Opportunistic infections according to the CD4+ T lymphocyte count in patients with HIV at a tertiary care referral center

Opportunistic infections (OIs) have marked the prognosis in the natural course of patients with human immunodeficiency virus (HIV) infection. Objective: identifying the most common OIs and determining their relationship with the CD4+ lymphocyte count (CD4+TL) can improve our clinical practice and facilitate early diagnosis, the use of empiric treatments and prompt targeted treatment. Materials and methods: an observational, retrospective study aimed at describing the characteristics and variations of the OIs diagnosed clinically, using direct or indirect methods, which occur in patients with HIV (related to their CD4+TL count) who are admitted to a tertiary care center in Cali, Colombia. Adult patients hospitalized from January 2018 to January 2019 with a diagnosis of HIV/AIDS and a history or current diagnosis of OI were included. Individuals under the age of 18 and pregnant women were excluded. Results: a sample of 190 patients with at least one opportunistic infection was obtained, of whom 65.3% were men with a median age of 37 years (29.0-46.0), and the rest were women with a median age of 35.5 years (31.2-43.0). Eighty-three percent had a C3 classification on admission, 86% with a CD4+TL count < 200 cells/mm3. The most frequent OIs included tuberculosis, with 28.4%, pneumocystosis with 27.9% and toxoplasmosis with 27.4%. Conclusions: in our population, despite advances in and greater availability of highly-effective antiretroviral therapy, most patients with HIV are hospitalized in advanced stages with opportunistic infections, in some cases with two or more concomitant infections, and with evidence of severe virological and immunological involvement. (Acta Med Colomb 2022; 48. DOI:https://doi.org/10.36104/amc.2023.2327).

A case of mitochondrial diabetes mellitus complicated with hypopituitarism and literature review / 中华内分泌代谢杂志

The clinical data of a patient with mitochondrial diabetes mellitus complicated with hypopituitarism were analyzed, the patient′s mitochondrial gene was detected by microarray capture high-throughput sequencing, and the related domestic and foreign literature was reviewed and analyzed. The results showed that the patient had m. 3243 A>G variant on MT-TL1 gene and the clinical features were consistent with mitochondrial diabetes mellitus and hypopituitarism.

Development Of Halosulphate Based Phosphors And It's Applications

Synthesis and characterization of halosulphate-based phosphors is important for thermoluminescence dosimetry (TLD), radiophotoluminescence dosimetry (RPL) and scintillator materials. The enhancement of luminescence output in halosulphate-based phosphors and it may be useful for lamp, solid-state lamp and radiation. Dosimetry by activator as well as sensitizer are well known properties. The combustion technique is not applicable for the synthesis of TLD phosphors due to very fine particles, which show less TL intensity, while sol-gel, solid-state diffusion, melt method and precipitation methods are applicable for TLD phosphors. Two halosulphates namely Na21( SO4 ) 7 F6 Cl and 2K3Ca2(SO4)3F were prepared and doped with Dy and Tm for different concentration .Halosulphate , Na21( SO4 ) 7 F6 Cl was prepared by wet chemical method and Halosulphate , 2K3Ca2(SO4)3F was prepared by solid state diffusion method . The characterization was done by X - ray diffraction ( XRD ) , Thermo luminescence (TL) was also studied . For Dy doped Na21( SO4) 7 F6 Cl , The peak was observed at 1200 C and shoulder at 1750C for 0.2 % molar concentration of Dy. and for 2K3Ca2(SO4)3F doped with Tm the shoulder peak was observed at 240 0 C and at 150 0C for 0.7 % molar concentration of Tm.

MELAS syndrome caused by A3252G mutation in MT-TL1 gene: One case report and literature review / 中华内分泌代谢杂志

Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes(MELAS) is one of the most common inherited mitochondrial diseases. This paper reports a rare mutation associated with MELAS syndrome, the m. 3252 A>G mutation in the MT-TL1 gene encoding the mitochondrial tRNALeu(UUR). The 6-year-old girl suffered from recurrent convulsion and lactic acidemia. The mtDNA sequencing detected a variant m. 3252A>G(MT-TL1 gene) in the proband and her maternal relatives. The heteroplasmic levels in peripheral blood and urine sediment were 66.53% and 97.42%, respectively, which were obviously higher than those of her maternal relatives. Together with 3 previously reported cases, the variant m. 3252A>G could be classified pathogenic. All the reported pathogenic variants in MT-TL1 gene were reviewed to explore the genotype-phenotype correlations of pathogenic variants in MT-TL1 gene.

Análisis temporal del covid-19 en Colombia: indicadores asociados y modelización / Temporal analysis of covid-19 in Colombia: associated indicators and modeling

AbstractIntroduction. This study shows statistical information regarding COVID-19 in Colombia up to this date (March 1-2022). Specifically, the daily, monthly and cumulative evolution of infections and deaths, correlated with the distribution of the population according to age and gender. Objective. Show statistical information about COVID-19 that allows help to plan and design, in future Pandemics, public health policy strategies in Colombia. Methods. Daily information since the official declaration of Pandemic in Colombia (March 16 ­ 2020) was obtained by the National Health Institute (INS) and was organized in a database in order to conduct respective analysis. This information was compared to similar studies obtained based on the bibliographical review. Results and Conclusions. Results and conclusions are similar to those found in the reference literature: most part of those dead by COVID-19 are of senior age and male gender. Regarding Case Fatality Rate (CFR), it notoriously increases with age. The most vulnerable population displays an average age of ≥ 52.8 years. The less vulnerable population are young persons under 30 years of age, but specifically, those within the age range of 10 and 20 years. Gompertz and Logistic models can mathematically simulate the evolution of deaths and the evolution of CFR according to age

ResumenIntroducción. Este estudio muestra información estadística sobre el COVID-19 en Colombia a la fecha (1 de marzo de 2022). Específicamente, la evolución diaria, mensual y acumulada de contagios y defunciones, correlacionada con la distribución de la población según edad y sexo. Objetivo. Mostrar información estadística sobre COVID-19 que permita ayudar a planificar y diseñar, en futuras Pandemias, estrategias de política de salud pública en Colombia. Metodología. La información diaria desde la declaratoria oficial de Pandemia en Colombia (16 de marzo de 2020) fue obtenida del Instituto Nacional de Salud (INS) y fue organizada en una base de datos para realizar los análisis respectivos. Esta información se comparó con estudios similares obtenidos a partir de revisión bibliográfica. Resultados y conclusiones. Los resultados y conclusiones son similares a los encontrados en la literatura de referencia: la mayor parte de los fallecidos por COVID-19 son de edad avanzada y sexo masculino. En cuanto a la tasa de letalidad (CFR), ésta aumenta notoriamente con la edad. La población más vulnerable presenta una edad promedio ≥ 52.8 años. La población menos vulnerable son los jóvenes menores de 30 años, pero específicamente, los que se encuentran en el rango de edad de 10 y 20 años. Los modelos Gompertz y Logistic pueden simular matemáticamente la evolución de las muertes y la evolución de la CFR según la edad.

Virological outcomes of second-line antiretroviral therapy for HIV-1 patients in center of excellence, Gandhi Hospital, Secundrabad, Telangana

Introduction: In India, ART service was established in 2004 and viral load facility was started in 2009 through National Public Health Laboratory (NPHL). Phased scale-up has been planned to efficiently and successfully expand viral load testing services, taking into account the targets for enrollment of People Living with HIV in to Anti Retroviral Therapy program. Methods: This is an observational study conducted at the Centre of Excellence (COE), Gandhi Hospital Secundrabad. It is a referral centre for evaluation of patients suspected of treatment failure from ART centers. Data of all patients >18 years of age who were started on second line therapy due to failure of first line ART was taken in the study. The data of patients admitted between the time period of January 2009 to January 2010 was included. Results: A total of 147 HIV infected patients received second line ART of which 114 were men and 33 were women. Of these, 147 were treated with regimen TL, ATV/r. The most common cause to switch on second line ART was combined immunological and clinical failure (135) followed by all three failure (12).Mean baseline CD4 count was 220.06 (95% confidence interval [CI]: 243.73-196.38) and mean base line of PVL of patients was 291356.6 cells/mm3 (95% CI: 364843.8-217869.29) copies/ml, respectively. Conclusion: Good long term outcome as well as virological suppression in patients starting second line therapy under programmatic conditions in India. This early mortality can be circumvented by introducing routine virological monitoring in the program which will help in early detection of patients with failure.

Study on the Quality of Scutellaria baicalensis with Different Harvesting Periods by IR-TL and HPLC-MS / 中国药房

OBJECTIVE： To study effective component kinds and content difference of Scutellaria baicalensis with different harvesting periods collected in spring and autumn， and to determine the optimal harvesting time. METHODS： IR-IL was used to analyze the constitutions change of the components in S. baicalensis collected in different harvesting periods （annual， biennial and triennial， in spring and autumn， respectively）. HPLC-MS method was used to analyze the contents change of 6 flavonoids （qroxylin A， chrysin， wogonin， wogonoside， baicalin， baicalein）. RESULTS： Results of IR-TL analysis showed that S. baicalensis contained different components such as flavonoids， glycosides， saccharides， easters in different growth stages， among which the contents of glycosides in biennial S. baicalensis were the highest with more stable quality. The results of content determination of 6 flavonoids showed that different harvesting periods had a great influence on the contents of the above indicators. The overall content of biennial samples collected in spring was higher than that of autumn samples collected in the same year. CONCLUSIONS： This study provides a reliable analytical method for the quality control of S. baicalensis； spring harvest in two-year growth period may be the best harvesting time for S. baicalensis.

Aclimatación a la alta temperatura y tolerancia al calor (TL50) en 6 variedades de Chenopodium quinoa / High temperature acclimation and termotolerance (TL50) in 6 varieties of Chenopodium quinua

Se estudió la capacidad de aclimatación de 6 variedades de Chenopodium quinoa Willd. (Kancolla, Salcedo, Ccoito, Negra collana, Pasancalla e Illpa) a alta temperatura. Las plantas de quinua se obtuvieron a partir de semillas, las que crecieron en macetas, en un sombreadero, hasta el estado fenológico de 6 hojas verdaderas. Estas fueron expuestas a un tratamiento por calor en una cámara de crecimiento con termostato a 34/32 °C día/noche (D/N) por 3 días y a baja intensidad luminosa. Las no aclimatadas crecieron en las mismas condiciones pero a la temperatura de 22/20 °C D/N. La tolerancia a la alta temperatura se determinó exponiendo discos de hojas a diferentes tiempos (8, 16, 32 y 64 min) a 50 °C (baño maría), midiendo la termoestabilidad de la membrana celular, por la pérdida electrolitos utilizando un conductimetro. El grado de termotolerancia fue hallado según el TL50(tiempo letal al 50% de daño). Los resultados muestran que las variedades Pasancalla e Illpa presentaron capacidad de aclimatación, la variedad más termotolerante fue la variedad Illpa TL50= 64 min cuando fue aclimatada y la más sensible fue la variedad Pasancalla TL50= 8 min cuando no fue aclimatada. También se observó que el porcentaje de daño celular se incrementó a medida que el tiempo de exposición a la alta temperatura fue mayor

The capacity of acclimatization at high temperature of 6 varieties (Kancolla, Salcedo, Ccoito, Negra collana, Pasancalla and Illpa) of Chenopodium quinoa Willd was studied. Quinoa plants were obtained from seeds, which grew in pots, in a grennhouse, until the phenological stage of 6 true leaves. These were exposed to a heat treatment in a growth chamber with a thermostat at 34/32 °C day/night (D/N) for 3 days and at low light intensity. The non-acclimated plants grew under the same conditions but at temperature of 22/20 °C D/N. The tolerance to high temperature was determined by exposing leaf discs at different times (8, 16, 32 and 64 min) at 50 °C (warm bath), measuring the thermostability of the cell membrane trough the loss of electrolytes with a conductimeter. The degree of thermotolerance was found according to the TL50 (time lethal to 50% of damage). The results showed that the varieties Pasancalla and Illpa presented acclimatization capacity, the most thermotolerant variety was the variety Illpa TL50 = 64 min when it was acclimatized and the most sensitive was Pasancalla TL50 = 8 min when it was not acclimatized. It was also observed that the percentage of cell damage increased as the exposure time to the high temperature was higher.

Effects of overexpression tumor necrosis factor-related ligand-1A on T helper 9 cells in chronic experimental colitis / 中华消化杂志

Objective To investigate the effects of tumor necrosis factor-related ligand-1A(TL1A)on activation of T helper 9(Th9)cells of colonic tissues in chronic experimental colitis mice.Methods The chronic experimental colitis mice model was established with drinking dextran sulfate sodium salt(DSS).A total of 32 lymphocytes TL1A highly expressed mice and wild type(WT)mice were divided into WT control group, transgene control group,WT modeling group and transgene modeling group.The mice of control groups were administrated with distilled water. The mice of modeling groups received 3% DSS in drinking water discontinuously.The mice were sacrificed on 29 days after modeling.Body mass was measured,length of colon was recorded,scores of gross colon and the disease activity index(DAI)were calculated.The colonic morphological changes were observed by hematoxylin-eosin(H-E)staining.The lamina propria mononuclear cells(LPMC)were isolated and the number of Th9 cells was tested by flow cytometry.The levels of interleukin-9(IL-9)in serum and LPMC were detected by enzyme-linked immunosorbent assay(ELISA).The expressions of IL-9 protein and mRNA of the colonic tissues were measured by Western blotting and real-time polymerase chain reaction(PCR),respectively.T test and single factor analysis of variance were performed for statistical analysis.Results The percentage of body mass loss of WT modeling group was lower than that of transgene modeling group(16.2% ± 1.0% vs 18.9% ± 1.2%),and the difference was statistically significant(t=4.90, P<0.05).The scores of gross colon,DAI and pathology of transgene modeling group were all higher than those of WT modeling group(2.80 ± 0.64 vs 1.60 ± 0.31,2.55 ± 0.20 vs 1.58 ± 0.17,and 11.85 ± 0.86 vs 9.50 ± 0.79),and the differences were statistically significant(t=4.77,10.45 and 5.69,all P<0.05).The number of LPMC in transgene modeling group was higher than that of WT modeling group(3.70×106± 0.28×106vs 2.65×106± 0.32 × 106)and the difference was statistically significant(t= 6.98,P< 0.05).The percentage of Th9 in total CD4+T cells of LPMC in colonic tissues of transgene modeling group was higher than that of WT modeling group(0.54% ± 0.04% vs 0.23% ± 0.03%),and the difference was statistically significant(t= 17.54,P< 0.05).The serum IL-9 level of transgene modeling group was higher than that of WT modeling group((170.23 ± 5.69)pg/mL vs(150.62 ± 6.45)pg/mL),and the difference was statistically significant(t= 6.50,P< 0.05).The level of IL-9 secreted by LMPC of transgene modeling group was higher than that of WT modeling group((265.21 ± 8.76)pg/mL vs (237.58 ± 10.24)pg/mL),and the difference was statistically significant(t= 5.80,P< 0.05).The expressions of IL-9 protein and mRNA of transgene modeling group were higher than those of WT modeling group(1.31 ± 0.09 vs 1.18 ± 0.03,and 8.26 ± 1.13 vs 2.25 ± 0.29,respectively),and the differences were statistically significant(t=3.88 and 14.57,both P< 0.05).Conclusion TL1A high expression in lymphocytes can promote Th9 cells differentiation and IL-9 secretion which involved in the genesis of chronic experimental colitis.

A Case of Atypical Leber Hereditary Optic Neuropathy Associated with MT-TL1 Gene Mutation Misdiagnosed with Glaucoma

PURPOSE: Leber hereditary optic neuropathy (LHON) is one of the most common hereditary optic neuropathies caused by mutations of mitochondrial DNA. Three common mitochondrial mutations causing LHON are m.3460, m.11778, and m.14484. We report a rare mutation of the mitochondrial tRNA (Leu [UUR]) gene (MT-TL1) (m.3268 A > G) in a patient with bilateral optic atrophy. CASE SUMMARY: A 59-year-old female diagnosed with glaucoma 3 years earlier at a community eye clinic presented to our neuro-ophthalmology clinic. On examination, her best corrected visual acuity was 0.4 in the right eye and 0.7 in the left eye, and optic atrophy was noticed in both eyes. Optical coherence tomography revealed retinal nerve fiber layer (RNFL) thinning in both eyes; average RNFL thickness was 52 µm in the right eye and 44 µm in the left eye, but the papillomacular bundle was relatively preserved in both eyes. Goldmann perimetry demonstrated peripheral visual field defects, mostly involving superotemporal visual field in both eyes. Mitochondrial DNA mutation test showed an unusual mutation in MT-TL1 gene seemingly related to this optic neuropathy. CONCLUSIONS: We found a rare mutation (m.3268 A > G) of the mitochondrial DNA in a patient having bilateral optic atrophy, which led to the diagnosis of LHON. There have been previous reports about mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) and infantile myopathy caused by MT-TL1 mutation, but this is the first case of LHON associated with the same mutation. In this case of LHON associated with MT-TL1 mutation, atypical clinical features were observed with a relatively mild phenotype and peripheral visual field defects.

Introduction Of Case Based Learning In Teaching Of Biochemistry In IGIMS Patna.

Background & Objectives: Biochemistry is the basic science subject of first year MBBS course. It describes all the biochemical reactions occurring in the body, which makes the subject difficult and the student looses interest in it. In our institute, teaching is done mainly by didactic method. We introduced case based learning method (CBL) for teaching. The objective of this study was -1. To compare score of students by two methods of teaching – traditional lectures and case based methodology. 2. To evaluate student’s feedback regarding their perception to case based learning. Methods: After getting written consent from 1st year MBBS students , they were divided into two groups. One group (50 students - case) was taught by case based learning method and another group (50 students control group) was taught by traditional method. Improvement in their performance was assessed by MCQ and statistically compared. Perception of both groups about CBL was taken by a set of questionnaire based on Likert’s scale. Results: Statistically significant increase in performance of student taught by CBL method than student taught by traditional method was seen. Student’s and faculties’s perception about CBL was positive. All students found the CBL as effective method for learning. Conclusion: CBL is a good teaching learning method to increase involvement and interest of student in learning and enhance their academic performance. [Dr. Rekha K NJIRM 2016; 7(5):82-86]

Acceptance And Impact Of Integrated Teaching In Undergraduate Medical Student: An Observational Cross- Sectional Study.

Background & Objective: Among various method of medical education integrated teaching help in integration of basic, clinical and psychosocial sciences. Integrated teaching involves bringing together traditionally separate subjects so that students can grasp subject with more authentic understanding. We conducted the study to compare this scientific method of teaching with traditional learning and also obtained student’s and teacher’s feedback. Methodology: After approval from ethic committee faculty members from various departments we arranged integrated teaching program on important topic. Basic science faculty were made toparticipate actively in both case based learning and hospital visits along with clinical experts. The completed program was evaluated based on structured questionnaire and student and teacher feedback. Results: Among 58 students of 8th semester students, Pre test (TL) and post test (IL) mean of incorrect answers out of 10 structured questionnaires were 4.5517 and 2.9310. There was 35.5% improvement in result after integrated method of learning. 63% of faculty members felt that integrated teaching could be very useful. 85% students were enthusiastic about the new teaching methodology& felt that they had a better clinico pathological correlation. Conclusion: The new method of integrated teaching was found to be more effective than the traditional one. This method was well accepted by faculty as well as students. So it is need of today’s medical curriculum.

Clinical Efficacy and Influence on Serum TL1A, TNF-ɑ, IL-6 and IL-17 of Etanercept Combined with Methotrexate in the Treatment of Rheumatoid Arthritis / 中国药师

Objective:To study the clinical effect of etanercept combined with methotrexate in the treatment of rheumatoid arthritis ( RA) . Methods:Totally 62 patients with RA from May 2014 to May 2015 in our hospital were divided into the observation group and the control group with 31 cases in each according to the random number table. The control group was treated with methotrexate (10mg, po, once a week), the observation group was treated with etanercept (25 mg, twice a week) additionally, and the treatment course was 12 weeks. Before and after the treatment, serum TL1A, TNF-a, IL-6 and IL-17, time of morning stiffness, joint swelling, tenderness and pain change scores in the two groups were studied and compared. The clinical efficacy and adverse reactions of the two groups were analyzed as well. Results:After the theatment, compared with before theatment, two groups’ TL1A, TNF-a, IL-6 and IL-17 had de-creased, and observation group was lower than control group(P0. 05). Conclusion:Etanercept combined with methotrexate in the treatment of RA can reduce serum levels of TL1A, TNF-a, IL-6 and IL-17, and significantly alleviate joint swelling, tenderness and pain symptoms with high safety.

New discovery rarely runs smooth: an update on progranulin/TNFR interactions

Progranulin (PGRN) is a growth factor implicated in various pathophysiological processes, including wound healing, inflammation, tumorigenesis, and neurodegeneration. It was previously reported that PGRN binds to tumor necrosis factor receptors (TNFR) and has therapeutic effects in inflammatory arthritis (Tang et. al, in Science 332:478-484, 2011); however, Chen et al. reported their inability to demonstrate the PGRN-TNFR interactions under their own conditions (Chen et. al, in J Neurosci 33:9202-9213, 2013). A letter-to-editor was then published by the original group in response to the Chen et al. paper that discussed the reasons for the latter's inability to recapitulate the interactions. In addition, the group published follow-up studies that further reinforced and dissected the interactions of PGRN-TNFR. Recently, the dispute about the legitimacy of PGRN-TNFR interactions appears to be finally settled with independent confirmations of these interactions in various conditions by numerous laboratories. This review presents a chronological update on the story of PGRN-TNFR interactions, highlighting the independent confirmations of these interactions in various diseases and conditions.

Influence of accumulation of heaps of steel slag on the environment: determination of heavy metals content in the soils

The presence of high level of heavy metals involves a human healthy risk that could induce chronic diseases. This work reports on the metal contamination due to heaps of steel-slag accumulated during more than 40 years in allotments and industrial areas in the southern part of Madrid (Spain). Several slag and soil samples were collected in an area of 10 km² and characterized by different conventional (XRD and XRF) and no so common methods (ESEM, thermoluminescence and EDS-WDS). The analysis reveal the presence of: (i) important amounts of Fe (43 percent), Mg (26 percent), Cr (1.1 percent), Mn (4.6 percent), S (6.5 percent) in the form of Fe-rich slag phases (wustite, magnetite...), Si and Ca-rich phases (larnite, ghelenite...), Cr (chromite), Mn (bustamite) and graphite, (ii) traces of some other contaminants such as Cr (7700 ppm), Zn (3500 ppm), Ba (3000 ppm), Pb (700 ppm) or Cu (500 ppm) on pathway soil samples that come from the steel slag, and (iii) Co (13 ppm), Pb (78 ppm) and V (54 ppm) in farmland soil samples. Although the existing heavy metals content is not appropriate for the current use, the extremely high metal contamination of the surrounding areas is more worrying. The properties of the soil farmlands (pH circa 7, 13 percent of clay, mainly illite, and 1-4 percent of organic matter content) show suitable conditions for the retention of cationic metals, but further studies on the movilization of these elements have to be performed to determine the possibility of severe human health risks. This sort of study can provide useful information for the politicians regarding the appropriate use of the territory to prevent possible health hazard for the population.

A presença de altos niveis de metais pesados envolve riscos à saúde humana e pode induzir doenças crônicas. Este trabalho relata a contaminação metálica causada por pilhas de escória siderúrgica acumulada durante mais de 40 anos em áreas industriais na parte sul de Madrid (Espanha). Amostras de escória e solo foram coletadas em uma área de 10 km² e caracteri-zada por diferentes métodos, convencionais (XRD, XRF) ou não (ESEM, termoluminescência e EDS-WDS). A análise revela a presença de: i) quantidades importantes de Fe (43 por cento), Mg (26 por cento), Cr (1,1 por cento), Mn (4,6 por cento), S (6,5 por cento) formando várias fases ricas em Fe (wüstita, magnetita), Si e Ca (larnita, guelenita), Cr (cromita), Mn (bustamita) e grafite; (ii) tiajos de outros contaminantes, como Cr (7700 ppm), Zn (3500 ppm), Ba (3000 ppm), Pb (700 ppm) e Cu (500 ppm), no solo dos caminhos para as pilhas de resíduos e (iii) Co (13 ppm), Pb (78 ppm) e V (54 ppm) em amostras de solo agrícola. Embora os teores de metais pesados não sejam apropriados para uso corrente, a elevada contaminação de areas adjacentes é mais preocupante. Os solos adjacentes (pH ca. 7, 13 por cento de argila - principalmente ilita) e 1-4 por cento de matéria orgânica mostram condições adequadas para a retenção de cátions, mas outros estudos deverão ser realizados para determinar a possibilidade de riscos à saúde humana. Este tipo de trabalho pode fornecer informaçãoo útil para gestores públicos, com relação ao uso do território e prevenção de riscos à saúde da população.

Defect of 18F-FDG Uptake Observed in Infarcted Myocardium Showing Reverse Redistribution on Rest / 24-Hour Delayed 201Tl Myocardial SPECT after Acute Myocardial Infarction / 핵의학분자영상

Reverse redistribution is frequently observed after revascularization in acute myocardial infarction, and usually regarded as a predictor of viable myocardium on stress/rest and 2- to 4-hour redistribution 201Tl SPECT. However, there is not enough report of reverse redistribution in case of 24-hour delayed SPECT, which is commonly used for viability assessment. In this report, a case of reverse redistribution on rest and 24-hour delayed 201Tl SPECT is reported with use of automatic segmental quantitative analysis. The myocardium of reverse redistribution was dysfunctional on gated SPECT, and diagnosed as non-viable on 18F-FDG PET.

Post-Laminectomy Kyphosis in Patients with Cervical Ossification of the Posterior Longitudinal Ligament: Does It Cause Neurological Deterioration?

OBJECTIVE: Total laminectomy (TL) is an effective surgical technique for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL) along multiple levels. However, kyphosis and probable neurological deterioration have been frequently reported after laminectomy. We analyzed the changes in the cervical curvature after TL and subsequent changes in neurological status. METHODS: We retrospectively reviewed the records of 14 patients who underwent TL for the treatment of cervical OPLL between Jan. 1998 and Dec. 2003. TL was selected according to the previously determined criteria. The curvature of the cervical spine was visualized on a lateral cervical spine X-ray and measured using Ishihara's Curvature Index (CI) before the operation and at the last follow-up examination. Perioperative neurological status was estimated using the modified Japanese Orthopedic Association score and the Improvement Rate (IR) at the same time as the images were evaluated. RESULTS: The mean age of the patients was 57 years, the male/female ratio was 10:4, and the mean follow-up period was 41 months. The mean number of OPLL was 4.9, and the mean number of operated levels was also 4.9. The CI decreased after TL (p=0.002), which was indicative of a kyphotic change. However, this kyphotic change showed no correlation with the length of the follow-up period, number of operated levels and preoperative CI. Neurological examination at the last follow-up showed an improved neurological status in all patients (p=0.001). There was no neurological deterioration in any case during the follow-up period. Moreover, there was no correlation between IR and the degree of kyphotic change. Postoperative complications, such as C5 radiculopathy and epidural bleeding, resolved spontaneously without neurological sequelae. CONCLUSION: Kyphotic change was observed in all but one patient who underwent TL for the treatment of cervical OPLL. However, we did not find any contributing factors to kyphosis or evidence of postoperative neurological deterioration.

Brain Abscess Uptake at Tl-201 Brain SPECT / 핵의학분자영상

A 22-year-old woman with a history of acute lymphoblastic leukemia was hospitalized for headache and vomiting. CT scan showed a well-defined, ring like enhancing mass in the left frontal lobe with surrounding edema and midline shift. Magnetic resonance imaging demonstrated a round homogeneous mass with a ring of enhancement in the left frontal lobe. Tl-201 brain SPECT showed increased focal uptake coinciding with the CT and MRI abnormality. Aspiration of the lesion performed through a burr hole yielded many neutrophils, a few lymphocytes and histiocytes with some strands of filamentous microorganism-like material. Modified AFB stained negative for norcardia. Gram stain showed a few white blood cells and no microorganism. Antibiotics were started and produced a good clinical response. After one month, CT scan showed markedly reduction in size and extent was observed.

Myocardial Tracer Uptake in SPECT Images after Direct Intracoronary Injection Of Tl-201: Comparison with Stress-Reinjection Images / 핵의학분자영상

PURPOSE: To investigate the feasibility of Tl-201 SPECT with intracoronary injection (IC-I) in the detection of viable myocardium, we have performed SPECT imaging after direct intracoronary injection of Tl-201 and images were compared with those of stress-reinjection (Re-I) SPECT. METHODS: Fourteen coronary artery disease patients (male 11, mean age 54 years) who had myocardial infarction or demonstrated left ventricular wall motion abnormality on echocardiography were enrolled. Three mCi of Tl-201 was injected into both coronary arteries during angiography and images were acquired between 6- and 24-hour after injection. Reinjection imaging with 1 mCi of Tl-201 was performed at 4-hour after adenosine stress imaging with 3 mCi of Tl-201. Images were interpreted according to 4-grade visual scoring system (grade 0-3). Segments with mild to moderated uptake (< or=grade 1), and upgraded more than one score with reinjection, and were defined as viable myocardium. RESULTS: Image quality was poor in two cases with IC-I. Numbers of non-viable segments were 60 (23.8%) with IC-I, and 38 (15.1%) with Re-I, respectively. Overall agreement for perfusion grade per myocardial segment in each IC-I and Re-I was 76.5%. Overall agreement for viable segment between IC-I and Re-I was 90.5%. Only one out of 38 segments interpreted as non-viable with Re-I were interpretated as viable with IC-I. And 23 out of 214 segments interpreted as viable with Re-I were interpreted as non-viable with IC-I. CONCLUSION: Intracoronary Tl-201 SPECT seemed to be not advantageous over stress-rest reinjection imaging in the assessment of myocardial viability, mainly due to low count statistics at 6-hour or 24-hour delayed time points. The feasibility of intracoronary Tl-201 SPECT is considered to be limited.

Myocardial Tracer Uptake in SPECT Images after Direct Intracoronary Injection Of Tl-201: Comparison with Stress-Reinjection Images / 핵의학분자영상

PURPOSE: To investigate the feasibility of Tl-201 SPECT with intracoronary injection (IC-I) in the detection of viable myocardium, we have performed SPECT imaging after direct intracoronary injection of Tl-201 and images were compared with those of stress-reinjection (Re-I) SPECT. METHODS: Fourteen coronary artery disease patients (male 11, mean age 54 years) who had myocardial infarction or demonstrated left ventricular wall motion abnormality on echocardiography were enrolled. Three mCi of Tl-201 was injected into both coronary arteries during angiography and images were acquired between 6- and 24-hour after injection. Reinjection imaging with 1 mCi of Tl-201 was performed at 4-hour after adenosine stress imaging with 3 mCi of Tl-201. Images were interpreted according to 4-grade visual scoring system (grade 0-3). Segments with mild to moderated uptake (< or=grade 1), and upgraded more than one score with reinjection, and were defined as viable myocardium. RESULTS: Image quality was poor in two cases with IC-I. Numbers of non-viable segments were 60 (23.8%) with IC-I, and 38 (15.1%) with Re-I, respectively. Overall agreement for perfusion grade per myocardial segment in each IC-I and Re-I was 76.5%. Overall agreement for viable segment between IC-I and Re-I was 90.5%. Only one out of 38 segments interpreted as non-viable with Re-I were interpretated as viable with IC-I. And 23 out of 214 segments interpreted as viable with Re-I were interpreted as non-viable with IC-I. CONCLUSION: Intracoronary Tl-201 SPECT seemed to be not advantageous over stress-rest reinjection imaging in the assessment of myocardial viability, mainly due to low count statistics at 6-hour or 24-hour delayed time points. The feasibility of intracoronary Tl-201 SPECT is considered to be limited.