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1.
Int J Soc Welf ; 33(2): 355-369, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38800468

ABSTRACT

This study investigated the associations between early parental warmth, harsh discipline, and adolescent depressive symptoms from early to late adolescence, with attention to gender differences in these associations. The sample was drawn from a longitudinal study, the Taiwan Youth Project, including 2,690 Taiwanese adolescents from wave 1 in 2000 (first year in junior high school) to wave 6 (third year in high school) in 2005. The results showed a nonlinear developmental trajectory of adolescent depressive symptoms during the middle- to high-school period. Harsh discipline was associated with the significantly higher initial presence and faster growth rate of depressive symptoms, while parental warmth and monitoring were associated with the significantly lower initial presence of depressive symptoms. In addition, female adolescents displayed a higher initial level of depressive symptoms than males when parents exercised higher levels of monitoring and harsh discipline. Finally, we provided suggestions for practice and research.

2.
Arch Suicide Res ; : 1-9, 2023 Sep 28.
Article in English | MEDLINE | ID: mdl-37767810

ABSTRACT

Despite the importance of emotions in our daily lives, less is known about the role of emotional reactivity in suicidal risk. This brief study investigated whether emotional reactivity is associated with adolescent suicidal ideation six months later. Participants were 139 adolescents (55% female; Mage = 12.79, SDage = 0.73) who completed baseline assessments, a 10-day daily diary protocol, and six-month follow-up assessments. Results showed that higher emotional reactivity indicated by increased negative emotions and decreased positive emotions was associated with a greater risk for suicidal ideation. The findings suggest that adolescents with greater emotional reactivity to daily school problems had elevated risks for suicidal ideation. This study supports the importance of emotional reactivity in daily life for preventing adolescent suicidal ideation.

3.
J Adolesc ; 95(6): 1168-1178, 2023 08.
Article in English | MEDLINE | ID: mdl-37170670

ABSTRACT

INTRODUCTION: In adolescence, life satisfaction is an early indicator of later psychological well-being. However, researchers know little about how daily family relationships shape adolescent life satisfaction. The current study examined the day-to-day associations between parent-adolescent relationships and life satisfaction, and whether adolescent emotion dysregulation moderated these associations. METHODS: A total of 191 adolescents (Mage = 12.93, SDage = 0.75, 53% female) recruited from junior high schools in Taiwan participated in a 10-day daily diary protocol. We conducted multilevel analyses to examine within-family and between-family processes. RESULTS: At the within-family level, adolescents reported higher life satisfaction on days when parent-adolescent closeness was higher, but lower life satisfaction on days when parent-adolescent conflict was higher. At the between-family level, higher parent-adolescent closeness was associated with greater life satisfaction on average, while parent-adolescent conflict was not related to adolescent life satisfaction. Cross-level interactions indicated that within-family changes in parent-adolescent closeness and conflict were only associated with life satisfaction for adolescents with higher levels of emotion dysregulation, indicating emotion dysregulation may intensify the role of daily parent-adolescent relationships in shaping adolescent life satisfaction. CONCLUSIONS: This study expands current literature and provides novel evidence that changes in day-to-day parent-adolescent relationships have important implications for adolescent life satisfaction, especially for youth higher in emotion dysregulation. The findings underscore the importance of evaluating family and individual characteristics to better support adolescent well-being.


Subject(s)
Adolescent Behavior , Parent-Child Relations , Adolescent , Child , Female , Humans , Male , Adolescent Behavior/psychology , Emotions , Family Relations , Parents/psychology
4.
J Fam Psychol ; 37(4): 538-546, 2023 Jun.
Article in English | MEDLINE | ID: mdl-36892926

ABSTRACT

Emotional variability has been posited as a risk factor for adolescent psychopathology. However, it is unclear whether parent emotional variability may also function as a risk factor that heightens adolescent mental health problems. To fill this gap, the present study examined whether parent and adolescent emotional variability in both positive emotion (PE) and negative emotion (NE) is associated with adolescent psychopathology and potential sex differences in these associations. Participants were 147 adolescents and their parents in Taiwan who completed a baseline assessment, a 10-day daily diary study, and a 3-month follow-up assessment. The results indicated that parent NE variability was associated with risk for adolescent internalizing problems and depressive symptoms, after accounting for baseline levels, adolescent NE variability, parent internalizing problems, and mean levels of parent and adolescent NE. Adolescent PE variability was also associated with the risk for adolescent externalizing problems. Furthermore, higher parent PE variability was associated with more internalizing problems only for female but not male adolescents. The findings highlight the importance of assessing emotion dynamics in both parents and adolescents to better understand the development of adolescent psychopathology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Subject(s)
Adolescent Behavior , Mental Disorders , Humans , Male , Female , Adolescent , Parents/psychology , Emotions , Adolescent Behavior/psychology , Risk Factors , Mental Disorders/psychology
5.
J Microbiol Immunol Infect ; 56(2): 207-235, 2023 Apr.
Article in English | MEDLINE | ID: mdl-36586743

ABSTRACT

Coronavirus disease-19 (COVID-19) is an emerging infectious disease caused by SARS-CoV-2 that has rapidly evolved into a pandemic to cause over 600 million infections and more than 6.6 million deaths up to Nov 25, 2022. COVID-19 carries a high mortality rate in severe cases. Co-infections and secondary infections with other micro-organisms, such as bacterial and fungus, further increases the mortality and complicates the diagnosis and management of COVID-19. The current guideline provides guidance to physicians for the management and treatment of patients with COVID-19 associated bacterial and fungal infections, including COVID-19 associated bacterial infections (CABI), pulmonary aspergillosis (CAPA), candidiasis (CAC) and mucormycosis (CAM). Recommendations were drafted by the 7th Guidelines Recommendations for Evidence-based Antimicrobial agents use Taiwan (GREAT) working group after review of the current evidence, using the grading of recommendations assessment, development, and evaluation (GRADE) methodology. A nationwide expert panel reviewed the recommendations in March 2022, and the guideline was endorsed by the Infectious Diseases Society of Taiwan (IDST). This guideline includes the epidemiology, diagnostic methods and treatment recommendations for COVID-19 associated infections. The aim of this guideline is to provide guidance to physicians who are involved in the medical care for patients with COVID-19 during the ongoing COVID-19 pandemic.


Subject(s)
COVID-19 , Mycoses , Humans , COVID-19/diagnosis , COVID-19/epidemiology , SARS-CoV-2 , Taiwan/epidemiology , Pandemics , Mycoses/diagnosis , Mycoses/drug therapy , COVID-19 Testing
6.
J Microbiol Immunol Infect ; 56(4): 672-679, 2023 Aug.
Article in English | MEDLINE | ID: mdl-36543722

ABSTRACT

The incidence of COVID-19-associated candidiasis (CAC) is increasing, resulting in a grave outcome among hospitalized patients with COVID-19. The most alarming condition is the increasing incidence of multi-drug resistant Candida auris infections among patients with COVID-19 worldwide. The therapeutic strategy towards CAC caused by common Candida species, such as Candida albicans, Candida tropicalis, and Candida glabrata, is similar to the pre-pandemic era. For non-critically ill patients or those with a low risk of azole resistance, fluconazole remains the drug of choice for candidemia. For critically ill patients, those with a history of recent azole exposure or with a high risk of fluconazole resistance, echinocandins are recommended as the first-line therapy. Several novel therapeutic agents alone or in combination with traditional antifungal agents for candidiasis are potential options in the future. However, for multidrug-resistant C. auris infection, only echinocandins are effective. Infection prevention and control policies, including strict isolation of the patients carrying C. auris and regular screening of non-affected patients, are suggested to prevent the spread of C. auris among patients with COVID-19. Whole-genome sequencing may be used to understand the epidemiology of healthcare-associated candidiasis and to better control and prevent these infections.


Subject(s)
COVID-19 , Candidiasis, Invasive , Humans , Fluconazole/therapeutic use , Candida auris , Antifungal Agents/pharmacology , Antifungal Agents/therapeutic use , Candidiasis, Invasive/drug therapy , Echinocandins/therapeutic use , Azoles , Microbial Sensitivity Tests
7.
J Res Adolesc ; 33(1): 361-368, 2023 03.
Article in English | MEDLINE | ID: mdl-36168992

ABSTRACT

Although the sensitization hypothesis posits that heightened reactivity to interparental conflict is linked to adolescent psychopathology, limited studies tested whether sensitization would emerge in parent-adolescent conflict and across ethnicity or culture. This study revisits the sensitization hypothesis by examining adolescent emotional reactivity to interparental and parent-adolescent conflicts on a daily timescale. The sample included 163 adolescents (55% girls; Mage = 12.79) and their parents (78% females; Mage = 45.46) who completed a 10-day reports in Taiwan. Multilevel modeling results showed that, instead of interparental conflict, adolescents with greater histories of parent-adolescent conflict exhibited higher emotional reactivity when parent-adolescent conflict was higher. The findings underscore the importance of parent-adolescent conflict in evaluating adolescent developmental risk.


Subject(s)
Family Conflict , Parent-Child Relations , Female , Adolescent , Humans , Child , Middle Aged , Male , Family Conflict/psychology , Parents/psychology , Adolescent Development , Ethnicity
8.
Curr Psychol ; : 1-6, 2022 Aug 10.
Article in English | MEDLINE | ID: mdl-35967511

ABSTRACT

The continuing impact of daily stress during the COVID-19 pandemic has disrupted the lives of families worldwide, and increased the risk of psychological problems for parents and their children. The current study investigated the daily effect of COVID-19 cases on parents' positive and negative emotions among 163 Taiwanese families using daily diary methodology across 10 weekdays. Results of multilevel modeling indicated that parents reported fewer positive emotions on days when COVID-19 cases were higher than average. Further moderating analyses showed the adverse effect of COVID-19 cases was only evident when the same-day marital relationship quality was lower than usual. The findings highlight the psychological stress of COVID-19 cases on parents' daily emotions and identify the protective role of marital relationship quality. Policies and clinical interventions should consider the implications of daily COVID-19 stressors for parents' emotional well-being, and target the protective role of marital relationship quality in daily life.

12.
J Formos Med Assoc ; 121(9): 1668-1679, 2022 Sep.
Article in English | MEDLINE | ID: mdl-34876342

ABSTRACT

BACKGROUND/PURPOSE: Invasive candidiasis is a severe infectious disease that could lead to mortality in critically ill children. METHODS: We collected data regarding demographics, underlying diseases, predisposing factors, outcomes for pediatric patients with candidemia at a medical centre in Taiwan from 2011 to 2017. RESULTS: Fifty-eight patients with 60 candidemia episodes were diagnosed. The 3 most common species were Candida albicans (42%), Candida parapsilosis (25%) and Candida tropicalis (23%). C. parapsilosis predominantly infected infants and neonates (median age: 0.8 years, range: 0.1-14.5). Cases with C. tropicalis had significantly higher rates of multidrug resistance (p = 0.011) and disseminated candidiasis (p = 0.025) compared with other cases. The all-cause mortality rate was 43%, and the candidemia-related mortality rate was 29%. Pediatric sequential organ failure assessment score >8 [adjusted odds ratio (aOR) 66.2, 95% CI 4.03-1088.5] and posaconazole resistance (aOR 33.57, 95% CI 1.61-700.3) were the most significant risk factors associated with candidemia-related mortality, whereas treatment with effective antifungal agents within 48 h (aOR 0.07, 95% CI 0.01-0.9) was the only significant protective factor. CONCLUSION: Candidemia-related mortality was related to azole resistance; therefore, empirical therapy with echinocandin or amphotericin B is recommended pending species and susceptibility results.


Subject(s)
Candidemia , Candidiasis , Antifungal Agents , Candida , Child , Humans , Infant , Infant, Newborn , Microbial Sensitivity Tests
13.
J Microbiol Immunol Infect ; 54(6): 1078-1085, 2021 Dec.
Article in English | MEDLINE | ID: mdl-32768337

ABSTRACT

BACKGROUND/PURPOSE: Although Streptococcus gallolyticus subspecies pasteurianus (SGSP) is a rare pathogen in children, it can cause invasive infections among neonates and infants. Herein, we report bacteremia/meningitis caused by SGSP in three neonates and review the literature on bacteremia and/or meningitis caused by this organism. METHODS: Three neonates, referred from an obstetrics clinic within a 2-month period, presented with invasive SGSP infections. The bacterial isolates were analyzed using Bruker Biotyper MALDI-TOF, sequencing of 16S rRNA and sodA genes (encoding manganese dependent superoxide dismutase), and PCR restriction fragment length polymorphism assay of groESL gene. Molecular typing was performed to evaluate the genetic relatedness. RESULTS: The median onset age of infection in the three neonates was 3 days (range 2-5 days). They were delivered through cesarean section in the same operation room under different doctors, and were cared for by different nurses. Patient A presented with bacteremia, patient B with bacteremia and meningitis, and patient C with meningitis. Four isolates were identified as SGSP and were susceptible to penicillin G, cefotaxime, and vancomycin. All patients were treated with ampicillin plus cefotaxime for 14 days, and no complications were observed. The molecular typing results suggested that all isolates belonged to a single clone, which indicated the possibility of an outbreak in the obstetrics clinic. CONCLUSION: Infection by a rare pathogen such as SGSP in multiple patients belonging to a single healthcare unit indicates that detailed investigation and stringent infection control policy are necessary for preventing further outbreaks of such diseases.


Subject(s)
Bacteremia/microbiology , Meningitis/microbiology , Streptococcal Infections/microbiology , Streptococcus/genetics , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Bacteremia/drug therapy , Bacterial Proteins/genetics , Cluster Analysis , Cross Infection/drug therapy , Cross Infection/microbiology , Female , Humans , Infant, Newborn , Male , Meningitis/drug therapy , Microbial Sensitivity Tests , RNA, Ribosomal, 16S/genetics , Streptococcal Infections/drug therapy , Streptococcus/drug effects , Streptococcus/isolation & purification
14.
Article in English | MEDLINE | ID: mdl-29805467

ABSTRACT

Qigong is a gentle exercise that promotes health and well-being. This study evaluated the acute physiological and psychological effects of one session of qigong exercise in older practitioners. A total of 45 participants (mean age, 65.14 years) were recruited. Meridian electrical conductance, State-Trait Anxiety Inventory (STAI), heart rate variability (HRV), and Short Form 36 (SF-36) were evaluated and compared before and after one session of qigong exercise. The results revealed that the electrical conductance of all meridians, except spleen and bladder meridians, increased significantly (p < 0.05). Compared with baseline values, upper to lower body ratio and sympathetic/vagal index were significantly improved and closer to 1 (p = 0.011 and p = 0.007, resp.). STAI-S and STAI-T scores decreased significantly (p < 0.001 and p = 0.001, resp.). The RR interval of HRV decreased significantly (p = 0.035), a significant positive correlation was observed between kidney meridian electrical conductance and SF-36 physical scores (r = 0.74, p = 0.018), and a positive correlation was observed between pericardium meridian electrical conductance and SF-36 mental scores (r = 0.50, p = 0.06). In conclusion, one session of qigong exercise increased meridian electrical conductance, reduced anxiety, and improved body and autonomic nervous system balance. These findings provide scientific evidence for acute physiological and psychological effects of qigong exercise in older practitioners.

15.
J Endod ; 43(1): 69-76, 2017 Jan.
Article in English | MEDLINE | ID: mdl-27939733

ABSTRACT

INTRODUCTION: Calcium silicate (CS) -based materials play an important role in the development of endodontic materials that induce bone/cementum tissue regeneration and inhibit bacterial viability. The aim of this study was to prepare novel mesoporous CS (MesoCS) nanoparticles that have osteogenic, drug delivery, and antibacterial characteristics for endodontic materials and also have an excellent ability to develop apatite mineralization. METHODS: The MesoCS nanoparticles were prepared using sol-gel methods. In addition, the mesoporous structure, specific surface area, pore volume, and morphology of the MesoCS nanoparticles were analyzed. The apatite mineralization ability, in vitro odontogenic differentiation, drug delivery, and antibacterial properties of the MesoCS nanoparticles were further investigated. RESULTS: The results indicate that the 200-nm-sized MesoCS nanoparticles synthesized using a facile template method exhibited a high specific surface area and pore volume with internal mesopores (average pore size = 3.05 nm). Furthermore, the MesoCS nanoparticles can be used as drug carriers to maintain sustained release of gentamicin and fibroblast growth factor-2 (FGF-2). The MesoCS-loaded FGF-2 might stimulate more odontogenic-related protein than CS because of the FGF-2 release. CONCLUSIONS: Based on this work, it can be inferred that MesoCS nanoparticles are potentially useful endodontic materials for biocompatible and osteogenic dental pulp tissue regenerative materials.


Subject(s)
Calcium Compounds/therapeutic use , Drug Delivery Systems , Nanoparticles/therapeutic use , Odontogenesis/drug effects , Silicates/therapeutic use , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/therapeutic use , Calcium Compounds/administration & dosage , Dental Pulp/cytology , Dental Pulp/drug effects , Dental Pulp/physiology , Drug Delivery Systems/methods , Gentamicins/administration & dosage , Microscopy, Electron, Transmission , Nanoparticles/ultrastructure , Silicates/administration & dosage , X-Ray Diffraction
16.
Am J Respir Crit Care Med ; 195(3): 369-382, 2017 Feb 01.
Article in English | MEDLINE | ID: mdl-27858493

ABSTRACT

RATIONALE: How host genetic factors affect Mycobacterium tuberculosis (Mtb) infection outcomes remains largely unknown. SP110b, an IFN-induced nuclear protein, is the nearest human homologue to the mouse Ipr1 protein that has been shown to control host innate immunity to Mtb infection. However, the function(s) of SP110b remains unclear. OBJECTIVES: To elucidate the role of SP110b in controlling host immunity and susceptibility to tuberculosis (TB), as well as to identify the fundamental immunological and molecular mechanisms affected by SP110b. METHODS: Using cell-based approaches and mouse models of Mtb infection, we characterized the function(s) of SP110b/Ipr1. We also performed genetic characterization of patients with TB to investigate the role of SP110 in controlling host susceptibility to TB. MEASUREMENTS AND MAIN RESULTS: SP110b modulates nuclear factor-κB (NF-κB) activity, resulting in downregulation of tumor necrosis factor-α (TNF-α) production and concomitant upregulation of NF-κB-induced antiapoptotic gene expression, thereby suppressing IFN-γ-mediated monocyte and/or macrophage cell death. After Mtb infection, TNF-α is also downregulated in Ipr1-expressing mice that have alleviated cell death, less severe necrotic lung lesions, more efficient Mtb growth control in the lungs, and longer survival. Moreover, genetic studies in patients suggest that SP110 plays a key role in modulating TB susceptibility in concert with NFκB1 and TNFα genes. CONCLUSIONS: These results indicate that SP110b plays a crucial role in shaping the inflammatory milieu that supports host protection during infection by fine-tuning NF-κB activity, suggesting that SP110b may serve as a potential target for host-directed therapy aimed at manipulating host immunity against TB.


Subject(s)
Antigens, Nuclear , Autoantigens , Epistasis, Genetic/immunology , Genetic Predisposition to Disease , Immunity, Innate/genetics , Minor Histocompatibility Antigens , Mycobacterium tuberculosis/genetics , Mycobacterium tuberculosis/immunology , Nuclear Proteins , Tuberculosis/genetics , Tuberculosis/immunology , Animals , Antigens, Nuclear/genetics , Antigens, Nuclear/immunology , Apoptosis/genetics , Apoptosis/immunology , Autoantigens/genetics , Autoantigens/immunology , Disease Models, Animal , Gene Expression Regulation/immunology , Humans , Mice , Microarray Analysis , Minor Histocompatibility Antigens/genetics , Minor Histocompatibility Antigens/immunology , NF-kappa B/genetics , NF-kappa B/immunology , Nuclear Proteins/genetics , Nuclear Proteins/immunology , Polymorphism, Single Nucleotide , Tumor Necrosis Factor-alpha/genetics , Tumor Necrosis Factor-alpha/immunology
17.
Biomed Res Int ; 2014: 875230, 2014.
Article in English | MEDLINE | ID: mdl-25114927

ABSTRACT

Butylidenephthalide (Bdph, 30~300 µM), a constituent of Ligusticum chuanxiong Hort., significantly enhanced tension in isolated guinea-pig trachea. In this study, we investigate the mechanism(s) of Bdph-induced contraction in the tissue. Isolated trachea was bathed in 5 mL of Krebs solution containing indomethacin (3 µM), and its tension changes were isometrically recorded. Cromakalim (3 µM), an ATP-dependent K+ channel opener, significantly antagonized the Bdph-induced enhancement of baseline tension. Bdph (300 µM) also significantly antagonized cromakalim-induced relaxation. Bdph (300 µM) did not significantly influence the antagonistic effects of glibenclamide (GBC, 1 µM) and tetraethylammonium (TEA, 8 mM) against the cromakalim-induced relaxation. However, Bdph (300 µM) and 4-aminopiridine (4-AP, 5 mM), a blocker of K v 1 family of K+ channels, in combination significantly rightward shifted the log concentration-relaxation curve of cromakalim. The antagonistic effect of the combination almost equals the sum of the individual effects of Bdph and 4-AP, suggesting that the antagonistic mechanism of Bdph may be similar to that of 4-AP. All calcium channel blockers influenced neither the baseline tension nor antagonistic effect of Bdph against cromakalim. In conclusion, Bdph may be similar to 4-AP, a blocker of K v 1 family of K+ channels, to enhance the baseline tension of guinea-pig trachea.


Subject(s)
Calcium Channel Blockers/pharmacology , Muscle Relaxation/drug effects , Phthalic Anhydrides/pharmacology , Potassium Channels/drug effects , Trachea/drug effects , Animals , Drug Antagonism , Guinea Pigs , Male , Nifedipine/pharmacology , Trachea/physiology , Verapamil/pharmacology
18.
Clin Nucl Med ; 38(11): 863-8, 2013 Nov.
Article in English | MEDLINE | ID: mdl-24089058

ABSTRACT

PURPOSE: This study evaluated the effect of fluid-filled intragastric balloon treatment on the scintigraphic gastric emptying times in humans for weight control. PATIENTS AND METHODS: Ten obese patients were prospectively recruited in our study. Three participants followed a solid food diet, and 7 participants followed a liquid meal diet to evaluate their scintigraphic gastric emptying times before and 3 months after fluid-filled intragastric balloon treatment. RESULTS: The participants included 3 males and 7 females. The mean age, body mass index, and body weight before intragastric balloon treatment were 36.8 ± 9.16 years, 35.91 ± 8.86 kg/m(2), and 93.9 ± 24.09 kg, respectively. The mean body weight, body mass index, and body weight loss 3 months after the treatment were 80.2 ± 21.32 kg, 31.50 ± 8.90 kg/m(2), and 13.7 ± 6.60 kg, respectively. The solid gastric emptying times before and 3 months after intragastric balloon treatment were 114 ± 18.52 minutes and 375.33 ± 207.04 minutes, respectively. The liquid gastric emptying times before and after intragastric balloon treatment were 38.71 ± 15.91 minutes and 318.71 ± 168.07 minutes, respectively. Statistically significant differences were observed in the solid and liquid gastric emptying times before and 3 months after intragastric balloon treatment using the Wilcoxon t test (P = 0.027, P = 0.001). Significantly positive correlations were observed between body weight loss and solid and liquid gastric emptying times after intragastric balloon placement using the Spearman correlation (ß = 1.0, P < 0.001; ß = 0.95, P = 0.001). CONCLUSIONS: The solid and liquid scintigraphic gastric emptying half time is significantly longer after intragastric balloon treatment in humans. A significantly positive correlation between body weight loss and scintigraphic gastric emptying time was observed after intragastric balloon treatment. We can predict the effect of intragastric balloons on weight control through scintigraphic gastric emptying times after the treatment. The effect of intragastric balloons on weight loss may be reinforced by combining intragastric balloon treatment with medication that can reduce gastric motility.


Subject(s)
Gastric Balloon , Gastric Emptying , Weight Loss/physiology , Adult , Demography , Female , Humans , Male , Time Factors
19.
Nucl Med Commun ; 34(3): 229-32, 2013 Mar.
Article in English | MEDLINE | ID: mdl-23238227

ABSTRACT

BACKGROUND AND PURPOSE: Phase analysis of gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) has been validated as a reliable tool to assess left-ventricular (LV) mechanical dyssynchrony. The initial results were all confirmed from studies using technetium-99m (Tc-99m) sestamibi or tetrofosmin as the radiotracers. The purpose of this study was to evaluate the feasibility of phase analysis in thallium-201 (Tl-201) gated SPECT MPI. MATERIALS AND METHODS: Seventeen patients referred from a cardiology clinic for evaluation of coronary artery disease were studied. All patients underwent both Tl-201 and Tc-99m sestamibi gated SPECT MPI within 1 week. An additional 34 patients with Tl-201 gated SPECT and 22 patients with Tc-99m sestamibi gated SPECT, who had a low likelihood of coronary artery disease, normal LV function, and normal perfusion on MPI, were used as normal controls. LV dyssynchrony parameters, including phase standard deviation (PSD) and phase histogram bandwidth (PHB), were measured using a standard phase analysis tool and compared between Tl-201 and Tc-99m sestamibi images. RESULTS: The LV dyssynchrony parameters correlated well (r=0.93 for PSD and r=0.84 for PHB) between Tl-201 and Tc-99m sestamibi images. The dyssynchrony parameters of Tl-201 were significantly larger than those of Tc-99m sestamibi (PSD: 24.5±12.0 vs. 17.4±9.7, P<0.001; PHB: 74.7±35.5 vs. 50.6±25.0, P<0.001). In comparison with normal controls, Tl-201 and Tc-99m sestamibi images showed concordant results. CONCLUSION: LV dyssynchrony parameters correlated well between Tl-201 and Tc-99m sestamibi images, even though the values were significantly larger for Tl-201 than for Tc-99m sestamibi. Tl-201 images showed results similar to those of Tc-99m sestamibi in the diagnosis of LV dyssynchrony.


Subject(s)
Myocardial Perfusion Imaging , Radiopharmaceuticals , Technetium Tc 99m Sestamibi , Thallium Radioisotopes , Tomography, Emission-Computed, Single-Photon/methods , Ventricular Dysfunction, Left/pathology , Adult , Aged , Cardiac Resynchronization Therapy/methods , Coronary Artery Disease/pathology , Female , Humans , Male , Middle Aged , Prohibitins , Reproducibility of Results
20.
Eur J Nucl Med Mol Imaging ; 39(12): 1904-9, 2012 Dec.
Article in English | MEDLINE | ID: mdl-22875446

ABSTRACT

PURPOSE: In (201)Tl SPECT myocardial perfusion imaging (MPI) data are acquired shortly after the stress injection to assess early post-stress left ventricle (LV) function. The purpose of this study was to use (201)Tl SPECT MPI to investigate whether stress-induced myocardial ischemia is associated with LV mechanical dyssynchrony. METHODS: Enrolled in the study were 75 patients who were referred for dipyridamole stress and rest (201)Tl gated SPECT MPI. The early post-stress scan was started 5 min after injection, and followed by the rest scan 4 h later. The patients were divided into three groups: ischemia group (N = 25, summed stress score, SSS, ≥5, summed rest score, SRS, <5), infarct group (N = 16, SSS ≥5, SRS ≥5) and normal group (N = 34, SSS <5, SRS <5). LV dyssynchrony parameters were calculated by phase analysis, and compared between the stress and rest images. RESULTS: In the ischemia group, LV dyssynchrony was significantly larger during stress than during rest. On the contrary, LV dyssynchrony during stress was significantly smaller than during rest in the normal and infarct groups. LV dyssynchrony during rest was significantly larger in the infarct group than in the normal and ischemia groups. There were no significant differences in LV dyssynchrony during rest between the normal and ischemia groups. CONCLUSION: Stress-induced myocardial ischemia caused dyssynchronous contraction in the ischemic region, leading to a deterioration in LV synchrony. Normal myocardium had more synchronous contraction during stress. The different dyssynchrony pattern between ischemic and normal myocardium early post-stress may aid the diagnosis of coronary artery disease using (201)Tl gated SPECT MPI.


Subject(s)
Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography , Coronary Artery Disease/diagnostic imaging , Myocardial Perfusion Imaging , Radiopharmaceuticals , Stress, Physiological , Thallium , Ventricular Dysfunction, Left/diagnostic imaging , Aged , Case-Control Studies , Coronary Artery Disease/etiology , Dipyridamole/pharmacology , Female , Humans , Male , Middle Aged , Ventricular Dysfunction, Left/etiology , Ventricular Function/drug effects
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