Longitudinal Tissue Velocity and Deformation Imaging in Inferobasal Left Ventricular Aneurysm

Background: Longitudinal myocardial tissue velocity imaging (TVI) and strain rate imaging (SRI) quantify regional myocardial function. We aimed to measure TVI and SRI indices for inferobasal aneurysmal segments by echocardiography at rest. Method: Sixteen patients with inferobasal left ventricular (LV) aneurysm, LV ejection fraction (EF) ≤50%, and 14 normal coronaries with normal echocardiography (control group) were studied. In SRI, peak systolic strain (ST), strain rate (SR), and pattern of strain curves and in TVI, peak systolic inward motion (Sm) were evaluated all at rest. Ascending curve means systolic expansion and descending means shortening. Results: LVEF was significantly lower in the patient group. Mean ST, SR, and Sm of inferobasal segment showed significant difference between patient and control groups; for ST: 1.45 ± 7.18% versus ?17.64 ± 7.45%, P < 0.0001; SR: ?0.25 ± 0.26 versus ?1.44 ± 0.64 sec^?1, P < 0.0001; and Sm: 3.85 ± 1.26 versus 5.56 ± 1.28 cm/sec, P = 0.006, respectively. All inferobasal aneurysmal segments had ascending curve while normal segments showed a descending curve. In patient group, aneurysmal segments had significantly reduced ST and SR compared to normal segments. Normal functioning segments of patients showed significant reduction of ST and SR compared to normal LV segments in control subjects. The range of SR and ST for inferobasal aneurysmal segments did not overlap with that of the normal segments (?0.60, 0.19 and ?3.00, ?0.80 sec^?1 for SR, and ?8.30, 23.30 and ?35.30, ?10.00% for ST, respectively). Conclusion: SRI indices were significantly reduced in inferobasal aneurysmal segment in comparison with either the same segment in normal subjects or normal functioning segments in the same patients. SR and ST may be superior to Sm in the evaluation of inferobasal aneurysmal segments. (Echocardiography 2010;27:803‐808)     

Anatomical retinal reattachment after scleral buckling with and without retinopexy: a pilot study

Purpose: To compare the anatomical results of scleral buckling with and without retinopexy and to assess the effect of retinopexy on the scleral buckling outcome. Methods: This randomized clinical trial was performed on 55 patients. Twenty‐two eyes were treated with scleral buckling (segmental or encircling) with or without drainage of subretinal fluid without any type of retinopexy (group 1); 33 patients received transscleral retinal cryopexy around retinal break(s) in addition to the former procedure. The two groups were matched regarding age, sex, myopia, aphakia, stage of proliferative vitroretinopathy (PVR) and number, type and location of the break(s). Results: In the non‐retinopexy group, 19 patients (86%) had complete retinal reattachment and one patient had partial reattachment after 34–48 months of follow‐up. One patient did not develop attachment because of missed break out of the buckle, and one had no attachment at all because of PVR. Overall success rate was 91% (20 of 22) in this group. In the retinal cryopexy group, 26 patients (79%) had complete retinal reattachment and two had partial reattachment during 35–56 months of follow‐up. In two patients, no attachment was achieved because of missed break out of the buckle; three patients developed redetachment after 1 and 3 months because of PVR. Overall success rate was 85% (28 of 33). The anatomical results in these two groups were the same statistically. Conclusion: With the permanent scleral buckling technique, retinal cryopexy adds no benefit to the success rate of anatomical retinal reattachment.     

Arc-scanning very high-frequency digital ultrasound for 3D pachymetric mapping of the corneal epithelium and stroma in laser in situ keratomileusis

PURPOSE: To test and demonstrate measurement precision, imaging resolution, 3D thickness mapping, and clinical utility of a new prototype 3D very high-frequency (VHF) (50 MHz) digital ultrasound scanning system for corneal epithelium, flap, and residual stromal thickness after laser in situ keratomileusis (LASIK). METHODS: VHF ultrasonic 3D data was acquired by arc-motion, meridional scanning within a 10-mm zone. Digital signal processing techniques provided high-resolution B-scan imaging, and I-scan traces for high-precision pachymetry in 4 eyes. Thickness maps of individual corneal layers were constructed. Reproducibility of epithelial, flap, and full corneal pachymetry was assessed for single-point and 3D thickness mapping by repeated measures. Thickness mapping of the epithelium, stroma, flap, and full cornea were determined before and after LASIK. Preoperative to postoperative difference maps for epithelium, flap, and stroma were produced to demonstrate anatomical changes in the thickness profile of each layer. RESULTS: Surface localization precision was 0.87 microm. Central reproducibility for single-point pachymetry of epithelium was 0.61 microm; flap, 1.14 microm; and full cornea, 0.74 microm. Reproducibility for central pachymetry on 3D thickness mapping was 0.5 microm for epithelium and 1.5-microm for full cornea. B-scans and 3D thickness maps after LASIK demonstrated resolution of epithelial, stromal component of the flap, and residual stromal layers. Large epithelial profile changes were demonstrated after LASIK. Topographic variability of flap thickness and residual stromal thickness were significant. CONCLUSIONS: VHF digital ultrasound arc-B scanning provides high-resolution imaging and high-precision three-dimensional thickness mapping of corneal layers, enabling accurate anatomical evaluation of the changes induced in the cornea by LASIK.     

Correlation of intellectual impairment in Parkinson's disease with FDG PET scan

This study investigated the relationship between regional glucose metabolism with intellectual impairment in patients with Parkinson's disease using statistical parametric mapping. Regional cerebral glucose metabolism using [18F]deoxyglucose (FDG) PET scans were performed on 10 patients with Parkinson's disease. We used the intellectual impairment score from the UPDRS. PET scans were analyzed with SPM96. Patients showed significant positive correlations with left limbic structures such as the cingulate gyrus, parahippocampal gyrus, and medial frontal gyrus. Patients showed significant negative correlations with associative neocortical posterior structures such as bilateral parietal and occipital gyrus. There were significant relationships between regional glucose metabolism and intellectual impairment.     

Mitral and Aortic Annular Enlargement for Insertion of Adequate Size Prosthetic Valves

A bstract Mitral and aortic valve rings were radically enlarged in a 70-year-old white female presenting with unusually tiny and severely stenotic rheumatic mitral and aortic valve disease. A common aorto-left atrial incision created by cutting across the two valves made it possible to implant adequate size St. Jude valves. The resulting defect in the roof of the left atrium and the aortic root were closed with a generous patch of polytetrafluoroethylene (PTFE). The center of the patch and the unattached segments of the two prostheses were incorporated with interrupted horizontal mattress sutures.     

Synthesis and antihypertensive activity of 1-(2-thiazolyl)-3, 5-disubstituted -2-pyrazolines

Several substituted 3-aryl-1-(4-aryl-2-thiazolyl)-5-(3-pyridyl)-2-pyrazolines were synthesized by reacting substituted 3-aryl-5-(3-pyridyl)-1-thiocarbamoyl-2-pyrazolines with phenacyl bromide in ethanol. The structures of all compounds were confirmed by IR, (1)H-NMR, mass spectral data and elemental analyses. The antihypertensive activity of compounds was examined by the tail-cuff method and compared with clonidine. Compounds 24-28 showed significant antihypertensive activity.