Stress-associated neurobiological activity is linked with acute plaque instability via enhanced macrophage activity: a prospective serial 18F-FDG-PET/CT imaging assessment.

AIMS: Emotional stress is associated with future cardiovascular events. However, the mechanistic linkage of brain emotional neural activity with acute plaque instability is not fully elucidated. We aimed to prospectively estimate the relationship between brain amygdalar activity (AmygA), arterial inflammation (AI), and macrophage haematopoiesis (HEMA) in acute myocardial infarction (AMI) as compared with controls. METHODS AND RESULTS: 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) imaging was performed within 45 days of the index episode in 62 patients (45 with AMI, mean 60.0 years, 84.4% male; 17 controls, mean 59.6 years, 76.4% male). In 10 patients of the AMI group, serial 18F-FDG-PET/CT imaging was performed after 6 months to estimate the temporal changes. The signals were compared using a customized 3D-rendered PET reconstruction. AmygA [target-to-background ratio (TBR), mean ± standard deviation: 0.65 ± 0.05 vs. 0.60 ± 0.05; P = 0.004], carotid AI (TBR: 2.04 ± 0.39 vs. 1.81 ± 0.25; P = 0.026), and HEMA (TBR: 2.60 ± 0.38 vs. 2.22 ± 0.28; P < 0.001) were significantly higher in AMI patients compared with controls. AmygA correlated significantly with those of the carotid artery (r = 0.350; P = 0.005), aorta (r = 0.471; P < 0.001), and bone marrow (r = 0.356; P = 0.005). Psychological stress scales (PHQ-9 and PSS-10) and AmygA assessed by PET/CT imaging correlated well (P < 0.001). Six-month after AMI, AmygA, carotid AI, and HEMA decreased to a level comparable with the controls. CONCLUSION: AmygA, AI, and HEMA were concordantly enhanced in patients with AMI, showing concurrent dynamic changes over time. These results raise the possibility that stress-associated neurobiological activity is linked with acute plaque instability via augmented macrophage activity and could be a potential therapeutic target for plaque inflammation in AMI.

Assessment of Sex Differences in 5-Year Clinical Outcomes Following Endovascular Revascularization for Peripheral Artery Disease.

Percutaneous transluminal angioplasty (PTA) is an effective treatment strategy for peripheral artery disease (PAD). Data are limiting regarding sex differences in patients with PAD who underwent PTA. We assessed the sex-related differences on 5-year clinical outcomes in patients with PAD who underwent PTA. We prospectively evaluated 765 patients with PAD (596 males and 169 females) who underwent PTA. We performed propensity score matching (PSM) analysis to adjust for any potential confounders. The primary endpoints were 5-year major adverse cardiac and cerebrovascular events (MACE) and major adverse lower-limb events (MALE) assessed by Kaplan-Meier curved analysis and log rank test. After PSM analysis, baseline clinical characteristics were similar in male and female patients. There was a trend toward a higher rate of major hematoma in female patients (6.1% vs. 0.9%, p = 0.066) and a lower rate of below the ankle amputation (24.7% vs. 16.5%, p = 0.097). During the 5-year clinical follow-up, male and female patients had similar rates of MACE (14.9% vs. 15.8%, log rank p = 0.838) and MALE (34.8% vs. 28.2%, log rank p = 0.264) as well as the individual endpoints. In subgroup analysis adjusted by PSM, female patients had a higher risk of bleeding complications in age ≥ 65 years, hypertension, diabetes mellitus, chronic kidney disease, and in the non-critical limb ischemia patients. Of patients with preserved renal function, female patients had a higher risk of MALE as compared to males. In conclusion, female patients with PAD who underwent PTA showed similar 5-year MACE and MALE compared with male patients.

Assessment of the trueness and tissue surface adaptation of CAD-CAM maxillary denture bases manufactured using digital light processing.

STATEMENT OF PROBLEM: Limited information is available evaluating the trueness and tissue surface adaptation of computer-aided design and computer-aided manufacturing (CAD-CAM) maxillary denture bases fabricated using digital light processing (DLP). PURPOSE: The purpose of this in vitro study was to evaluate the trueness of DLP-fabricated denture bases and to compare the tissue surface adaptation of DLP with milling (MIL) and pack and press (PAP). MATERIAL AND METHODS: The maxillary denture bases were virtually designed on the reference cast and were fabricated using DLP and MIL. Their intaglio surfaces were scanned and superimposed on the reference computer-aided design denture base to evaluate the trueness. A total of 20 denture bases (10 per technique) were also fabricated on the duplicated master casts using DLP and MIL. Ten denture bases were additionally made using PAP. The intaglio surfaces of the dentures were scanned and superimposed on the corresponding casts to compare the degree of tissue surface adaptation among the 3 techniques. The Mann-Whitney test and Kruskal-Wallis ANOVA were used for statistical analyses (α=.05). RESULTS: The trueness of the DLP denture base was significantly better than that of the MIL denture base (P<.001). Statistically significant differences were detected with respect to tissue surface adaptation of the denture base among the groups (P<.001). The DLP denture base showed the best denture base fit among the 3 techniques with a small interquartile range. CONCLUSIONS: Within the limitations of this in vitro study, the DLP maxillary denture base showed better trueness and tissue surface adaptation of ≤100 µm of the 3-dimensional surface deviation than the MIL and PAP denture bases.

Study on the Validity of Surface Electromyography as Assessment Tools for Facial Nerve Palsy.

OBJECTIVES: The purpose of this study was to find out validity of Surface Electromyography(sEMG) compared with Nerve Conduction Study and clinical assessment scale as assessment factors for facial palsy. METHODS: We investigated 50 cases of patients with peripheral facial palsy who had records of sEMG and NCS to check. Then we analyzed the correlation between sEMG and NCS that carried out around 1 week after onset. And we analyzed the correlation between sEMG and clinical assessment scales that were measured three times around 1 week, 3-4 weeks and 5-6 weeks after onset. Clinical assessment scales used in this study were House-brackmann grade, Yanagihara unweighted grading scale and Sunnybrook facial grading system. We used Pearson's correlation for statistical analysis. RESULTS: sEMG and NCS, measured at similar times, were statistically correlated. Especially, the correlation with the forehead region was high. And sEMG and clinical assessment scale, measured at same time, were statistically correlated, especially after 5 weeks from onset. CONCLUSION: According to this study, sEMG is expected to be useful to assessment facial palsy.