Myocardial Impairment Detected by Late Gadolinium Enhancement in Hypertrophic Cardiomyopathy: Comparison with 99mTc-MIBI/Tetrofosmin and 123I-BMIPP SPECT

Purpose: Myocardial fibrosis is considered to be an important factor in myocardial dysfunction and sudden cardiac death in hypertrophic cardiomyopathy (HCM). The purpose of this study was to compare myocardial fibrosis detected by late gadolinium enhancement (LGE) on cardiac MRI with myocardial perfusion and fatty acid metabolism assessed by single photon emission computed tomography in HCM.Materials and Methods: We retrospectively evaluated 20 consecutive HCM patients (female, 7; mean age, 53.4 years) who underwent LGE, technetium-99m methoxyisobutylisonitrile/tetrofosmin (99mTc-MIBI/tetrofosmin), and iodine-123 beta-methyl-iodophenylpentadecanoic acid (123I-BMIPP) imaging. We calculated the myocardium-to-lumen signal ratio (M/L) for LGE in 17 segments based on the American Heart Association statement. Scoring of 99mTc-MIBI/tetrofosmin (PI) and 123I-BMIPP (BM) was performed for each segment using a 5-point scale (0, normal; 4, highly decreased).Results: Nineteen of 20 patients (95%) and 153 of 340 segments (45%) showed LGE. M/Ls were 0.42ｱ・.16, 0.55ｱ・.17, and 0.65ｱ・.24 in PI0/BM0, PI0/BM1-4 and PI1-4/BM1-4, respectively. All M/Ls were significantly higher than that of a normal control (0.34ｱ・.14) (p<0.001).Conclusions: Myocardial fibrosis in HCM can occur despite normal perfusion and fatty acid metabolism, and is more strongly associated with disorders of fatty acid metabolism than with perfusion abnormalities. M/L may be a useful indicator of disease severity

Parlons Japonais A1

National audienceCette méthode a été élaborée grâce aux réflexions didactiques théoriques fondées sur l'expérience de nombreuses années d'enseignement à l'université et sur des recherches en linguistique et didactique de langue. Le contenu pédagogique tient compte des besoins communicatifs des étudiants en France. Ainsi, les questions récurrentes et les erreurs fréquemment commises par ce public sont largement exploitées, permettant un apprentissage ciblé et efficace pour ce public francophone. Ce manuel est une réédition révisée et actualisée (avec les objectifs reliés au CECRL et les activités actionnelles) de parlons japonais (paru en 1989, puis réédité en 2000); le premier manuel de japonais en français basé sur une approche communicative. Cette méthode met l'accent sur la communication et d'appuie sur l'aspect pragmatique et sociolinguistique du japonais. Une grande importance est accordée au mode de conversation, ce qui permettra aux apprenants de se sensibiliser à l'aspect interculturel et d'acquérir les stratégies nécessaires pour participer de manière adéquate à une conversation

Parlons Japonais A1

National audienceCette méthode a été élaborée grâce aux réflexions didactiques théoriques fondées sur l'expérience de nombreuses années d'enseignement à l'université et sur des recherches en linguistique et didactique de langue. Le contenu pédagogique tient compte des besoins communicatifs des étudiants en France. Ainsi, les questions récurrentes et les erreurs fréquemment commises par ce public sont largement exploitées, permettant un apprentissage ciblé et efficace pour ce public francophone. Ce manuel est une réédition révisée et actualisée (avec les objectifs reliés au CECRL et les activités actionnelles) de parlons japonais (paru en 1989, puis réédité en 2000); le premier manuel de japonais en français basé sur une approche communicative. Cette méthode met l'accent sur la communication et d'appuie sur l'aspect pragmatique et sociolinguistique du japonais. Une grande importance est accordée au mode de conversation, ce qui permettra aux apprenants de se sensibiliser à l'aspect interculturel et d'acquérir les stratégies nécessaires pour participer de manière adéquate à une conversation

Utilization of volcanic ejecta as a high-performance supplementary cementitious material by gravity classification and pulverization

The reaction of natural pozzolans is caused by volcanic glass composed of amorphous silicate; however, volcanic ejecta also contains crystal mineral, pumice, and sometimes weathered clay fraction in their natural conditions. By focusing on the differences of physical properties between these components, high-purity volcanic glass powder (VGP) was manufactured by dry gravity classification and pulverization. This paper reports the results of investigations to utilize pyroclastic flow deposits as a supplementary cementitious material (SCM). Through this method, the glass content of VGP increased to 88% with a mean particle size of 1 μm, when that of the raw material is about 60%. Chemical analysis indicated that VGP is principally composed of silica (about 72%) and alumina (about 13%). The performance of VGP as a SCM was evaluated by conducting tests on concrete mixtures, replacing 0% to 30% by weight of portland cement by VGP with a 20% to 60% water to cement ratio. VGP concrete showed better results of 7-and 28-day compressive strength compared to control concrete in all experiments. In particular, VGP demonstrated better flowability and strength development in concrete with a low water-binder ratio in comparison to silica fume

Prevalence of dural ectasia in Loeys-Dietz syndrome: comparison with Marfan syndrome and normal controls.

BACKGROUND AND PURPOSE: Dural ectasia is well recognized in Marfan syndrome (MFS) as one of the major diagnostic criteria, but the exact prevalence of dural ectasia is still unknown in Loeys-Dietz syndrome (LDS), which is a recently discovered connective tissue disease. In this study, we evaluated the prevalence of dural ectasia in LDS according by using qualitative and quantitative methods and compared our findings with those for with MFS and normal controls. MATERIAL AND METHODS: We retrospectively studied 10 LDS (6 males, 4 females, mean age 36.3 years) and 20 MFS cases (12 males, 8 females, mean age 37.1 years) and 20 controls (12 males, 8 females, mean age 36.1 years) both qualitatively and quantitatively using axial CT images and sagittal multi-planar reconstruction images of the lumbosacral region. For quantitative examination, we adopted two methods: method-1 (anteroposterior dural diameter of S1> L4) and method-2 (ratio of anteroposterior dural diameter/vertebral body diameter>cutoff values). The prevalence of dural ectasia among groups was compared by using Fisher's exact test and the Tukey-Kramer test. RESULTS: In LDS patients, the qualitative method showed 40% of dural ectasia, the quantitative method-1 50%, and the method-2 70%. In MFS patients, the corresponding prevalences were 50%, 75%, and 85%, and in controls, 0%, 0%, and 5%. Both LDS and MFS had a significantly wider dura than controls. CONCLUSIONS: While the prevalence of dural ectasia varied depending on differences in qualitative and quantitative methods, LDS as well as MFS, showed, regardless of method, a higher prevalence of dural ectasia than controls. This finding should help the differentiation of LDS from controls

Diagnostic performance of CT, PET, side-by-side, and fused image interpretations for restaging of non-Hodgkin lymphoma.

The purpose of this study was to compare the diagnostic performance of positron emission tomography (PET) alone, computed tomography (CT) alone, side-by-side reading, and fused images for restaging or follow-up of patients with malignant lymphoma. METHODS: Fifty patients with histologically confirmed non-Hodgkin lymphoma underwent an (18)fluoro-2-deoxyglucose (FDG)-PET scan, followed by a CT scan. CT alone, PET alone, side-by-side reading, and fused images were interpreted separately and visually using a five-point grading scale for the following eight regions: cervical, supraclavicular, axillary, mediastinal, para-aortic to iliac, mesenteric, inguinal, and extra-nodal. Diagnostic accuracy was compared on the basis of the final diagnoses determined by histological confirmation and/or clinical course. RESULTS: For all regions combined, the interpretation of PET alone (sensitivity = 86.1%, specificity = 99.4%, accuracy = 91.0%), side-by-side reading (96.0%, 99.4%, 98.9%), and fused images (98.0%, 99.4%, 99.2%) yielded significantly higher diagnostic performance than that of CT alone (59.4%, 96.1%, 91.0%; P < 0.001). The cervical, supraclavicular, and extra-nodal regions were more accurately diagnosed with PET (P < 0.05), whereas the para-aortic to iliac regions were diagnosed more accurately with side-by-side reading and fused images than with CT alone or PET alone (P < 0.05). CONCLUSIONS: Although fused images are clinically valuable, side-by-side reading showed equivalent performance, whereas the interpretation of PET alone yielded reasonably high diagnostic performance for restaging or follow-up of patients with malignant lymphoma

Mean DSR values.

<p>DSR, dural sac ratio; LDS, Loeys-Dietz syndrome; MFS, Marfan syndrome; DE, dural ectasia; NS, not significant; a, difference between LDS and MFS; b, difference between LDS and control; c, difference between MFS and control.</p><p>CI*, this column shows the confidence interval for significant differences.</p

Scheme of sagittal CT images of the lumbosacral spine.

<p>Lines with arrows represent measurements of vertebral body diameters (VBD) and dural sac diameters (DSD).</p

Patient characteristics and prevalence of DE determined with qualitative and quantitative methods.

<p>LDS, Loeys-Dietz syndrome; MFS, Marfan syndrome; DSR, dural sac ratio; DE, dural ectasia; NS, not significant; a, difference between LDS and MFS; b, difference between LDS and control; c, difference between MFS and control.</p><p>Difference*, In this column, p values are shown. Differences were not tested for each level from L1 to S1.</p