BACKGROUND: Global and regional ventricular function may be evaluated by using gated myocardial perfusion single photon emission computed tomography (SPECT). This study investigated two parameters of regional contraction of the left ventricle, segmental wall motion (WM) and wall thickening (WT), to determine their similarity and disparity in each myocardial segment in patients with normal myocardial perfusion. METHODS AND RESULTS: Thirty-five patients with normal myocardial perfusion and cardiac function (mean left ventricular ejection fraction, 62.6%+/-8.8%) were included in this study. A 1-day stress/rest protocol was used as a means of acquiring technetium 99m (Tc-99m) sestamibi gated SPECT protocol for each patient. A commercially available software package for quantitative gated SPECT (QGS) was used to generate cine loop three-dimensional surface display and SPECT images. The left ventricle was divided into 9 segments to score WM and WT (on a scale of 0 to 4, with 0 being normal and 4 being severely reduced) by 6 independent observers. The WM score was significantly higher than the WT score in the septum, whereas the WM score was lower than the WT score in the inferior segment. Similar WM and WT scores were observed in the remaining segments. CONCLUSIONS: Heterogeneous myocardial WM and WT were observed by using QGS software. These findings suggest that different criteria are required in each segment to evaluate segmental WM and WT by means of gated myocardial perfusion SPECT.

Adenosine Triphosphate↗

PubMedDate not supplied

Bilateral angle closure glaucoma and visual loss precipitated by antidepressant and antianxiety agents in a patient with depression.

A 71-year-old woman with depression had been treated with an antidepressant (maprotiline) and antianxiety agents (clotiazepam and alprazolam). She had previously complained of ocular pain and blurred vision. However, thorough ocular examination was not performed at those times. On examination, visual acuity was no light perception OD and hand motion OS. Intraocular pressures were 33 mm Hg OU. Moderately dilated pupils, atrophic irises, shallow anterior chambers and closed angles were seen in both eyes. Despite treatment, her visual acuity decreased to no light perception bilaterally. Psychiatrists and ophthalmologists should be aware that antidepressants and antianxiety agents can precipitate angle closure glaucoma in susceptible eyes.

Adrenergic beta-Antagonists↗

PubMedDate not supplied

Clinical application of Ga-67 DFO-DAS-fibrinogen.

Scintigraphy with 67Ga-DFO-DAS-fibrinogen (67Ga-fibrinogen) was performed for the positive delineation of thrombi in patients with suspected venous or arterial thrombus formation. Five out of 17 patients showed 67Ga-fibrinogen accumulation corresponding to thrombus formation, as confirmed by other examination including radionuclide venography, contrast angiography, and CT scan. There was some difference in 67Ga-fibrinogen uptake between venous and arterial thrombi. With arterial thrombi, 67Ga-fibrinogen uptake was observed over one year after the appearance of clinical symptoms of dissecting aneurysm and arteriosclerosis obliterans. However, with venous thrombi, 67Ga-fibrinogen uptake occurred less than three weeks after the onset of venous edema. These results may indicate different mechanisms of thrombus organization between venous and arterial thrombi. Further, the thrombi age seems to be an important factor in analyzing the diagnostic accuracy of radioagents used for thrombus scintigraphy.

Adult↗