Is there a relationship between non-obstructive coronary artery disease or cardiac syndrome X and migraine? Αn integrated multi-disciplinary approach

Abstract Non-obstructive coronary artery disease (CAD) which is mostly called cardiac syndrome X (CSX) is noted in about 30% of men and 40%-60% of women and seems to be incremental. In addition, frequent myocardial perfusion defects with various levels of severity are often seen in this disease. Recently, we noticed that the frequency of migraine in patients with CSX was noticeably higher than in healthy people and in CAD patients. This may support the evolving story that CSX is related to migraine and to chest pain and that CSX and migraine may have a similar pathophysiology. Hence, myocardial perfusion imaging could be used as a complement any diagnostic test to support the relation between CSXand migraine

Comparison of Thyroid Blood Flow and Uptake Indices Using Technetium-99m Pertechnetate in Patients with Graves’ Disease and Euthyroid Subjects

Objective: The aim of the present study was to evaluate parameters of early blood flow (EBF) including duration of EBF, perfusion index (PI), uptake indexes 1 and 2 (UI1 and UI2) derived from dynamic thyroid scintigraphy in patients with Graves’ disease (GD), and euthyroid (EI). Maximum instant uptake and maximum uptake of the thyroid gland were also assessed. Methods: A total of 50 patients with GD and EI were included in this study. Each patient underwent two dynamic scans of 1-minute (20 images at 3 seconds) and 20-minute (20 images at 1 minute) with 99mTcO4. The time-activity curve of a 1-minute scan was employed to derive EBF parameters; likewise, the time-activity curve of a 20-minute scan was used to determine maximum instant uptake, and the gradient of the curve from the 10th to 20th minute was used to assess maximum uptake. Results: Values of EBF duration, PI, UI1, UI2, and maximum instant uptake were significantly lower in patients with GD than in those with EI (p<0.05). The calculated gradient of the second half of the curves for all of the patients ranged from 0 to 0.88 and was significantly higher in patients with GD than in those with EI. Conclusion: Lower values of PI, UI1, UI2 and durations of EBF, along with faster maximum instant uptake in patients with GD in comparison to EI are indicators of a heightened desire for hyper-functioning thyroid glands of patients with GD to absorb 99mTcO4. Additionally, because of the uprising gradient at the end of the 20-minute time-activity curve, a maximum thyroid uptake of 99mTcO4 was achieved at more than 20 minutes after the radiopharmaceutical injection

Radioprotective Effect of Beta D-Glucan and Vitamin E on Gamma Irradiated Mouse

Introduction: It is shown that beta-D-glucan is an immunologic system booster with radioprotectory effects. Radioprotectors are chemical components that can alleviate biological damage produced by ionizing radiation. Aim: This study was designed to investigate the synergistic radioprotectory effects of beta-D-glucan and vitamin E on irradiated mice with 60Co source. Materials and Methods: A total of 240 female mice were arranged in four, equal population groups of control group (C), treated group with beta D-glucan (G), treated group with vitamin E (E), and treated group with both beta D-glucan and vitamin E (G+E). Each group was divided into three equal population groups of D6, D7 and D8 exposed to 60Co radiation with prescribed total body dose of 6, 7 and 8 Gray (Gy), respectively. After the exposure, the number of survived animals was counted by time, then Lethal Dose50/30 (LD50/30), Lethal Dose50/60 (LD50/60) and Dose Reduction Factor (DRF) were calculated in all groups and corresponding groups. R esults: Based on the results of current study, treatment of the animals with vitamin E did not change values of LD50/30 and LD50/60, in comparison to control group. LD50/30 and LD50/60 of treated groups with beta D-glucan and beta D-glucan + vitamin E showed significant difference with those of control group (p<0.01). The DRF values in groups E, G and G + E, were calculated respectively as 1, 1.25 and 1.375 based on LD50/30, and respectively as 1, 1.17 and 1.33 based on LD50/60. While values of DRF in groups G and G + E showed significant difference in comparison to that of control group (p<0.01), but the difference between DRF of groups G and G + E was not significant (p=0.395). C onclusion: The findings of study obviously showed that, presence of beta D-glucan in the body of mice, during exposure to ionizing radiation, leads to DRF of higher than one, proving the radioprotectory effect of this agent. Also, we demonstrated that, while vitamin E had no radioprotectory effect on irradiated mice, beta D-glucan in combination with vitamin E increased resistance of mice against ionizing radiation

Comparison of 180° and 360° Arc Data Acquisition to Measure Scintigraphic Parameters from Gated Single Photon Emission Computed Tomography Myocardial Perfusion Imaging: Is There Any Difference?

Objective: The aim of the current study was to compare 180° and 360° data collection modes to measure end diastolic volume (EDV), end systolic volume (ESV) and ejection fraction (EF) values of the cardiac system by gated myocardial perfusion tomography. Methods: Thirty-three patients underwent gated myocardial perfusion tomography. Single photon emission computed tomography data of patients’ heart were acquired by 180°, 45° left posterior oblique to 45° right anterior oblique, and 360° to obtain EDV, ESV, EF and cardiac volume changes (V1, V2, V3, V4, V5, V6, V7 and V8) throughout each cardiac cycle. Results: Results of the current study indicated that there were no significant differences between 180° and 360° angular sampling in terms of measuring EDV, ESV and EF in myocardial perfusion imaging. Cardiac volume change patterns during a cardiac cycle were also similar in 360° and 180° scans. We also observed that there was no difference in EDV, ESV and EF values between the group with stress induced by exercise and the group with stress imposed by dipyridamole. Conclusion: As there is no difference between 180°and 360° cardiac scanning in terms of EDV, ESV and EF, half-orbit scan is recommended to study these cardiac system parameters because it offers more comfort to patients and a shorter scanning time. Keywords: 180° data collection, 360° data collection, ejection fraction, end diastolic volume, end systolic volume, gated myocardial perfusio

Comparison of Thyroid Blood Flow and Uptake Indices Using Technetium-99m Pertechnetate in Patients with Graves’ Disease and Euthyroid Subjects

Objective: The aim of the present study was to evaluate parameters of early blood flow (EBF) including duration of EBF, perfusion index (PI), uptake indexes 1 and 2 (UI1 and UI2) derived from dynamic thyroid scintigraphy in patients with Graves’ disease (GD), and euthyroid (EI). Maximum instant uptake and maximum uptake of the thyroid gland were also assessed. Methods: A total of 50 patients with GD and EI were included in this study. Each patient underwent two dynamic scans of 1-minute (20 images at 3 seconds) and 20-minute (20 images at 1 minute) with 99mTcO4. The time-activity curve of a 1-minute scan was employed to derive EBF parameters; likewise, the time-activity curve of a 20-minute scan was used to determine maximum instant uptake, and the gradient of the curve from the 10th to 20th minute was used to assess maximum uptake. Results: Values of EBF duration, PI, UI1, UI2, and maximum instant uptake were significantly lower in patients with GD than in those with EI (p<0.05). The calculated gradient of the second half of the curves for all of the patients ranged from 0 to 0.88 and was significantly higher in patients with GD than in those with EI. Conclusion: Lower values of PI, UI1, UI2 and durations of EBF, along with faster maximum instant uptake in patients with GD in comparison to EI are indicators of a heightened desire for hyper-functioning thyroid glands of patients with GD to absorb 99mTcO4. Additionally, because of the uprising gradient at the end of the 20-minute time-activity curve, a maximum thyroid uptake of 99mTcO4 was achieved at more than 20 minutes after the radiopharmaceutical injectio

False-positive defects on exercise 99mTc-sestamibi SPECT imaging, but not on dipyridamole 99mTc-sestamibi SPECT imaging, in a patient with right bundle branch block (RBBB)

False-positive findings with myocardial perfusion imaging (MPI)have frequently been identified in the presence of left bundlebranch block (LBBB) and tend to lower the accuracy of MPI inindividuals with normal coronary angiographs. Pharmacologicstress is recognized as the preferred method for MPI in patientswith LBBB. In contrast, very few studies have evaluated the effectof right bundle branch block (RBBB) on MPI, and there isno consensus regarding the selection of pharmacologic versusexercise stress during MPI for the RBBB patient. In this study,we present a 45-year-old man with RBBB, who has a normal coronary artery angiography, but who showed abnormal myocardialperfusion with exercise MPI, and normal perfusion ondipyridamole MPI. The aim of the study is to stimulate awarenessthat the stress method selected for patients with RBBB canpotentially interfere with the accuracy of the data

Relation between clinical features and gastric emptying time in diabetic patients

BACKGROUND: Gastroparesis is characterized by delayed gastric emptying. This pathology is usually observed in patients with diabetes. One standard approach to quantitative assessment of gastric emptying is scintigraphic study. The aim of present study was to perform scintigraphic study of gastric emptying time in patient with diabetes and to find its correlation with patients’ characteristics. MATERIALS AND METHODS: Gastric emptying was assessed in 19 patients with type 2 diabetes (mean age of 61.04 ± 6.09 years) and 6 healthy volunteers. Characteristics of the patients were sex, age, duration of diabetes, blood sugar and serum HbA1c level. RESULTS: Results of present study revealed that gastric emptying half time was significantly larger in patients with type 2 diabetes as compared with healthy volunteers (P-value &lt; 0.05). While correlation of sex, age, duration of diabetes and blood sugar with gastric emptying time was not statistically significant, HbA1c level had significant effect on gastric emptying time. CONCLUSION: Results of this prospective study indicated that level of serum HbA1c is an effecting factor on gastric emptying time in patients with type 2 diabetes; however, these preliminary findings should be validated in larger and well-designed studies

The association of increased stomach wall radiotracer uptake with prolonged use of Omeprazole capsules on myocardial perfusion imaging (MPI) using 99mTc-sestamibi SPECT

Myocardial perfusion imaging (MPI) is widely used in routinepractice for diagnosis and risk stratification of coronary arterydisease (CAD). Intense curvilinear activity in the stomach wallof a patient was seen on MPI raw data. This phenomenon was completely dissimilar to the familiar intraluminal gastricreflux of sestamibi. This observed activity could have resultedin false-positive or false-negative artifacts — and inaccurate diagnosis — of the inferior wall of the left ventricle after MPI processing. On further exploration, the current researchers found that the patient had a history of 10-year Omeprazole capsule consumption. The authors present this infrequent case of intense stomach uptake to stress the related clinical and diagnostic implications with the aim to stimulate acute awareness of possible, unexpected infringements on image quality that could potentially interfere with accurate interpretation of the data