Preoperative risk stratification with myocardial perfusion imaging in intermediate and low-risk non-cardiac surgery.

Background: Perioperative cardiac risk in high risk surgery is often stratified with myocardial perfusion single-photon emission computed tomography (SPECT). However, little and no data are available about intermediate and low-risk surgery, respectively.

Methods And Results: A total of 1,220 consecutive patients underwent electrocardiography-gated dipyridamole stress SPECT to evaluate myocardial perfusion and cardiac function before intermediate or low risk non-cardiac surgery.

Oxygen tension is an important mediator of the transformation of osteoblasts to osteocytes.

Osteocytes are derived from osteoblasts, but reside in the mineralized bone matrix under hypoxic conditions. Osteocyte-like cells show higher expression of ORP150, which is induced by hypoxia, than osteoblast-like cells. Accordingly, we hypothesized that the oxygen tension may regulate the transformation of osteoblasts to osteocytes.

The mode of destruction in shoulders with rheumatoid arthritis based on radiographic findings.

The objective of the present study was to elucidate the mode of rheumatoid arthritis shoulder destruction. The study included 402 shoulders from 201 patients with rheumatoid arthritis. Plain radiographic findings were used to assess and statistically analyze the severity of the glenohumeral joint destruction (GHD) and greater tuberosity destruction (GTD).

Blunt thyroid trauma with acute hemorrhage and respiratory distress.

We report a rare event of acute hemorrhage into a thyroid adenoma after blunt trauma and causing respiratory distress. A 65-year-old woman fell and hit the left side of her anterior neck without any other injuries. The next day, she suffered from severe dyspnea and respiratory distress, and visited a community hospital.

Study of active controlled monotherapy used for rheumatoid arthritis, an IL-6 inhibitor (SAMURAI): evidence of clinical and radiographic benefit from an x ray reader-blinded randomised controlled trial of tocilizumab.

Objective: To evaluate the ability of tocilizumab (a humanised anti-IL-6 receptor antibody) monotherapy to inhibit progression of structural joint damage in patients with RA.

Methods: In a multi-centre, x ray reader-blinded, randomised, controlled trial, 306 patients with active RA of <5 years' duration were allocated to receive either tocilizumab monotherapy at 8 mg/kg intravenously every 4 weeks or conventional disease-modifying antirheumatic drugs (DMARDs) for 52 weeks. Radiographs of hands and forefeet were scored by the van der Heijde modified Sharp method.

Role of salivary gland scintigraphy with Tc-99m pertechnetate in determining treatment of solitary parotid gland tumors: a retrospective study.

Purpose Of The Report: Although salivary gland scintigraphy has been useful for the diagnosis of Warthin's tumor (WT), there are no reports concerning the clinical impact of this scintigraphy.

Materials And Methods: We retrospectively investigated 127 patients with solitary parotid tumors who had undergone salivary gland scintigraphy.

Results: For patients who had surgery, the sensitivity, specificity, and accuracy of differentiating WT from non-WTs were 95%, 91%, and 92%, respectively.

Celecoxib prevents juxta-articular osteopenia and growth plate destruction adjacent to inflamed joints in rats with collagen-induced arthritis.

The effect of celecoxib, a selective cyclooxygenase-2 inhibitor, on juxta-articular osteopenia and growth plate destruction adjacent to inflamed joints was investigated in rats with collagen-induced arthritis. Forty rats were assigned to the following six groups: (1) an untreated arthritis group; (2-5) arthritis rats receiving indomethacin (3 mg/kg per day), dexamethasone (0.2 mg/kg per day), or celecoxib (5 or 50 mg/kg per day), and (6) normal control rats.

Scatter correction based on an artificial neural network for 99mTc and 123I dual-isotope SPECT in myocardial and brain imaging.

Unlabelled: The aim of this study was to elucidate the clinical usefulness of scatter correction with an artificial neural network (ANN) in 99mTc and 123I dual-isotope SPECT.

Methods: Two algorithms for ANN scatter correction were tested: ANN-10 and ANN-3 employing 10 and 3 energy windows for data acquisition, respectively. Three patients underwent myocardial or brain SPECT with one of the following combinations of radiopharmaceuticals administered: 99mTc-tetrofosmin and 123I-metaiodobenzylguanidine (MIBG), 99mTc-methoxyisobutylisonitrile (MIBI) and 123I-beta-methyl-paraiodophenyl-pentadecanoic acid (BMIPP), or 99mTc-ethyl-cistainate dimmer (ECD) and 123I-iomazenil.

Influence of ageing on perioperative cardiac risk in non-cardiac surgery.

Background: ageing is known to augment perioperative cardiac risk in non-cardiac surgery. However, it remains unclear whether the increased risk is attributable to ageing itself or to the associated cardiac risk factors and coronary artery disease.

Methods: this retrospective study enrolled 1,351 patients who underwent non-cardiac surgery after dipyridamole stress myocardial perfusion scintigraphy.

In vivo three-dimensional skeletal alignment analysis of the hindfoot valgus deformity in patients with rheumatoid arthritis.

The purpose of this study was to analyze the skeletal alignment of the hindfoot valgus deformity in patients with rheumatoid arthritis using bone models reconstructed from three-dimensional computerized tomography data. Computed tomography was performed on 21 feet of patients with rheumatoid arthritis, and magnetic resonance imaging was taken of 10 normal feet of eight volunteers. An image processing system was used to create bone models and analyze the three-dimensional displacement of the calcaneus, talus, navicular, and cuboid bones.

[Clinical features of fracture with glucocorticoid induced osteoporosis and rheumatoid arthritis].

Fracture in patients with glucocorticoid-induced osteoporosis (GIO) is occurred despite properly maintained bone mineral density. So the criteria of primary osteoporosis cannot be adapted to GIO. This is caused by the difference of disease's pathology.

Hydroxyapatite augmentation for bone atrophy in total ankle replacement in rheumatoid arthritis.

Although total ankle replacement is routinely used for rheumatoid arthritis of the ankle, it has been hampered by early implant failures such as loosening and subsidence of the tibial component due to poor bone quality. To prevent this complication, total ankle replacement augmented by a specially designed hydroxyapatite coating was used in 14 patients (16 feet). Patients were reviewed after an average follow-up of 23.

Guidelines for diagnosis and management of Paget's disease of bone in Japan.

We here propose guidelines for the diagnosis and management of Paget's disease of bone (PDB) in Japan. These guidelines provide basic information on the epidemiology, pathophysiology, clinical signs and symptoms, diagnosis, indications for treatment, and available therapy, including orthopedic surgery. PDB is a chronic disorder characterized by focal abnormalities of bone turnover.

Value of CT thallium-201 SPECT fusion imaging over SPECT alone for detection and localization of nasopharyngeal and maxillary cancers.

Objective: The purpose of this study was to investigate the incremental clinical utility of CT and high-resolution SPECT fusion imaging.

Materials And Methods: Eighteen patients with nasopharyngeal cancer or cancers around the maxilla were scanned with high-resolution SPECT at the time of initial diagnosis (18 studies) and during follow-up after chemoradiotherapy (23 studies). SPECT results were compared with histologic findings or the findings of other imaging techniques.

Imatinib mesylate inhibits osteoclastogenesis and joint destruction in rats with collagen-induced arthritis (CIA).

Macrophage colony-stimulating factor (M-CSF) is a key factor for osteoclastogenesis at the bone-pannus interface in patients with rheumatoid arthritis as well as a receptor activator of NF-kappaB ligand (RANKL). Imatinib mesylate inhibits the phosphorylation of c-fms, a receptor for M-CSF. The present study investigates the effect of imatinib mesylate on joint destruction in rats with collagen-induced arthritis (CIA) and on osteoclastogenesis in vitro.

A case of hepatitis C-associated osteosclerosis in an elderly Japanese man.

Hepatitis C-Associated Osteosclerosis (HCAO) is characterized by a marked increase in bone mass with deep bone pain. Since 1992, eleven cases of HCAO have been reported. This report describes an elderly Japanese man with HCAO, whose clinical course we followed for 3 years.

Radiographic study of joint destruction patterns in the rheumatoid elbow.

Knowledge of the pattern of joint destruction is important for planning the therapeutic approach to rheumatoid arthritis (RA) of the elbow. Accordingly, we carried out a large-scale radiographic study with the objective of elucidating the joint destruction pattern in rheumatoid elbows. From 2001 through 2003, we examined and took plain X-rays of both elbows of 193 RA patients (i.

Prevalence and clinical features of Paget's disease of bone in Japan.

The present study aimed to evaluate the prevalence and clinical presentation of Paget's disease of bone (PDB) in Japan. As PDB is a very rare disease in Japan, a nationwide mail survey was conducted targeting doctors in the specialty most frequently diagnosing and treating PDB patients in Japan. First, the literature for all case reports in Japan published between January 1990 and December 2002 was reviewed to determine who was diagnosing and treating PDB in Japan.

Does alendronate prevent collapse in osteonecrosis of the femoral head?

Unlabelled: Progression of collapse in osteonecrosis of the femoral head is related to the repair response, especially bone resorption around the necrotic region. A preliminary clinical study was done to determine whether systemic alendronate would prevent collapse and lead to pain relief in patients with osteonecrosis of the femoral head. Fourteen patients (20 hips) with osteonecrosis of the femoral head received daily administration of 5 mg alendronate (alendronate group) for 1 year.

Influence of photon scattering and attenuation on ROI analysis in brain perfusion single-photon emission tomographic imaging of normal subjects.

Objective: The aim of this study was to evaluate the effect of scatter and attenuation correction in region of interest (ROI) analysis in brain perfusion single-photon emission tomography (SPECT) and to assess the influence of selecting the reference area on semi-quantification.

Methods: Ten normal subjects were enrolled and injected with 123I-iodoamphetamine to undergo simultaneous emission and transmission scanning for scatter and attenuation correction. We reconstructed three SPECT images from common projection data of each subject: with scatter correction and non-uniform attenuation correction, with scatter correction and uniform attenuation correction, and with uniform attenuation correction applied to data without scatter correction.

Nurse-like cells from patients with rheumatoid arthritis support the survival of osteoclast precursors via macrophage colony-stimulating factor production.

Objective: To elucidate the role of nurse-like cells (NLCs) obtained from rheumatoid arthritis (RA) patients in bone loss during progressive synovial expansion.

Methods: CD14+ monocytes were cocultured with NLCs for 4 weeks and collected as NLC-supported CD14+ (NCD14+) monocytes. To determine their ability to differentiate into osteoclasts, NCD14+ monocytes were further cultured with macrophage colony-stimulating factor (M-CSF) together with RANKL or tumor necrosis factor alpha (TNFalpha).

Use of virtual, interactive, musculoskeletal system (VIMS) in modeling and analysis of shoulder throwing activity.

Our purpose in this study was to apply the virtual, interactive, musculoskeletal system (VIMS) software for modeling and biomechanical analysis of the glenohumeral joint during a baseball pitching activity. The skeletal model was from VIMS library and muscle fiber attachment sites were derived from the visible human dataset. The muscular moment arms and function changes are mainly due to the large humeral motion involved during baseball pitching.

Evaluation of ischemic heart disease on a 1.5 Tesla scanner: combined first-pass perfusion and viability study.

Purpose: We implemented a fast gradient echo (GRE) sequence with an echo-planar imaging (EPI) read-out (FGRE-ET) to conduct myocardial perfusion studies on a conventional scanner. The accuracy of combined perfusion and viability studies is evaluated in comparison with coronary angiography (CAG).

Materials And Methods: We enrolled 33 patients suspected of having coronary artery disease in this study.