luz , Oxígeno/toxicidad , Porfirinas/toxicidad , Fármacos Sensibilizantes a Radiaciones/toxicidad , Animales , Circulación Coronaria/efectos de los fármacos , Relación Dosis-Respuesta a Droga , Electrocardiografía , Frecuencia Cardíaca/efectos de los fármacos , Masculino , Fotoquímica , Ratas , Ratas Endogámicas , Oxígeno SingleteRESUMEN
BACKGROUND AND PURPOSE: Intracranial collaterals influence the prognosis of patients treated with intravenous tissue plasminogen activator in acute anterior circulation ischemic stroke. We compared the methods of scoring collaterals on pre-tPA brain CT angiography for predicting functional outcomes in acute anterior circulation ischemic stroke. MATERIALS AND METHODS: Two hundred consecutive patients with acute anterior circulation ischemic stroke treated with IV-tPA during 2010-2012 were included. Two independent neuroradiologists evaluated intracranial collaterals by using the Miteff system, Maas system, the modified Tan scale, and the Alberta Stroke Program Early CT Score 20-point methodology. Good and extremely poor outcomes at 3 months were defined by modified Rankin Scale scores of 0-1 and 5-6 points, respectively. RESULTS: Factors associated with good outcome on univariable analysis were younger age, female sex, hypertension, diabetes mellitus, atrial fibrillation, small infarct core (ASPECTS ≥8), vessel recanalization, lower pre-tPA NIHSS scores, and good collaterals according to Tan methodology, ASPECTS methodology, and Miteff methodology. On multivariable logistic regression, only lower NIHSS scores (OR, 1.186 per point; 95% CI, 1.079-1.302; P = .001), recanalization (OR, 5.599; 95% CI, 1.560-20.010; P = .008), and good collaterals by the Miteff method (OR, 3.341; 95% CI, 1.203-5.099; P = .014) were independent predictors of good outcome. Poor collaterals by the Miteff system (OR, 2.592; 95% CI, 1.113-6.038; P = .027), Maas system (OR, 2.580; 95% CI, 1.075-6.187; P = .034), and ASPECTS method ≤5 points (OR, 2.685; 95% CI, 1.156-6.237; P = .022) were independent predictors of extremely poor outcomes. CONCLUSIONS: Only the Miteff scoring system for intracranial collaterals is reliable for predicting favorable outcome in thrombolyzed acute anterior circulation ischemic stroke. However, poor outcomes can be predicted by most of the existing methods of scoring intracranial collaterals.
Asunto(s)
Encéfalo/irrigación sanguínea , Angiografía Cerebral/métodos , Circulación Colateral/fisiología , Accidente Cerebrovascular/diagnóstico por imagen , Anciano , Alberta , Encéfalo/diagnóstico por imagen , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Pronóstico , Resultado del TratamientoRESUMEN
Singlet oxygen and superoxide production by rose bengal photoactivation leads to rapid electrophysiological changes and arrhythmias. To investigate which intermediate is causative and to probe possible mechanisms, hearts (n = at least 6/group) were perfused aerobically for 10 min without rose bengal followed by 5 min with rose bengal before illumination for 20 min. In controls, all or most hearts exhibited ventricular premature beats, ventricular tachycardia, and complete atrioventricular block. Most antioxidants tested had no protective effect; histidine, however, significantly delayed the onset of electrocardiographic (ECG) changes. In further studies, two antiarrhythmic agents (quinidine and verapamil) had no little protective effect, whereas R56865 significantly delayed the onset of ECG changes and reduced the incidence of arrhythmias. However, spectrophotometric and laser pulse radiolysis studies showed that this apparent protective effect might have resulted from an interaction between R56865 and the rose bengal molecule, leading to a reduction in singlet oxygen production. In conclusion, the electrophysiological changes induced by rose bengal photoactivation are likely to be due to singlet oxygen; antiarrhythmic drugs appear to be unable to protect against the injury unless there is some interaction with the photoactivation process.
Asunto(s)
Antioxidantes , Arritmias Cardíacas/inducido químicamente , Rosa Bengala/toxicidad , Animales , Arritmias Cardíacas/tratamiento farmacológico , Benzotiazoles , Circulación Coronaria/efectos de los fármacos , Electrocardiografía , Radicales Libres , Frecuencia Cardíaca/efectos de los fármacos , Masculino , Oxígeno/toxicidad , Fotólisis , Piperidinas/farmacología , Ratas , Ratas Endogámicas , Superóxidos/toxicidad , Tiazoles/farmacologíaRESUMEN
The seco-Cl 3-methoxycarbonyl-2-trifluoromethylcyclopropapyrroloindole (MCTFCPI) derivatives dl- and/or (S)-10 carrying various acyl moieties at the N6-position were synthesized along with their prodrugs (S)-12, and their antitumor activity was evaluated. Among these derivatives, AT-3510 [(S)-12m], the novel prodrug MCTFCPI derivative carrying a 5-(7-methoxybenzofuran-2-ylcarbonyl)aminoindole-2-carb onyl group at the N6-position, was found to exhibit more excellent antitumor activity against human tumor xenografts than the clinical trial candidates carzelesin (6) and KW-2189 (7) and cisplatin.
Asunto(s)
Antineoplásicos/síntesis química , Benzofuranos/síntesis química , Profármacos/síntesis química , Pirroles/síntesis química , Animales , Antineoplásicos/química , Antineoplásicos/farmacología , Benzofuranos/química , Benzofuranos/farmacología , Ensayos de Selección de Medicamentos Antitumorales , Femenino , Humanos , Ratones , Ratones Endogámicos BALB C , Profármacos/química , Profármacos/farmacología , Pirroles/química , Pirroles/farmacología , Estereoisomerismo , Relación Estructura-Actividad , Trasplante Heterólogo , Células Tumorales CultivadasRESUMEN
Into 25 patients with heart disorders, 99mTc-tetrofosmin 555-740 MBq was injected intravenously at rest. After 40 minutes, ECG-gated myocardial perfusion SPECT was performed with a two detector gamma camera VERTEX (ADAC), setting up two detectors to form a 90-degree angle. Sixteen frames per R-R interval were acquired during a 180 degree rotation from the RAO 45 degrees to the LPO 45 degrees. A pair of data sets with standard (SDA) and rapid data acquisition (RDA) protocols was collected. In an SDA protocol, SPECT imaging was performed for 50 sec per step in 5 degree angular steps (total acquisition time; 15 minutes). An RDA protocol was conducted with 12 sec per step, 6 degree angular steps (acquisition time, 3 minutes). LVEF (%) and LVEDV (ml) quantitated automatically with a QGS program showed excellent correlations between two protocols with correlation coefficients of 0.980 (p < 0.01) and 0.983 (p < 0.01), respectively. Subsequently visual assessment of regional wall motion based on a four-point grading system was carried out with a 3-D cine LV display. High complete agreement was gained with 158 (90.3%) out of total 175 segments, so that assessment of the global and regional LV function with the RDA protocol demonstrated high reliability and feasibility.
Asunto(s)
Electrocardiografía , Corazón/diagnóstico por imagen , Compuestos Organofosforados , Compuestos de Organotecnecio , Radiofármacos , Tomografía Computarizada de Emisión de Fotón Único/métodos , Humanos , Análisis de Regresión , Factores de TiempoRESUMEN
BACKGROUND: Left ventricular remodeling (LVR) process is one of the important secondary sequele after acute myocardial infarction (AMI). However, little is known about the relationship between LVR and angiotensin converting enzyme (ACE) gene polymorphism as well as endothelial nitric oxide synthase (ecNOS) gene polymorphism. METHODS: Coronary angiography and left ventriculography were performed within 24 hours and 30+/-7 days after AMI onset. All consecutive 24 patients (57+/-6 years) had acute anterior MI with one vessel disease of left anterior descending artery and successful revascularization therapy during acute phase. Patients were divided into three groups according to the change of end-diastolic volume index (EDVI)(Delta EDVI = EDVI 1 month-EDVI within 24 hrs); LVR(+) (Delta EDVI>7.0 ml/m(2), n = 5), LVR (-)(Delta EDVI<-7.0 ml/m(2), n = 13), and LVR (+/-)(-7.0Asunto(s)
Infarto del Miocardio/patología
, Peptidil-Dipeptidasa A/genética
, Polimorfismo Genético
, Remodelación Ventricular/genética
, Anciano
, Endotelio/enzimología
, Femenino
, Genotipo
, Humanos
, Masculino
, Persona de Mediana Edad
, Óxido Nítrico Sintasa/genética
RESUMEN
The concentrations of cefotiam (CTM) in the exudate of pericardium were investigated, and determined in 8 patients accompanied open heart surgery after a single intravenous injection or intravenous drip infusion of 1 or 2 grams. The peak concentrations of CTM have been appeared after 30 minutes or 1 hour, and prolonged for 3 hours, these concentrations of CTM showed about 8--30 times of MIC values which inhibit the growth of E. coli, K. pneumoniae. P. mirabilis and S. aureus. Therefore, it is recommended that CTM will be administered by intravenous infusion just prior to the operation.
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Cefotaxima/análogos & derivados , Derrame Pericárdico/metabolismo , Adulto , Cefotaxima/administración & dosificación , Cefotaxima/sangre , Cefotaxima/metabolismo , Cefotiam , Femenino , Humanos , Infusiones Parenterales , Inyecciones Intravenosas , Masculino , Persona de Mediana EdadRESUMEN
Although 201TlCl myocardial scintigraphy has so far been widely used for the evaluation of the viability of the myocardial infarcted area, functional evaluation using low dose dobutamine (DOB) loaded echography also became recently available. We performed 99mTc-mIBI gated SPECT on eight cases of myocardial infarction at rest and low dose (4-6 micrograms/kg/min) DOB-loading and related data were collected. Next, we calculated myocardial count increase rate (% WT = ES-ED/ED x 100) with left ventricular contraction from end-diastolic (ED) and end-systolic (ES) pictures in short-axial image, and made a comparative examination of regional contractilities at rest and DOB-loading. DOB-loaded echography performed on the same cases at the same dose revealed 15 segments as infarcted area (WM (+)) presenting improvement in wall movement at loading and 5 segments as infarcted area (WM (-)) presenting no such improvement, and %WT at rest and loading were 29.1 +/- 6.2 and 33.2 +/- 2.4 for (WM (-)) and 26.8 +/- 9.8 and 40.0 +/- 12.3 for (WM (+)), indicating a significant increase (p < 0.05) at loading. Contractility analysis using MIBI gated SPECT in combined use of DOB-loading was considered as a useful method of examination in view of its reflectability in the evaluation of the wall movement in DOB-loaded echography and of its high quantitativity.
Asunto(s)
Dobutamina , Corazón/diagnóstico por imagen , Contracción Miocárdica , Infarto del Miocardio/diagnóstico por imagen , Tecnecio Tc 99m Sestamibi , Anciano , Dobutamina/administración & dosificación , Electrocardiografía , Prueba de Esfuerzo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/fisiopatología , Tomografía Computarizada de Emisión de Fotón ÚnicoRESUMEN
ECG-gated dual-isotope acquisition protocol involving rest imaging with 201Tl and stress 99mTc-tetrofosmin (TF) SPECT was designed for the simultaneous assessment of rest/stress myocardial perfusion and rest ventricular systolic function. This study assessed the feasibility and diagnostic accuracy of this protocol. Forty-five patients underwent the dual-isotope SPECT protocol. Twenty minutes after resting injection of 111 MBq of 201Tl, 370 MBq of 99mTc-TF was administered at a peak exercise. The dual-isotope gated SPECT acquisition was performed 1 hour later. Then, the regional count increase rate (%WT) of 99mTc-TF from end-diastole end-systole was calculated using an automated method which was developed for quantification of regional wall thickening based on circumferential profile analysis in our laboratory. Myocardial perfusion and contractility analysis was carried out using 8 segments of left ventricle with comparison of coronary angiographical findings. The sensitivity and specificity for the detection of diseased coronary vessels (> = or 75% stenosis) were 76% and 94%, respectively. Infarcted regions showing reversible defect had significantly greater %WT as compared with those with fixed defects (63 seg; 12.7 +/- 6.1% vs. 36 seg; 8.9 +/- 7.2%, p < 0.01). In conclusion, this dual-isotope protocol has some advantages; i.e., shortening an examination time, having the exact registration of stress/rest perfusion, and simultaneous evaluation of resting regional wall thickening.
Asunto(s)
Electrocardiografía , Imagen de Acumulación Sanguínea de Compuerta , Corazón/diagnóstico por imagen , Compuestos Organofosforados , Compuestos de Organotecnecio , Radiofármacos , Radioisótopos de Talio , Tomografía Computarizada de Emisión de Fotón Único , Función Ventricular Izquierda , Angiografía Coronaria , Femenino , Humanos , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/diagnóstico por imagenRESUMEN
For prediction of recovery of LV contractility, 99mTc-MIBI gated SPECT at rest and that with dobutamine (DOB) loading were performed in 15 patients with myocardial infarction (MI). Regional % uptake (regionalx100/maximal count), % wall thickening [%WT; (ES-ED)x100/ED maximal count], and delta %WT (%WT at DOB stress-%WT at rest) were calculated for each of 8 segments (seg.), including 34 MI out of total 120 seg., which derived from short axis LV count profile. These 34 seg. were divided into two groups, recontractile (18 seg.) and non-recontractile (16 seg.), whether improvement of the wall motion following the intervention (3-5 months) was observed by echocardiography. In the result, there were 7 recontractile seg. in 8 seg. with mildly reduced perfusion (> or = normal mean % uptake-2 S.D.), and there were 11 recontractile seg. in 26 seg. with severe reduced perfusion (< normal mean % uptake-2 S.D.). Moreover, in segments with severely reduced perfusion, there was no significant % uptake difference between recontractile and non-recontractile seg. However, delta %WT of recontractile group (11.1 +/- 4.8%) was significantly higher than that of non-recontractile group (5.7 +/- 2.9%) (p < 0.01). In conclusion, although the improvement of contractility on early stage after the revascularization was sometimes underestimated with only perfusion (% uptake), myocardial DOB response of %WT which were obtained by gated SPECT with MIBI would avoid the underestimation.
Asunto(s)
Cardiotónicos , Dobutamina , Contracción Miocárdica/fisiología , Infarto del Miocardio/terapia , Revascularización Miocárdica , Tecnecio Tc 99m Sestamibi , Tomografía Computarizada de Emisión de Fotón Único , Función Ventricular Izquierda/fisiología , Angioplastia Coronaria con Balón , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/fisiopatología , Terapia TrombolíticaRESUMEN
Simultaneous dual-isotope SPECT with 99mTc-methoxy isobutyl isonitrile (MIBI) and 123I-beta-methyl iodophenyl-pentadecanoic acid (BMIPP) was performed in 25 patients with ischemic heart disease. ECG-gated myocardial SPECT was acquired following the injection of MIBI (555 MBq) and BMIPP (148 MBq). Both MIBI and BMIPP scans provided high-quality myocardial images. Then, myocardial count increase rate (%WT = ES-ED/ED x 100) was calculated as an index of left ventricular contraction using MIBI gated SPECT data. The %WT was well correlated with severity scores of both MIBI image (r = -0.70) and BMIPP image (r = -0.72). Thus, ECG-gated dual-isotope SPECT with MIBI and BMIPP was considered to be useful method for assessment of left ventricular contraction as well as myocardial perfusion and fatty acid metabolism.
Asunto(s)
Ácidos Decanoicos , Ácidos Grasos , Corazón/diagnóstico por imagen , Radioisótopos de Yodo , Yodobencenos , Isquemia Miocárdica/diagnóstico por imagen , Tecnecio Tc 99m Sestamibi , Tomografía Computarizada de Emisión de Fotón Único/métodos , Anciano , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Although 99mTc-pyrophosphate (PYP) myocardial scintigraphy has so far been widely used for the diagnosis of right ventricular infarction, PYP accumulation disappears within one week or so. To evaluate the myocardial condition of the right ventricle alternatively, myocardial SPECT with 99mTc-MIBI was performed in 16 patients with acute inferior left ventricular infarction, and ECG-gated myocardial SPECT data acquisition was accompanied in 14 of 16 patients. Right ventricular perfusion defect was observed in 4 of 16 patients (RVI (+) group), and the remains were negative (RVI (-) group). Then, right ventricular count increase rate (RV %WT) of MIBI from end-diastole to end-systole was calculated using an automated method which was developed for quantification of wall thickening in our laboratory. The RV %WT was conceived to be an objective index representing right ventricular contractility. RVI (+) group (n = 3) as compared with RVI (-) group (n = 11) had significant lower RV %WT (26.7 +/- 3.2 vs. 49.6 +/- 14.2; p < 0.01). In conclusion, ECG-gated myocardial SPECT with MIBI was considered to be useful for assessment of myocardial perfusion and contractility of right ventricle.
Asunto(s)
Corazón/diagnóstico por imagen , Tecnecio Tc 99m Sestamibi , Tomografía Computarizada de Emisión de Fotón Único/métodos , Disfunción Ventricular Derecha/diagnóstico por imagen , Anciano , Electrocardiografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Contracción Miocárdica , Disfunción Ventricular Derecha/fisiopatología , Función Ventricular DerechaRESUMEN
ECG-gated myocardial Technetium-99m sestamibi SPECT is a useful technique to measure myocardial perfusion and function simultaneously. In this study, wall thickening (WT) and regional ejection fraction (rEF) using ECG-gated SPECT have been studied to determine which parameter would be more sensitive to detect coronary artery stenosis in patients with acute myocardial infarction (AMI). Forty-five patients (36 men, 9 women, mean age 63 +/- 9 years old) with AMI were examined. CAG was performed for all patients. ECG-gated SPECT was performed 60 min after the intravenous injection of 555 MBq 99mTc-sestamibi at rest. Commercially available software (QGS) was used to produce WT and rEF polar maps from acquired SPECT data. The WT and rEF polar maps were evaluated visually and quantitatively. WT indicated higher sensitivity (80.3% vs. 59.1%, p < 0.05) and accuracy (86.7% vs. 74.8%, p < 0.05) than rEF for detecting overall coronary artery stenosis on visual interpretation. On quantitative analysis, WT had higher specificity (91.3% vs. 75.4%, p < 0.05) and accuracy (85.9% vs. 72.6%, p < 0.05) than rEF for detecting overall coronary artery stenosis, and showed a higher specificity (93.8% vs. 59.4%, p < 0.01) and accuracy (88.9% vs. 62.2%, p < 0.01) for detecting LCX stenosis. Moreover, sensitivity of WT for detecting coronary artery stenosis without infarction was higher than that of rEF significantly in quantitative analysis (75.0% vs. 31.3%, p < 0.05). These results suggested that WT was superior to rEF for detecting the coronary artery stenosis in patients with and without myocardial infarction. We concluded that WT is more sensitive indicator to determine localization of regional left ventricular dysfunction in AMI than rEF.
Asunto(s)
Imagen de Acumulación Sanguínea de Compuerta , Contracción Miocárdica , Infarto del Miocardio/diagnóstico por imagen , Volumen Sistólico , Función Ventricular Izquierda , Anciano , Enfermedad Coronaria/diagnóstico por imagen , Enfermedad Coronaria/fisiopatología , Electrocardiografía , Femenino , Corazón/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/fisiopatología , Radiofármacos , Sensibilidad y Especificidad , Tecnecio Tc 99m SestamibiRESUMEN
123I-iodophenyl-9-methyl-pentadecanoic acid (9MPA) is a modified long-chain (15 carbons) fatty acid with a methyl branch on its 9 carbon location. Myocardial SPECT images (two sets, 10 min each) were obtained starting 10 min (early phase) and 50 min (delay phase) after the injection of 160 MBq 123I-9MPA at rest in 10 patients with acute myocardial infarction. The segmental myocardial uptake (% uptake) and clearance (% washout) from early to delay image were calculated by the SPECT data. ECG-gated myocardial SPECT with 99mTc-sestamibi was also performed and segmental left ventricular (LV) wall motion was evaluated using QGS (quantitative gated SPECT) program. The % uptake of LV segments with hypokinetic or akinetic wall motion were significantly lower than those with normokinesis (p < 0.01) for both early and delay phases. The % washout of hypokinetic segments were significantly lower than those of normokinetic regions (p < 0.01), while the % washout of akinetic segments were significantly higher than those of severely hypokinetic segments (p < 0.05). Thus, 123I-9MPA myocardial distribution and clearance thought to be associated with left ventricular regional wall motion.
Asunto(s)
Ácidos Grasos , Radioisótopos de Yodo , Yodobencenos , Infarto del Miocardio/diagnóstico por imagen , Tecnecio Tc 99m Sestamibi , Tomografía Computarizada de Emisión de Fotón Único , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/fisiopatología , Función Ventricular Izquierda/fisiologíaRESUMEN
Non-invasive assessment of ischemic heart disease requires information of both LV function and myocardial perfusion. Recently, ECG-gated myocardial SPECT with technetium-labeled radiopharma-ceuticals can provide both of them. Gated myocardial SPECT were performed in thirty-three patients with cardiac disease using a two-headed rotating gamma camera system (ADAC; VERTEX), 30-60 minutes after resting injection of 555-740 MBq of 99mTc-Tetrofosmin. Then, the SPECT data were used to determine the LV epi- and endocardial surface, and LV volume for measurement of LVEF was calculated automatically. This entire computational process required only 210 seconds per 16 frame study. Interobserver agreement of EF values obtained from gated SPECT was excellent (r = 0.996, n = 10, p < 0.01). LVEFs obtained from gated SPECT showed good correlation to those calculated from radionuclide ventriculography (MUGA) (r = 0.91, p < 0.01). In conclusion, this automatic method using gated myocardial SPECT data was considered to be useful for assessment of LV function with reproducibility.
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Imagen de Acumulación Sanguínea de Compuerta , Corazón/diagnóstico por imagen , Compuestos Organofosforados , Compuestos de Organotecnecio , Sístole , Tomografía Computarizada de Emisión de Fotón Único/métodos , Función Ventricular Izquierda , Anciano , Volumen Cardíaco , Electrocardiografía , Endocardio , Femenino , Humanos , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/diagnóstico por imagen , Isquemia Miocárdica/fisiopatología , PericardioRESUMEN
BACKGROUND: There are only very few reports of cervical toxoplasma lymphadenitis being diagnosed exclusively via fine-needle aspiration cytology (with serology). CASE REPORT: We describe a case of toxoplasma lymphadenitis that was successfully diagnosed by fine-needle aspiration cytology. The case involved a male patient who was immunocompromised as a result of recurrent acute myelogenous leukaemia with cervical lymphadenopathy. The biopsy showed typical features of a well-defined pseudocyst containing Toxoplasma gondii tachyzoites. CONCLUSION: Toxoplasma lymphadenitis is a common cause of lymph node enlargement. Fine-needle aspiration cytology is a useful method for diagnosing and differentiating toxoplasma lymphadenitis from more serious causes of lymphadenopathy, such as metastatic lymphadenopathy or lymphoma.
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Linfadenitis/patología , Enfermedades Raras/patología , Toxoplasmosis/patología , Biopsia con Aguja Fina , Resultado Fatal , Humanos , Masculino , Persona de Mediana Edad , CuelloRESUMEN
A new type polychromator has been designed for the edge Thomson scattering system in ITER. Signal light is parallelly dispersed into two parts at the first interference filter. Spectral transmissivities for some spectral channels may enhance better than the conventional type polychromator. In the new type polychromator, the misalignment due to the machine accuracy is expected to be within the margin of APD area. In order to calibrate the spectral transmissivity using the dual-laser injection method during the plasma discharge, it is preferred that the spectral channels are separated at the geometric mean of the injected two wavelengths.