ABSTRACT
OBJECTIVES: The purpose of this study was to analyze the prognostic value of dynamic CT perfusion imaging (CTP) and CT derived fractional flow reserve (CT-FFR) for major adverse cardiac events (MACE). METHODS: 81 patients from 4 institutions underwent coronary computed tomography angiography (CCTA) with dynamic CTP imaging and CT-FFR analysis. Patients were followed-up at 6, 12, and 18 months after imaging. MACE were defined as cardiac death, nonfatal myocardial infarction, unstable angina requiring hospitalization, or revascularization. CT-FFR was computed for each major coronary artery using an artificial intelligence-based application. CTP studies were analyzed per vessel territory using an index myocardial blood flow, the ratio between territory and global MBF. The prognostic value of CCTA, CT-FFR, and CTP was investigated with a univariate and multivariate Cox proportional hazards regression model. RESULTS: 243 vessels in 81 patients were interrogated by CCTA with CT-FFR and 243 vessel territories (1296 segments) were evaluated with dynamic CTP imaging. Of the 81 patients, 25 (31%) experienced MACE during follow-up. In univariate analysis, a positive index-MBF resulted in the largest risk for MACE (HR 11.4) compared to CCTA (HR 2.6) and CT-FFR (HR 4.6). In multivariate analysis, including clinical factors, CCTA, CT-FFR, and index-MBF, only index-MBF significantly contributed to the risk of MACE (HR 10.1), unlike CCTA (HR 1.2) and CT-FFR (HR 2.2). CONCLUSION: Our study provides initial evidence that dynamic CTP alone has the highest prognostic value for MACE compared to CCTA and CT-FFR individually or a combination of the three, independent of clinical risk factors.
Subject(s)
Computed Tomography Angiography/methods , Coronary Angiography/methods , Coronary Artery Disease/diagnostic imaging , Coronary Vessels/diagnostic imaging , Fractional Flow Reserve, Myocardial , Myocardial Perfusion Imaging/methods , Aged , Artificial Intelligence , Asia , Coronary Artery Disease/mortality , Coronary Artery Disease/physiopathology , Coronary Artery Disease/therapy , Coronary Vessels/physiopathology , Europe , Female , Humans , Male , Middle Aged , Predictive Value of Tests , Prognosis , Prospective Studies , Radiographic Image Interpretation, Computer-Assisted , Registries , Risk Assessment , Risk Factors , United StatesABSTRACT
This work investigated fugitive emissions of anthropogenic halocarbons in a semiconductor and electronics industrial park in Taiwan using both flask and in-situ measurement methods. Large concentration variabilities in methylchloroform, trichloroethene, and tetrachloroethene suggested substantial usage and emissions in the industrial park. While the variability of CFC-113, CCl4, and CFC-11 was rather small using the flask sampling technique, the in-situ method with its higher frequency, however, showed significantly larger variability arising from observing periodic emission episodes, which were highly correlated with wind direction and topography of the park.
Subject(s)
Air Pollutants/analysis , Hydrocarbons, Chlorinated/analysis , Environmental Monitoring , Guideline Adherence , Industry , Semiconductors , WindABSTRACT
Myxoma of the cornea is extremely rare. To our knowledge, only two cases have been reported in the literature. We report an additional case of a corneal myxomatous lesion that presented as a subepithelial, gelatinous, and whitish mass. Histologic examination revealed a loose mucoid stroma, rich in hyaluronic acid, with a relative paucity of cells.
Subject(s)
Corneal Diseases/diagnosis , Eye Neoplasms/diagnosis , Myxoma/diagnosis , Adult , Corneal Diseases/pathology , Eye Neoplasms/ultrastructure , Female , Humans , Hyaluronic Acid/metabolism , Myxoma/ultrastructureABSTRACT
Argon laser photocoagulation was performed on rabbit eyes with lipid keratopathy. The lipid keratopathy was induced by rendering 30 rabbits hypercholesterolemic and inciting neovascularization by insertion of corneal sutures. The number of laser shots required to occlude corneal vessels increased with the suture residence time, whereas the number of limbal shots remained essentially constant. Corneal opacification and cholesterol content increased as a result of greater suture residence time and unexpectedly from the laser applications which were administered in a single treatment session.
Subject(s)
Cornea/blood supply , Corneal Diseases/surgery , Hypercholesterolemia/surgery , Laser Therapy , Neovascularization, Pathologic , Animals , Cholesterol/metabolism , Cornea/metabolism , Disease Models, Animal , RabbitsABSTRACT
Rabbits rendered hypercholesterolemic on a high cholesterol diet while subjected to corneal suture placement to induce neovascularization made useful models for qualitatively and quantitatively studying lipid keratopathy. Forty rabbit eyes were subjected to placement of four sutures located between 1 and 4 mm from the limbus. The neovasculature grew at a constant rate of 0.24 mm/day, unaffected by serum cholesterol levels. Rabbits fed cholesterol prior to surgery were the earliest to display lipid keratopathy, followed by those who began cholesterol feedings on the day of surgery, and last by rabbits who began receiving high cholesterol food seven days following suture placement. A description of the corneal neovascularization process and histopathological and biochemical analyses of the induced lipid keratopathy are presented.
