PURPOSE: To evaluate the feasibility of comprehensive left ventricle (LV) functional parameters on routine coronary computed tomographic angiography (CCTA) based on two-dimensional echocardiography (2DE). MATERIALS AND METHODS: Ninety-nine patients who underwent CCTA accompanied by 2DE were included in the study. The volumetric LV systolic functional parameters were acquired from 10-phase reconstruction of CCTA data. By differentiating the time-LV volume curve by time domain and measuring mitral valvular orifice areas, transmitral time-velocity curves were drawn and the early (E) to late (A) mitral inflow peak velocities ratio (E/A ratio) was acquired. By measuring a longitudinal jerking velocity of the mitral valvular annulus on a four-chamber view, the mitral peak velocity of early filling (E) to early diastolic mitral annular velocity (E') ratio (E/E' ratio) was evaluated. All functional parameters were compared with the 2DE results. RESULTS: The LV end diastolic volume, LV end systolic volume, ejection fraction, stroke volume, cardiac output, and LV myocardial mass measured by CCTA and 2DE showed moderate to strong correlations (r = 0.732, 0.821, 0.416, 0.394, 0.328, and 0.764, respectively; p < 0.05). The E/A and E/E' ratios showed strong correlation between CCTA and echocardiography (r = 0.807 and 0.751, respectively; p < 0.05). CONCLUSION When CCTA is performed with retrospective electrocardiographic gating, additional information about the LV function can be acquired as reliably as with echocardiography.

No abstract available.
Tibial Nerve*

Acute coronary syndrome (ACS) is mainly caused by atherosclerotic coronary artery disease (CAD); however, it can also occur in patients with non-atherosclerotic CAD. Conventional coronary angiography only shows the lumen of arteries, indicating the presence of stenosis or dilatation. Thus, it has limited value in evaluating the coronary artery wall and offers low specificity for diagnosing CAD. Coronary CT angiography provides additional information, including the depiction of the concerned vessel and the aorta, as well as the pulmonary artery, which permits the diagnosis of non-atherosclerotic CAD and the differentiation of various causes of the disease. In this review, we present the pathophysiology and CT imaging features of non-atherosclerotic CAD.

OBJECTIVES: Several studies suggest that nocturia may be related to obstructive sleep apnea syndrome (OSAS). The mechanism by which OSAS develops nocturia has not been determined. The present study aimed to determine the prevalence of nocturia among adults with OSAS and to identify factors that may be predictive in this regard. METHODS: Retrospective review of clinical and polysomnographic data obtained from patients evaluated at the sleep clinics of the St. Paul's Hospital between 2009 and 2012. The urinary symptoms were assessed on the basis of the International Prostate Symptom Score (IPSS). Pathologic nocturia was defined as two or more urination events per night. OSAS was defined as apnea-hypopnea index (AHI) > or =5. A multivariate analysis using logistic regression was performed to examine the relationship between polysomnographic variables and the presence of pathologic nocturia, while controlling for confounding factor. RESULTS: A total of 161 men >18 years of age (mean age 46.7+/-14.1), who had been referred to a sleep laboratory, were included in the present study. Among these, 27 patients with primary snoring and 134 patients with obstructive sleep apnea were confirmed by polysomnography. Nocturia was found in 53 patients with OSAS (39.6%) and 8 patients with primary snoring (29.6%). The AHI was higher in patients with nocturia than in those without nocturia (p=0.001). OSAS patients with nocturia had higher arousal index (p=0.044), and lower nadir oxyhemoglobin saturation (p=0.001). Multiple regression analysis showed that age (beta=0.227, p=0.003), and AHI (beta=0.258, p=0.001) were associated with nocturia, and that the presence of pathologic nocturia was predicted by age (OR 1.04 ; p=0.004) and AHI (OR 1.02 ; p=0.001). CONCLUSION: Nocturia is common among patients with OSAS. The strongest predictors of nocturia are age and AHI in patients with OSAS.
Adult ; Arousal ; Humans ; Logistic Models ; Male ; Multivariate Analysis ; Nocturia* ; Oxyhemoglobins ; Polysomnography ; Prevalence* ; Prostate ; Retrospective Studies ; Sleep Apnea, Obstructive* ; Snoring ; Urination

OBJECTIVE: To investigate the relationship between commonly used radiologic parameters and occurrence of low back pain (LBP) through prospective study using pre-employment radiologic examination in high risk workplace. METHOD: One hundred and fifty four male workers in high risk workplace were evaluated. Lumbar lordosis, lumbosacral angle, lumbar gravity line and lumbar disc height-related parameters were measured using simple radiologic films of lateral lumbosacral view taken during pre-employment medical check. Relationship between occurrence of LBP during post-employment period with a mean 1.7+/-1.0 years and radiologic parameter was investigated. RESULTS: Lumbar lordosis, lumbosacral angle and lumbar disc height were not significantly correlated to the occurrence of LBP. Amount of anterior shift of lumbar gravity line did not showed correlation to occurrence of LBP, but subjects with posterior displacement of lumbar gravity line showed significantly low rate of occurrence of LBP. CONCLUSION: These results suggest that commonly used radiologic parameters are not so useful to predict occurrence of LBP in high risk workers. The possibile preventive effect of posterior shift of lumbar gravity line seems to be worth further researching.
Animals ; Gravitation ; Humans ; Lordosis ; Low Back Pain* ; Male ; Prospective Studies ; Spine*

PURPOSE: This study was done to identify whether pre-conditioning exercise has neuroprotective effects against cerebral ischemia, through enhance brain microvascular integrity. METHODS: Adult male Sprague-Dawley rats were randomly divided into four groups: 1) Normal (n=10); 2) Exercise (n=10); 3) Middle cerebral artery occlusion (MCAo), n=10); 4) Exercise+MCAo (n=10). Both exercise groups ran on a treadmill at a speed of 15 m/min, 30 min/day for 4 weeks, then, MCAo was performed for 90 min. Brain infarction was measured by Nissl staining. Examination of the remaining neuronal cell after MCAo, and microvascular protein expression on the motor cortex, showed the expression of Neuronal Nuclei (NeuN), Vascular endothelial growth factor (VEGF) & laminin. RESULTS: After 48 hr of MCAo, the infarct volume was significantly reduced in the Ex+MCAo group (15.6+/-2.7%) compared to the MCAo group (44.9+/-3.8%) (p<.05), and many neuronal cells were detected in the Ex+MCAo group (70.8+/-3.9%) compared to the MCAo group (43.4+/-5.1%) (p<.05). The immunoreactivity of laminin, as a marker of microvessels and Vascular endothelial growth factor (VEGF) were intensively increased in the Ex+MCAo group compared to the MCAo group. CONCLUSION: These findings suggest that the neuroprotective effects of exercise pre-conditioning reduce ischemic brain injury through strengthening the microvascular integrity after cerebral ischemia.
Animals ; Brain Infarction/pathology ; Disease Models, Animal ; Infarction, Middle Cerebral Artery/metabolism/pathology/*prevention & control ; Laminin/metabolism ; Male ; Microvessels/metabolism ; Neurons/metabolism ; *Physical Conditioning, Animal ; Rats ; Rats, Sprague-Dawley ; Stroke/prevention & control ; Vascular Endothelial Growth Factor A/metabolism

The obstacles for cardiac imaging are motion artifacts due to cardiac motion, respiration, and blood flow, and low signal due to small tissue volume of heart. To overcome these obstacles, fast imaging technique with ECG gating is utilized. Cardiac exam using MRI comprises of morphology, ventricular function, myocardial perfusion, metabolism, and coronary artery morphology. During cardiac morphology evaluation, double and triple inversion recovery techniques are used to depict myocardial fluidity and soft tissue structure such as fat tissue, respectively. By checking the first-pass enhancement of myocardium using contrast-enhanced fast gradient echo technique, myocardial blood flow can be evaluated. In addition, delayed imaging in 10-15 minutes can inform myocardial destruction such as chronic myocardial infarction. Ventricular function including regional and global wall motion can be checked by fast gradient echo cine imaging in quantitative way. MRI is acknowledged to be practical for integrated cardiac evaluation technique except coronary angiography. Especially delay imaging is the greatest merit of MRI in myocardial viability evaluation.
Artifacts ; Coronary Angiography ; Coronary Vessels ; Electrocardiography ; Heart ; Magnetic Resonance Imaging* ; Metabolism ; Myocardial Infarction ; Myocardium ; Perfusion ; Respiration ; Ventricular Function

PURPOSE: To evaluate the feasibility of MR arthrography and ultrasonography in evaluating shoulder pain. MATERIALS AND METHODS: The subject group consisted of all patients who visited our institute complaining of shoulder pain or instability from June 2002 to December 2004. There were a total of 92 patients with a mean age of 48. On the basis of arthroscopic results, the sensitivity, specificity, and accuracy of ultrasonography and MR arthrography were evaluated by comparing them with each other. RESULTS: In the diagnosis of supraspinatus tendon tears, ultrasonography had sensitivity and specificity of 100% and 64%, respectively, whereas MR arthrography had sensitivity and specificity of 80% and 94%, respectively. Ultrasonography also had high sensitivity and specificity in the diagnosis of subscapularis tendon tears (100% and 90%). MR arthrography was appropriate for identifying glenoid labral abnormalities (sensitivity, 95% and specificity, 61%). Similar results from ultrasonography and MR arthrography were obtained in the diagnosis of subscapular tendon tears or full-thickness tears of the rotator cuff tendons (kappa value, 0.644 and 0.911). CONCLUSION: While evaluating rotator cuff abnormalities, ultrasonography was appropriate for screening, whereas MR arthrography was useful to confirm the results of the ultrasonography.
Arthrography* ; Diagnosis ; Humans ; Mass Screening ; Rotator Cuff* ; Sensitivity and Specificity ; Shoulder Pain ; Tendons ; Ultrasonography*