Structurespecific accurate quantitation regarding plasmalogen glycerophosphoethanolamine
The aim of the study was to predict the results of 99mTc-hexamethylpropyleneamine oxime (HMPAO)-labeled autologous leukocytes scintigraphy assessing count ratios in the perfusion (Pr) and blood-pool (BPr) phase images in three-phase bone scan (3PBSr) between the prosthetic knee and the 'healthy' knee and a novel semiquantitative parameter (P/BP ratio) in patients with unilateral knee arthroplasty.
Patients with unilateral knee arthroplasty and available 3PBS and 99mTc-HMPAO-labeled autologous leukocytes scintigraphic images were searched in two hospitals (A and B). In center A, the perfusion phase was not available. Regions of interest (ROI) were delineated in the perfusion (P) and blood-pool (BP) phase images, incorporating the prosthetic region and applying an isocontour (40% of the maximum pixel activity); corresponding mirror ROIs were placed on the healthy knee. The P/BP ratio was calculated as [(Pr/BPr) × 100] - 100. Receiver operator curves (ROCs) were generated for each semiquantitative parameter to identify the optimal cutoff for predicting the results of the autologous leukocytes scintigraphy.
In the whole group (79 patients), BPr demonstrated an area under the curve (AUC) of 0.722 (optimal cutoff = 1.43). In center A (52 patients), BPr demonstrated an AUC of 0.737 (cutoff = 1.43), whereas, in center B (27 patients), AUC for BPr was 0.718 (cutoff = 1.6). A better diagnostic performance was obtained selecting Pr (AUC = 0.918; cutoff = 2.34) and P/BP ratio (AUC = 0.947; cutoff = 26.5%) for the discrimination between septic and aseptic loosening.
The novel P/BP ratio seems to be a promising semiquantitative parameter to predict septic loosening. These findings warrant confirmation in larger patient samples.
The novel P/BP ratio seems to be a promising semiquantitative parameter to predict septic loosening. These findings warrant confirmation in larger patient samples.
This study aims to explore the prognostic value of left ventricular mechanical dyssynchrony (LVMD) in hypertrophic cardiomyopathy (HCM) patients with low risk of sudden cardiac death (SCD).
This retrospective study was performed in 50 patients with HCM who underwent Tc-99m sestamibi GSPECT-MPI. All patients were at low risk of SCD, defined as HCM risk-SCD scores <6%. Phase SD (PSD) and phase histogram bandwidth (PBW) were measured for assessment of LVMD. The primary endpoint was the composite major adverse cardiovascular events (MACE), including all-cause mortality, rehospitalization of heart failure symptoms, new-onset stroke, and new-onset syncope. Variables with significant difference between MACE group and non-MACE group were further assessed by Cox regression analysis.
During follow-up, MACE occurred in 20 patients. Systolic-PSD, systolic-PBW, diastolic-PSD, and diastolic-PBW were all significantly greater in the MACE group. INCB084550 Multivariate analysis revealed that history of syncope, history of atrial fibrillation, and all the four LVMD parameters were independent predictors of MACE. All LVMD parameters showed similar accuracy to predict MACE. Sequential models indicated that both systolic and diastolic LVMD parameters added incremental value beyond atrial fibrillation and syncope.
LVMD parameters are independent predictors of MACE, which add incremental prognostic information in patients with HCM risk-SCD scores <6%.
LVMD parameters are independent predictors of MACE, which add incremental prognostic information in patients with HCM risk-SCD scores less then 6%.
The purpose of this study was to determine whether regional wall motion (WM) abnormalities by rest-only 99mtechnetium-sestamibi (99mTc-MIBI) electrocardiogram (ECG)-gated single-photon emission computerized tomography (SPECT) myocardial perfusion imaging (MPI) had incremental diagnostic value for detecting obstructive coronary artery disease (CAD) in suspected CAD patients.
This study retrospectively studied 255 consecutive suspected CAD patients who underwent rest-only ECG-gated SPECT MPI and were performed coronary angiography within 3 months. Obstructive CAD was defined as ≥70% narrowing of the inner diameter of the left anterior descending coronary artery, left circumflex coronary artery and right coronary artery or their main branches and ≥50% narrowing of the left main coronary artery. QPS and QGS were used to assess rest perfusion and WM. Summed rest score ≥4 and summed motion score ≥2 exhibited in two consecutive segments in one territory was considered abnormal.
The sensitivity of the combination of perfusion and regional WM abnormalities was significantly higher than perfusion alone for detecting obstructive CAD (46.8% vs. 30.9%; P < 0.001), with similar specificity (91.9% vs. 95.0; P = 0.063). The global chi-square value of combination of perfusion and WM increased from 31.40 to 50.71 (P < 0.001) compared to perfusion. The sensitivity of combination of perfusion and WM for detecting obstructive CAD in patients with multivessel disease was higher than single-vessel disease (56.1% vs. 25.0%; P < 0.001), with similar specificity.
Regional WM abnormalities at rest, as shown by rest-only 99mTc-MIBI ECG-gated SPECT MPI, have additional diagnostic value over perfusion alone for detecting obstructive CAD in suspected CAD patients.
Regional WM abnormalities at rest, as shown by rest-only 99mTc-MIBI ECG-gated SPECT MPI, have additional diagnostic value over perfusion alone for detecting obstructive CAD in suspected CAD patients.
To report a case of bilateral uveitis and hypotony associated with topical cidofovir treatment.
Case report.
A 59-year-old diabetic male with HIV/AIDS presented with photophobia, ocular pain, and decreased vision. He was found to have bilateral hypotony, anterior uveitis, and serous choroidal detachments. Infectious disease workup, patient-reported history, and review of the patient's electronic medication list did not identify the etiology. Treatment with intensive topical corticosteroids led to resolution of uveitis and choroidal effusions within 3 months and resolution of hypotony within 9 months. Two years after his initial presentation, the patient developed acute recurrence of bilateral hypotony, anterior uveitis, and serous choroidal detachments shortly after intravenous cidofovir treatment. Careful re-evaluation of the patient's outside medical records revealed that he had initiated treatment for rectal herpes simplex virus with compounded topical cidofovir one month prior to his initial presentation.