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Prevalence of Decreased Myocardial Blood Flow in Symptomatic Patients with Patent Coronary Stents: Insights from Low-Dose Dynamic CT Myocardial Perfusion Imaging

  • Yuehua Li;Mingyuan Yuan;Mengmeng Yu;Zhigang Lu;Chengxing Shen;Yining Wang;Bin Lu;Jiayin Zhang
    • Korean Journal of Radiology
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    • v.20 no.4
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    • pp.621-630
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    • 2019
  • Objective: To study the prevalence and clinical characteristics of decreased myocardial blood flow (MBF) quantified by dynamic computed tomography (CT) myocardial perfusion imaging (MPI) in symptomatic patients without in-stent restenosis. Materials and Methods: Thirty-seven (mean age, 71.3 ± 10 years; age range, 48-88 years; 31 males, 6 females) consecutive symptomatic patients with patent coronary stents and without obstructive de novo lesions were prospectively enrolled to undergo dynamic CT-MPI using a third-generation dual-source CT scanner. The shuttle-mode acquisition technique was used to image the complete left ventricle. A bolus of contrast media (50 mL; iopromide, 370 mg iodine/mL) was injected into the antecubital vein at a rate of 6 mL/s, followed by a 40-mL saline flush. The mean MBF value and other quantitative parameters were measured for each segment of both stented-vessel territories and reference territories. The MBFratio was defined as the ratio of the mean MBF value of the whole stent-vessel territory to that of the whole reference territory. An MBFratio of 0.85 was used as the cut-off value to distinguish hypoperfused from non-hypoperfused segments. Results: A total of 629 segments of 37 patients were ultimately included for analysis. The mean effective dose of dynamic CT-MPI was 3.1 ± 1.2 mSv (range, 1.7-6.3 mSv). The mean MBF of stent-vessel territories was decreased in 19 lesions and 81 segments. Compared to stent-vessel territories without hypoperfusion, the mean MBF and myocardial blood volume were markedly lower in hypoperfused stent-vessel territories (77.5 ± 16.6 mL/100 mL/min vs. 140.4 ± 24.1 mL/100 mL/min [p < 0.001] and 6.4 ± 3.7 mL/100 mL vs. 11.5 ± 4 mL/100 mL [p < 0.001, respectively]). Myocardial hypoperfusion in stentvessel territories was present in 48.6% (18/37) of patients. None of clinical parameters differed statistically significantly between hypoperfusion and non-hypoperfusion subgroups. Conclusion: Decreased MBF is commonly present in patients who are symptomatic after percutaneous coronary intervention, despite patent stents and can be detected by dynamic CT-MPI using a low radiation dose.

In Vitro Differentiated Functional Cardiomyocytes from Parthenogenetic Mouse Embryonic Stem Cells (단위발생유래 생쥐 배아줄기세포로부터 체외 분화된 기능성 심근세포)

  • Shin Hyun-Ah;Kim Eun-Young;Lee Keum-Sil;Cho Hwang-Yun;Lee Won-Don;Park Se-Pill;Lim Jin-Ho
    • Reproductive and Developmental Biology
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    • v.30 no.1
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    • pp.47-52
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    • 2006
  • This study was conducted to examine whether the parthenogenetic mouse embryonic stem (P-mES) cells can differentiate into functional cardiomyocytes in vitro similar to (mES) cells. p-mES04 and IVF-derived mES03 cells were cultured by suspension culture for 4 days. The formed embryoid bodies (EBs) were treated with 0.75% dimethyl-sulfoxide (DMSO) for further 4 days (4-/4+), and then plated onto gelatin coated culture dish. The appearance of contracting cardiomyocytes from the P-mES04 and mES03 cells was examined for 30 days. The highest cumulative frequency was detected at days 13 (69.83%) and 22 (61.3%), respectively. By immunocytochemistry, beating P-mES04 cells were positively stained with muscle specific anti-sarcomeric a-actinin Ab and cardiac specific anti-cardiac troponin I Ab similar to contracted mES03 cells. When the expression of cardiac muscle-specific genes was analyzed by RT-PCR, beating P-mES04 cells were expressed cardiac specific L-type calcium channel, a1C, cardiac myosin heavy chain a, cardiac muscle heavy polypeptide $7{\beta}$, GATA binding protein 4 and atrial natriuretic factor, but not expressed skeletal muscle specific L-type calcium channel, a1S, which was similar to male adult heart cells and mES03-derived beating cardiomyocytes. The result demonstrates that the P-mES cells can be used as an alternative for the study on the characteristic analysis of in vitro cardiomyocyte differentiation from the ES cells.

Clinical Significance of BCR-ABL Fusion Gene Subtypes in Chronic Myelogenous and Acute Lymphoblastic Leukemias

  • Ye, Yuan-Xin;Zhou, Juan;Zhou, Yan-Hong;Zhou, Yi;Song, Xing-Bo;Wang, Jun;Lin, Li;Ying, Bin-Wu;Lu, Xiao-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9961-9966
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    • 2014
  • Background: Some reports have suggested that chronic myeloid leukemia (CML) patients have a higher prevalence of M-bcr than acute lymphoblastic leukemia (ALL) patients, which show a higher prevalence of m-bcr. However, the relationship between BCR-ABL subtypes and progression of CML and ALL remains unclear. Materials and Methods: 354 CML chronic phase (CML-CP) patients, 26 CML blastic phase (CML-BP) patients and 72 ALL patients before treatment with BCR-ABL positive were recruited for blood routine examination and bone marrow smear cytology. Some 80 CML-CP and 32 ALL patients after imatinib (IM) treatment were followed-up for BCR-ABL relative concentrations detected after treatment for 3, 6 and 9 months and 1 year. Results: Before treatment, CML-CP patients showed lower BCR-ABL relative concentrations with a higher proportion of M-bcr (42.7%) compared to CML-BP and ALL patients while ALL patients had a higher BCR-ABL relative concentration with high expression of m-bcr (51.4%). Patients with M-bcr demonstrated higher WBC counts than those with m-bcr and the mixed group and higher PLT counts were noted in the CML-CP and ALL groups. After imatinib (IM) treatment, patients with m-bcr showed higher BCR-ABL relative concentrations in both CML-CP and ALL groups. Conclusions: This study identified the BCR-ABL gene as an important factor in CML and ALL cases. The M-bcr subtype was associated more with CML while the m-bcr subtype was associated more with ALL. Patients with m-bcr seem to have a poorer response to IM in either CML or ALL patients compared to M-bcr patients.

Recovery Rate of Nontuberculous Mycobacteria and the Clinical Course of Nontuberculous Mycobacterial Pulmonary Disease at a Secondary Hospital (일개 2차 의료기관에서의 비결핵성 마이코박테리아 분리비율 및 폐질환의 임상 경과)

  • Lee, Jae Kwang;Kwon, Hwuck Young;Kwon, Jong Kyu;Lee, Hwa Jeong;Lee, Dong Wook;Lee, Yu Jin;Yoon, Kyung Hwa;Song, Do Young;Lee, Byung Ki;Kim, Yeon Jae
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.3
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    • pp.199-204
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    • 2009
  • Background: To examine the recovery rate of nontuberculous mycobacteria (NTM) from respiratory specimens and the clinical course of NTM pulmonary disease at a 700-bed secondary hospital. Methods: This study analyzed the results of 843 acid-fast bacilli (AFB) culture-positive respiratory specimens from 650 subjects collected between May 2003 and April 2008. In addition, the clinical course of NTM pulmonary disease, diagnosed using criteria established by the American Thoracic Society, was examined. Results: There were 67 (7.9%) NTM isolates recovered from 52 (8.0%) subjects. Among the 535 AFB smear-positive specimens, 34 (6.3%) NTM isolates were recovered. There were 33 (10.7%) NTM isolates were recovered from 308 AFB smear-negative specimens. Of 52 subjects with isolated NTM, M. intracellulare was the most common species at 73.1% (n=33), followed by M. kansassi (n=7), M. abscessus (n=2), M. fortuitum (n=2), and M. avium (n=1). Sixteen (30.8%) patients had NTM pulmonary disease and the most common causative organism was M. intracellulare (n=14, 87.5%). Of these, 6 cases attained negative conversion in culture, 4 cases failed to attain negative conversion because of poor cooperation or expiration from complicated underlying lung disease, and 5 cases were transferred to a higher-grade hospital. Conclusion: The recovery rate of NTM from respiratory specimens was relatively low and the most common species was M. intracellulare. Patients with NTM pulmonary disease showed variable clinical outcomes.

Brain SPECT Using $^{99m}Tc$-HMPAO and $^{99m}Tc$-ECD in Subacute Cerebral Infarction: Case Report (아급성 뇌경색 환자에서 $^{99m}Tc$-HMPAO 및 $^{99m}Tc$-ECD 뇌 SPECT: 증례보고)

  • Ahn, Byeong-Cheol;Lee, Dong-Soo;Yoon, Byung-Woo;So, Young;Jung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.570-575
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    • 1996
  • For brain perfusion SPECT imaging, $^{99m}Tc$-HMPAO and $^{99m}Tc$-ECD are commonly used. Although these two tracers usually show similar distribution, it is well known that discrepant finding might be noted between $^{99m}Tc$-HMPAO and $^{99m}Tc$-ECD imaging in some conditions. Luxury perfusion(perfusion/metabolism mismatch) is one of the examples and could be observed in subacute cerebral infarction. We report a case of subacute cerebral infarction that revealed luxury perfusion. Increased perfusion was found in $^{99m}Tc$-HMPAO SPECT and perfusion defect was found in $^{99m}Tc$-ECD SPECT. We found large area of mismatch with a consecutive acquisition-subtraction method. Crossed cerebellar diaschisis was observed in both SPECT images.

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Downregulation of FoxM1 sensitizes nasopharyngeal carcinoma cells to cisplatin via inhibition of MRN-ATM-mediated DNA repair

  • Li, Dandan;Ye, Lin;Lei, Yue;Wan, Jie;Chen, Hongyan
    • BMB Reports
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    • v.52 no.3
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    • pp.208-213
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    • 2019
  • Chemoresistance is the primary obstacle in the treatment of locally advanced and metastatic nasopharyngeal carcinoma (NPC). Recent evidence suggests that the transcription factor forkhead box M1 (FoxM1) is involved in chemoresistance. Our group previously confirmed that FoxM1 is overexpressed in NPC. In this study, we investigated the role of FoxM1 in cisplatin resistance of the cell lines 5-8F and HONE-1 and explored its possible mechanism. Our results showed that FoxM1 and NBS1 were both overexpressed in NPC tissues based on data from the GSE cohort (GSE12452). Then, we measured FoxM1 levels in NPC cells and found FoxM1 was overexpressed in NPC cell lines and could be stimulated by cisplatin. MTT and clonogenic assays, flow cytometry, ${\gamma}H2AX$ immunofluorescence, qRT-PCR, and western blotting revealed that downregulation of FoxM1 sensitized NPC cells to cisplatin and reduced the repair of cisplatin-induced DNA double-strand breaks via inhibition of the MRN (MRE11-RAD50-NBS1)-ATM axis, which might be related to the ability of FoxM1 to regulate NBS1. Subsequently, we demonstrated that enhanced sensitivity of FoxM1 knockdown cells could be reduced by overexpression of NBS1. Taken together, our data demonstrate that downregulation of FoxM1 could improve the sensitivity of NPC cells to cisplatin through inhibition of MRN-ATM-mediated DNA repair, which could be related to FoxM1-dependent regulation of NBS1.

A Case of Choledochal Cyst Detected by $^{99m}Tc-DISIDA$ Hepatoblilary Scan ($^{99m}Tc-DISIDA$ 간담도 스캔으로 발견된 총담관낭종 1예)

  • Au, Ho-Yong;Kim, Dong-Woo;Park, Sung-Ki;Byun, Jong-Hoon;Shin, Hyun-Ja
    • The Korean Journal of Nuclear Medicine
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    • v.20 no.2
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    • pp.105-107
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    • 1986
  • It is well known that $^{99m}Tc-DISIDA$ hepatobilliary scan is a noninvasive and accurate method for detecting choledochal cyst. In the case we are reporting, $^{99m}Tc-DISIDA$ scan of a 17 year old female patient showed the characteristic pattern of a choledochal cyst, confirmed by surgery.

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A Rare Case of Hyponatremia Caused by Reset Osmostat in a Neonate with Cleft Lip, Cleft Palate, and Imperforate Anus

  • Ahn, Jung Gu;Lee, Jeong Eun;Chung, Woo Yeong;Koo, Soo Hyun;Shin, Jaeho;Jeon, Ga Won
    • Neonatal Medicine
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    • v.25 no.3
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    • pp.131-135
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    • 2018
  • Hyponatremia is defined as a plasma sodium concentration of <135 mEq/L. It is a common electrolyte imbalance in newborns. We report the case of a term neonate with cleft lip, cleft palate, imperforate anus, normal male karyotype, and chronic hyponatremia. On the 4th day of life, he showed hyponatremia (plasma sodium concentration 130 mEq/L) with low serum osmolality (275 mOsm/kg), high urine sodium (116.7 mEq/L), and high urine osmolality (412 mOsm/kg). His thyroid and adrenal functions were normal. Despite intravenous and oral sodium supplementation and hydrocortisone treatment, hyponatremia persisted. Brain magnetic resonance imaging showed normal results. He was diagnosed as having reset osmostat, a rare subtype of the syndrome of inappropriate secretion of antidiuretic hormone characterized by a subnormal threshold for antidiuretic hormone secretion, with hypotonic hyponatremia.

Type 3 muscarinic acetylcholine receptor stimulation is a determinant of endothelial barrier function and adherens junctions integrity: role of protein-tyrosine phosphatase 1B

  • Jiao, Zhou-Yang;Wu, Jing;Liu, Chao;Wen, Bing;Zhao, Wen-Zeng;Du, Xin-Ling
    • BMB Reports
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    • v.47 no.10
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    • pp.552-557
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    • 2014
  • The main purpose of this study was to investigate whether type 3 muscarinic acetylcholine receptor (M3R) dysfunction induced vascular hyperpermeability. Transwell system analysis showed that M3R inhibition by selective antagonist 4-diphenylacetoxy-N-methylpiperidine methiodide (4-DAMP) and small interfering RNA both increased endothelial permeability. Using coimmunoprecipitation and Western blot assay, we found that M3R inhibition increased VE-cadherin and ${\beta}$-catenin tyrosine phosphorylation without affecting their expression. Using PTP1B siRNA, we found that PTP1B was required for maintaining VE-cadherin and ${\beta}$-catenin protein dephosphorylation. In addition, 4-DAMP suppressed PTP1B activity by reducing cyclic adenosine monophosphate (cAMP), but not protein kinase $C{\alpha}$ ($PKC{\alpha}$). These data indicate that M3R preserves the endothelial barrier function through a mechanism potentially maintaining PTP1B activity, keeping the adherens junction proteins (AJPs) dephosphorylation.

Möbius Syndrome Demonstrated by the High-Resolution MR Imaging: a Case Report and Review of Literature

  • Hwang, Minhee;Baek, Hye Jin;Ryu, Kyeong Hwa;Choi, Bo Hwa;Ha, Ji Young;Do, Hyun Jung
    • Investigative Magnetic Resonance Imaging
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    • v.23 no.2
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    • pp.167-171
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    • 2019
  • $M\ddot{o}bius$ syndrome is a rare congenital condition, characterized by abducens and facial nerve palsy, resulting in limitation of lateral gaze movement and facial diplegia. However, to our knowledge, there have been few studies on evaluation of cranial nerves, on MR imaging in $M\ddot{o}bius$ syndrome. Herein, we describe a rare case of $M\ddot{o}bius$ syndrome representing limitation of lateral gaze, and weakness of facial expression, since the neonatal period. In this case, high-resolution MR imaging played a key role in diagnosing $M\ddot{o}bius$ syndrome, by direct visualization of corresponding cranial nerves abnormalities.