Predictive value of major adverse cardiac events by T2-mapping texture analysis of the myocardial remote zone in patients with acute myocardial infarction.

AIM: To assess the predictive value of major adverse cardiac events (MACEs) in patients with acute myocardial infarction (AMI) by T2-mapping texture analysis (TA) of the myocardial remote zone. MATERIALS AND METHODS: Data from 155 patients, who were diagnosed with AMI and were treated with primary percutaneous coronary intervention (PPCI), and 32 healthy controls who underwent cardiac magnetic resonance imaging (CMRI) were analysed retrospectively. T2-mapping TA of the myocardial remote zone was conducted accordingly. The patients were divided into two subgroups according to the occurrence of MACEs. The primary outcome was a composite of MACEs. RESULTS: Among 155 patients, 32 (20.6%) patients suffered MACEs, and the most common event was non-sustained ventricular tachycardia (84.3%). Five independent texture features on T2-mapping were selected: Perc.50%, S(4,-4)AngScMom, S(1,1)InvDfMom, S(0,2)DifEntrp, and Horzl_LngREmph. Among them, the mean value of Horzl_LngREmph in the myocardial remote zone among all patients, MACEsnegative, and MACEs-positive was 21.64, 19.12, and 34.52, respectively. Horzl_LngREmph provided the highest area under the receiver operating characteristic (ROC) curve (AUC) value, which enabled two subgroups to be distinguished (AUC = 0.914, p<0.05). According to the results of the univariate analysis, combined with late gadolinium enhancement (LGE) extent and the presence of left ventricular hypertrophy, Horzl_LngREmph, was strongly associated with the occurrence of MACEs (p<0.05, hazard ratio: 1.64, 95% confidence interval: 1.10-4.51). CONCLUSION: Together with LGE extent, Horzl_LngREmph, a texture feature obtained from T2-mapping TA of the myocardial remote zone, could predict the occurrence of MACEs in AMI patients.

Clinical and prognostic significance of bone marrow abnormalities in the appendicular skeleton detected by low-dose whole-body multidetector computed tomography in patients with multiple myeloma.

Clinical significance of medullary abnormalities in the appendicular skeleton (AS) detected by low-dose whole-body multidetector computed tomography (MDCT) in patients with multiple myeloma (MM) was investigated. A total of 172 patients with monoclonal gammopathy of undetermined significance (MGUS) (n=17), smoldering MM (n=47) and symptomatic MM (n=108) underwent low-dose MDCT. CT values (CTv) of medullary density of AS⩾0 Hounsfield unit (HU) was considered as abnormal. Percentage of medullary abnormalities and the mean CTv of AS in patients with MGUS, smoldering MM and symptomatic MM were 18, 55 and 62% and -44.5 , -20.3 and 11.2 HU, respectively (P<0.001 and P<0.001). Disease progression of MM was independently associated with high CTv on multivariate analysis. In symptomatic MM, the presence of abnormal medullary lesions was associated with increased incidence of high-risk cytogenetic abnormalities (34.4% vs 7.7%; P=0.002) and extramedullary disease (10.4% vs 0%; P=0.032). It was also an independent poor prognostic predictor (hazard ratio 3.546, P=0.04). This study showed that CTv of AS by MDCT is correlated with disease progression of MM, and the presence of abnormal medullary lesions is a predictor for poor survival.

[Prevention of hepatitis B--HLA DR/DQ in HBs Ag nonresponder].

To evaluate the immunological background in HBs Ag nonresponders against hepatitis B vaccine, the lymphocyte surface marker and HLA-DR/DQ antigen were determined on hospital personnel, 70 males and 256 females, injected hepatitis B vaccine for three times. The vaccine made from the plasma of HBs Ag carriers was injected at the first and second vaccination and recombinant hepatitis B vaccine was injected at the third vaccination. A month after the third vaccination, blood was withdrawn for HBs antigen test by RIA. Border line cases (cut off index 1.0-1.9) are included in nonresponder (cut off index less than 0.9). Both nonresponders and low responders (cut off index 2-49) are more often seen in males than females and high responder (cut off index 50 or more) are seen more often in young females than males. Lymphocyte surface markers were studied by flow cytometry using the following monoclonal antibodies; OKT 3, 4, 8, DR, NK, Ia 1 and B7. No differences between lymphocyte surface markers of nonresponders and responders were noted. HLA-DR/DQ antigens were studied by the cytotoxicity test using Locus DR/DQ, Terasaki Second DR W-60 Tray and using following antibodies; DR 1, DR 2, DRW 15, DR 4, DR 5, DR 7, DR 9, DRW 10, DRW 8, DRW 12, DRW 13, DRW 6, DRW 52, DRW 53, DQW 1, DQW 6, DQW 2, DQW 3, DQW 7 and DQW 4. No significant differences between HLA-DR/DQ of nonresponders and responders were noted.

Incidence and severity of retinopathy in low birth weight infants monitored by TCPO2.

The incidence and severity of retinopathy of prematurity (ROP) were studied in 561 survivors of low birth weight infants (LBWIs) weighing under 2,000g. They were the survivors out of 604 LBWIs admitted to Okayama National Hospital during the five years from January 1981 to December 1985. The tcPO2 of all the LBWIs on the respirator or under oxygen administration was monitored using an Oxymonitor SM 361. The upper limit of tcPO2 was maintained between 50 to 80 torr. The ophthalmologic funduscopy was continued until 12 months of age. The early active stages of ROP were recorded by "the International Classification 1984". The cicatricial change of retina was classified by the criteria of the Joint Committee for the Study of Retrolental Fibroplasia in Japan. In the survivors, 55 cases of active ROP were found. (Stage 1:29 cases, 2:17, 3:9, and 4:0) In the survivors, 27 cases of cicatricial ROP were found, (Grade I:27 cases, II:0, III:0, IV:0) None of them developed blinding retinopathy. Neither the artificial ventilation nor the duration of oxygen administration influenced the incidence of ROP with statistical significance. The incidence and severity of ROP in this study seems to be one of the lowest among those hitherto published. Though our study is not a controlled one, it can be concluded that tcPO2 monitoring eliminates the blinding ROP.

[The effects of neocarzinostatin on superoxide production by monocyte-derived macrophages].

Monocyte-derived macrophages (M phi) from cancer patients injected with low doses of Neocarzinostatin (NCS, 500 units/day, three times a week) 12 times produced significantly more superoxide (O2-) than controls. Lymphocyte functions, such as PHA response, surface marker and serum IAP, before and after NCS injections were the same. M phi from normal persons cultured with NCS (0.4 microgram/ml) for three days produced more O2- than controls, but those cultured with rINF gamma did not. These results suggest that the increased O2- production of M phi from patients taking low doses of NCS may be due to the direct action of NCS on the M phi.

[A clinical investigation of the combination therapy of 1-(2-tetrahydrofuryl)-5-fluorouracil (FH) fine granules and 5-FU dry syrup].

The anticancer effect and side effect of 1-(2-Tetrahydrofuryl)-5-fluorouracil (FH Fine granules "MI-TSUI") plus 5-FU Dry Syrup combination therapy was evaluated in 24 patients with cancer of the digestive organs. In this study, it was suggested that the daily oral administration of 400mg of FH Fine granules combined with 100mg of 5-FU Dry Syrup is most adequate and effective among them.

The effect of oral administration of amphotericin B on the incorporation of 5-fluorouracil into human gastric cancer tissue.

Amphotericin B (AmB)-5-fluorouracil (5-FU) combination therapy against cancer was evaluated when both were given orally. Seven gastric cancer patients were treated in this manner, and 4 gastric cancer patients treated with 5-FU alone to serve as the control. AmB syrup and 5-FU syrup were administered orally for 3 days before surgical operation. Then, the drugs were given through a gastric tube into the stomach 4 hr before the start of the gastric surgery. Lesion tissues and healthy tissues were collected from each patient and the 5-FU titers were measured by bioassay. It was shown in the majority of the gastric cancer cases that the 5-FU levels in the lesion tissues were substantially higher than those in the surrounding normal tissues, whereas in the gastric cancer patients who received 5-FU alone, most of the lesion tissues showed lower 5-FU content as compared with that of the surrounding tissues.

HLA antigens in juvenile onset diabetes.

To study association between juvenile onset diabetes (JOD) and major histocompatibility gene complex, 40 patients with childhood onset diabetes and 120 healthy subjects were typed for HLA. Bw54 was present in 33 percent of the patients with JOD, while it appeared in 8 percent of the controls. Expressed as a relative risk, the antigen Bw54 confers a susceptibility to the development of JOD which is 5.3 times that in the controls. JOD shows a little high degree of association with A9 (78%). However, the A9-antigen is common in the Japanese and appears in 58 percent. Though less striking, the decreased frequency of B12 was 3 percent of JOD, less than 15 percent of the controls (p less than 0.05). There was no association between Bw54 and JOD with family history of diabetes.

HLA antigens in inflammatory bowel disease.

HLA antigens were studied in 60 patients with ulcerative colitis, 10 with Crohn's disease and 120 healthy Japanese controls. HLA typing was performed by the microdroplet lymphocyte cytotoxicity test.B5 was recognized in 62% of the patients with ulcerative colitis, whereas in 40% of controls (p smaller than 0.01). Furthermore, in these patients B7 was decreased in incidence (p smaller than 0.05) and there was the highest relative risk value for A3 (R.R = 6.3). When the patients were classified into 2 groups according to the extent of the lesions, left-sided or total colitis group and proctitis group, B5 was recognized in 65% of the patients with left-sided colitis or total colitis; and this increase was statistically significant. However, no significant difference in the incidence of B5 was recognized between the patients with proctitis and controls, probably because the number of patients studied was too small for evaluation. In the patients with Crohn's disease, B27 was recognized in one patient, showing an increase in incidence (p smaller than 0.001), although the number of patients studied was very small.

HLA antigens in colorectal cancers and adenomas.

An investigation was made of the differences between colorectal cancer and adenoma using HLA markers. Subjects included 60 cases of colorectal cancer, 43 of colorectal adenoma and 120 healthy Japanese controls. In comparison with the controls, Bw40 was increased (p < 0.02) and B5 was decreased (p < 0.005) in the colorectal adenoma cases, whereas in the colorectal cancer cases, Bw35 was increased (p < 0.005). B5 was significantly less frequent in the adenoma cases than in the cancer cases (p < 0.05). It is suggested that the susceptibility of BW35 to the causal factors of colorectal cancer is under genetic control.