Clinical significance of mild inferolateral wall ischemia of the left ventricle on 99mTc-MIBI myocardial perfusion single photon emission computed tomography (SPECT).

INTRODUCTION: Mild ischemia in the inferolateral wall on myocardial perfusion imaging is seen frequently in practice. The aim of this study is to assess the importance of the above issue on myocardial perfusion SPECT with coronary angiography. PATIENTS AND METHODS: All patients enrolled in this study exhibited mild ischemia of the inferolateral wall on myocardial single photon emission computed tomography (SPECT) with 99mTc-MIBI, using the 20 left ventricular segments model. Each patient completed a questionnaire, including type of chest pain, risk factors, and previous examinations, and all cases were followed up for one year. Luminal stenosis of >50% was classified as significant stenosis on coronary angiography. A p value < 0.05 was considered statistically significant. RESULTS: During investigation, 105 cases had mild ischemia on myocardial perfusion imaging (MPI) of which 36 subjects (22 male and 14 female) underwent coronary angiography. The mean age was 56.62±10.23 years old (age range: 36-73 years). The inferolateral wall was compared to the left circumflex (LCX) territory. Nineteen out of 36 (52.7%) cases had stenosis in the LCX. Twenty-three of 105 (21.90%) underwent revascularization during the one year follow up. In multiple logistic regressions, with LCX stenosis on angiography as the dependent variable, only abnormal MPI was independently associated significantly. CONCLUSIONS: The findings of the study may indicate that even a mild perfusion defect in the inferolateral wall should be carefully managed, especially in high-risk subjects for coronary artery disease.

The association of rate pressure product (RPP) and myocardial perfusion imaging (MPI) findings: a preliminary study.

INTRODUCTION: The product of heart rate and systolic blood pressure, termed as rate-pressure product (RPP), is a very reliable indicator of myocardial oxygen demand and is widely used clinically. There have been previous attempts to describe the relationship between RPP and the onset of pain in angina pectoris. The current study aimed to evaluate the association between RPP results and scan findings. MATERIALS AND METHODS: In total, 497 patients with suspected coronary artery disease (CAD) underwent gated, single-photon emission computed tomography (SPECT) imaging with dipyridamole, exercise, or dobutamine stress, and were included in this study. Baseline and maximum heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and electrocardiogram (ECG) results were recorded. The rate-pressure product (RPP) was calculated as the product of heart rate and systolic arterial pressure for both baseline and maximum measures. The difference between the RPP max and the basal RPP is known as the RPP reserve. Researchers also obtained semi-quantitative analyses of myocardial perfusion imaging (MPI), using gated software, demographic information, risk factors of CAD, and pretest likelihoods of CAD using nomograms. RESULT: Four hundred and ninety-seven cases, including 426 patients with dipyridamole stress, 59 with exercise stress, and 12 with dobutamine stress, underwent myocardial perfusion imaging. Scan results were positive in 194 (45.5%) and negative in 232 (54.5%) patients with dipyridamole stress. In patients with exercise stress, the scan was positive in 24 (40.7%) cases and negative in 35 (59.3%) cases. In dobutamine stressed patients, the scan was positive in 6 (50%) cases and negative in the 6 remaining cases. Dipyridamole stress resulted in a significant difference between HR at rest and at maximum (28.95 ± 24.53, p-value<0.0001), between systolic BP at rest and maximum (6.75 ± 12.50, p-value<0.0001) and between diastolic BP at rest and maximum (1.45 ± 5.80; p-value<0.0001). There was a significant correlation between sum stress scores (SSS) and reserved RPP (r= -0.12, p-value<0.001) which, in dipyridamole patients, was r=-0.18, p-value=0.0001). In addition, there was a significant association between reserved RPP and risk of CAD (p-value<0.001). In the patients with dipyridamole stress, the ejection fraction (EF) change (odds ratio =0.92; 95% CI: 0.86-0.98; p=0.01), reserve RPP (odds ratio =1.00; 95% CI: 1.00-1.00; p=0.04), risk of CAD (odds ratio =5.80; 95% CI: 3.21-10.50; p<0.0001) and age (odds ratio =0.94; 95% CI: 0.89-0.98; p=0.01) were associated significantly with MPI results, using multiple logistic regressions. CONCLUSION: The study demonstrated that RPP is associated with MPI findings using gated SPECT imaging with dipyridamole stress. However, to confirm this preliminary result, further studies are mandatory.

The Relationship of Severe Early Childhood Caries and Body Mass Index in a Group of 3- to 6-year-old Children in Shiraz.

STATEMENT OF PROBLEM: Early childhood caries can cause pain, discomfort and also inability to have a healthy nutrition .Malnutrition can be characterized when there is a weight, height, and body mass index (BMI) deficiency. PURPOSE: The aim of this study was to evaluate the relationship between the severe early childhood caries (based on the dmft index) and BMI in pre-school children in Shiraz. MATERIALS AND METHOD: A descriptive analytical cross-sectional study was enrolled on 202 healthy preschool children with the age range of 3-6 years recruited from the kindergartens of different socio- economical parts of Shiraz, Iran. The Anthropometric measurements, weight and height were evaluated. The Z-scores were calculated employing WHO Anthro software (www.who.int/childgrowth/software/en/ index.html) to elucidate the subject's status on the age- and sex-specific growth chart. Every Child who has received two Z-scores under the normal value (< -2) was considered as abnormal. The relationship between dmft index and BMI was then investigated. RESULTS: The mean of dmft was 4.13. From children with severe early childhood caries, 12.5%were under weight, 5% had height deficiency and 19.5% had BMI deficiency, however, there was no significant relationship between increasing dmft and the height, weight and BMI deficiency. CONCLUSION: There was not a linear correlation between severe early childhood caries and BMI, height, and weight deficiency. An incidence of 55% was yielded for severe early childhood caries which was an additional finding of this study.

Inflammatory myofibroblastic tumor of the trachea.

This report described a 2-year-old boy who presented with severe respiratory distress and stridor. Bronchoscopy and CT revealed a mass in the left anterolateral tracheal wall and histopathology showed a tracheal inflammatory myofibroblastic tumor. Initial removal by rigid bronchoscopy resulted in prompt recurrence of the tumor. Therefore he underwent tracheal surgical resection. A bronchoscopy at 12 months after surgery did not show any recurrence sign.

Fabrication of a novel iron(III)-PVC membrane sensor based on a new 1,1'-(iminobis(methan-1-yl-1-ylidene))dinaphthalen-2-ol synthetic ionophore for direct and indirect determination of free iron species in some biological and non-biological samples.

In this novel, the iron(III)-PVC membrane sensor was investigated based on a new 1,1'-(iminobis(methan-1-yl-1-ylidene))dinaphthalen-2-ol (IBMYD) synthetic ionophore as a suitable carrier. The best performance was observed for the membrane composition including 33.0% PVC, 65.0% TEHP, 1.0% NaTPB and 1.0% ionophore. The electrode displayed a linear potential response over a wide concentration range from 1.0 x 10(-7) to 1.0 x 10(-1)mol L(-1), with a detection limit of 5.0 x 10(-8)mol L(-1) and a good Nernstian slope of 19.9+/-0.3 mV decade(-1). The sensor possessed some advantages such as short conditioning time, very fast response time (<12s) and especially good discriminating ability towards Fe(III) ions over a wide variety of alkali, alkaline earth, transition, and heavy metal ions. The potential response of the proposed sensor was independent of the pH of the test solution, in the pH working range from 3.0 to 6.3. The fabricated electrode was applied for at least 2 months, without any measurable divergence in the potential characteristics. The optimized sensor was used successfully for direct and indirect determination of free iron species in some different synthetic and real samples with satisfactory results.