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He SY, Min JK, Li HD, Zhang QH, Dai JL. [Effect of Kümmell's disease with kyphosis on spinal-pelvic sagittal parameters]. Zhongguo Gu Shang 2024; 37:142-7. [PMID: 38425064 DOI: 10.12200/j.issn.1003-0034.20230201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
OBJECTIVE To explore the effect of Kümmell's disease with kyphosis on the sagittal morphology of the spine-pelvis. METHODS A retrospective analysis of 34 patients of Kümmell's disease with kyphosis (Kümmell group) admitted from August 2015 to September 2022, including 10 males and 24 females with an average age of (71.1±8.5) years old. A control group of 37 asymptomatic population aged (69.3±6.7) years old was matched. Spinal-pelvic sagittal parameters were measured on the anterior-posterior and lateral X-rays of the whole spine in the standing position, including segmental kyphosis(SK) or thoracolumbar kyphosis(TLK), thoracic kyphosis(TK), lumbar lordosis(LL), pelvic incidence(PI), pelvic tilt(PT), sacral slope(SS), sagittal vertical axis(SVA), T1 pelvic angle(TPA) and PI-LL. Vertebral wedge angle(WA) in Kümmell was measured and differences in parameters among groups were analyzed and the relationship between spino-pelvic parameters and WA, SK were also investigated. RESULTS TK, SK, PT, SVA, TPA and PI-LL in Kümmell group were significantly larger than those in control group (P<0.05), LL and SS in Kümmell group were significantly decreased than those in control group (P<0.05), and there was no significant difference in PI between two groups (P>0.05). In Kümmell group, WA(30.8±5.9)° showed a positive correlation with SK and TK(r=0.366, 0.597, P<0.05), and SK was significantly correlated with LL and SS(r=0.539, -0.591, P<0.05). Strong positive correlation between LL and PI, SS, SVA, TPA, PI-LL were also confirmed in patients with Kümmell with kyphosis(r=0.559, 0.741, -0.273, -0.356, -0.882, P<0.05). CONCLUSION Patients with Kümmell with kyphosis not only have segmental kyphosis, but also changes the overall spinal-pelvic sagittal parameters, including loss of lumbar lordosis, pelvic retrorotation, trunk forward tilt. The surgical treatment of Kümmell disease should not only pay attention to the recovery of the height of the collapsed vertebra, but also focus on the overall balance of the spine-pelvic sagittal plane for patients with kyphosis.
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Affiliation(s)
- Shou-Yu He
- Department of Spine Surgery, the First Affiliated Hospital of Huzhou Teachers College, Huzhou 313000, Zhejiang, China
| | - Ji-Kang Min
- Department of Spine Surgery, the First Affiliated Hospital of Huzhou Teachers College, Huzhou 313000, Zhejiang, China
| | - Hai-Dong Li
- Department of Spine Surgery, the First Affiliated Hospital of Huzhou Teachers College, Huzhou 313000, Zhejiang, China
| | - Qiang-Hua Zhang
- Department of Spine Surgery, the First Affiliated Hospital of Huzhou Teachers College, Huzhou 313000, Zhejiang, China
| | - Ji-Lin Dai
- Department of Spine Surgery, the First Affiliated Hospital of Huzhou Teachers College, Huzhou 313000, Zhejiang, China
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He SY, Li HD, Min JK, Luo SC, Dai JL. [Effect of morphological changes in the sagittal plane of vertebrae and discs on degenerative kyphodeformity]. Zhongguo Gu Shang 2023; 36:653-7. [PMID: 37475630 DOI: 10.12200/j.issn.1003-0034.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
OBJECTIVE To explore the effects of morphological changes such as vertebral wedge deformation and disc degeneration (collapse) on adult thoracolumbar/lumbar degenerative kyphosis(TL/LDK) deformity. METHODS A retrospective analysis of 32 patients with spinal TL/LDK deformity admitted from August 2015 to December 2020, including 8 males and 24 females, aged 48 to 75(60.3±12.4) years old. On the long-cassette standing upright lateral radiographs, the coronal Cobb angle, sagittal thoracic lumbar/lumbar kyphosis angle(KA) of spine were measured, and the height and wedge parameters of apex vertebral(AV) and two vertebrae(AV-1, AV-2, AV+1, AV+2) above and below AV and the intervertebrae and the intervertebral disc(AV-1D, AV-2D, AV+1D, AV+2D) were evaluated, involving anterior vertebral body height(AVH), posterior vertebral body height(PVH), vertebral wedge angle(VWA), ratio of vertebral wedging(RVW), anterior disc height(ADH), posterior disc height(PDH), disc wedge angle(DWA), ratio of disc wedging(RDW), and DWA/KA. RESULTS The average angle of kyphosis was (44.2±19.1)°. A significant decrease in anterior height of vertebral was observed compared to the posterior height of vertebral(P<0.005). There was no significant difference in anterior and posterior height of discs. The vertebral wedging ratio/contribution ratio:AV-2(14.98±10.95)%/(14.21±8.08)%, AV-1(21.08±12.39)%/(18.09±7.38)%, AV(26.94±11.94)%/(25.52±8.64)%, AV+1(24.19±8.42)%/(20.82±8.69)%, AV+2(20.56±7.80)%/(15.60±9.71)%, total contribution(94.23±22.25)%, the disc wedging ratio/contribution ratio:AV-2D(2.88±2.57)%/(5.27±4.11)%, AV-1D(1.98±1.41)%/(2.29±2.16)%, AV+1D(-5.54±3.75)%/(-0.57±0.46)%, AV+2D(-8.27±4.62)%/(-1.22±1.11)%, total contribution (5.77±4.79)%. And the contribution rate of AV was significantly higher than that of adjacent vertebral(P<0.05). CONCLUSION The vertebral body and intervertebral disc shape both have influence on thoracolumbar kyphosis. However, the contribution of vertebral morphometry to the angle of TL/LDK deformity is relatively more important than the disc. The contribution of the wedge change of the AV to the TL/LDK deformity is particularly significant.
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Affiliation(s)
- Shou-Yu He
- Spine Surgery, the First Affiliated Hospital of Huzhou Teachers College, Huzhou 313000, Zhejiang, China
| | - Hai-Dong Li
- Spine Surgery, the First Affiliated Hospital of Huzhou Teachers College, Huzhou 313000, Zhejiang, China
| | - Ji-Kang Min
- Spine Surgery, the First Affiliated Hospital of Huzhou Teachers College, Huzhou 313000, Zhejiang, China
| | - Sheng-Chang Luo
- Spine Surgery, the First Affiliated Hospital of Huzhou Teachers College, Huzhou 313000, Zhejiang, China
| | - Ji-Lin Dai
- Spine Surgery, the First Affiliated Hospital of Huzhou Teachers College, Huzhou 313000, Zhejiang, China
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Zhu XH, Min JK, Zhang QH, Guo SH, Li HD, Zhu ZL. [Treatment of acetabular fracture involving quadrilateral body by external rectus abdominis incision combined with calcaneal profiled plate internal fixation]. Zhongguo Gu Shang 2022; 35:1031-1036. [PMID: 36415187 DOI: 10.12200/j.issn.1003-0034.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To investigate the therapeutic effect of lateral rectus abdominis incision combined with winged calcaneal plate on pelvic and acetabular fractures involving quadrilateral body. METHODS From January 2017 to April 2021, 21 cases of pelvic and acetabular fractures involving quadrilateral bodies were retrospectively analyzed, including 12 males and 9 females. The age ranged from 21 to 73 years with an average of (43.23±6.45) years. All patients were treated by lateral incision of rectus abdominis combined with open reduction and internal fixation with aerofoil plate, including 12 cases of pelvis with anterior and posterior column fractures, 7 cases of acetabular fractures with quadrilateral involvement, and 2 cases of acetabular fractures with central dislocation. RESULTS All 21 patients were followed up for 12 to 36 months with an average of (18.60±6.45) months. All fractures healed. According to Matta's image reduction evaluation after operation, 11 cases of pelvic anterior and posterior column fractures were all anatomic reduction, 1 case was satisfactory reduction, 7 cases of acetabular fractures involving quadrilateral were anatomic reduction, 1 case with central dislocation was anatomic reduction, and 1 case was satisfactory reduction. The modified Merle D'Aubigne Postel hip joint score was 13 to 17 points. CONCLUSION Lateral incision approach of rectus abdominis combined with wing-shaped steel plate can obtain good radiological and clinical results in the treatment of complex pelvic and acetabular fractures involving quadrilateral bodies, and has advantages in the treatment of complex pelvic fractures and acetabular quadrilateral fractures.
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Affiliation(s)
- Xin-Hong Zhu
- The Seventy-second Army Hospital of the PLA, Huzhou 313000, Zhejiang, China
| | - Ji-Kang Min
- The Seventy-second Army Hospital of the PLA, Huzhou 313000, Zhejiang, China
| | - Qiang-Hua Zhang
- The Seventy-second Army Hospital of the PLA, Huzhou 313000, Zhejiang, China
| | - Song-Hua Guo
- The Seventy-second Army Hospital of the PLA, Huzhou 313000, Zhejiang, China
| | - Hai-Dong Li
- The Seventy-second Army Hospital of the PLA, Huzhou 313000, Zhejiang, China
| | - Zong-Li Zhu
- The Seventy-second Army Hospital of the PLA, Huzhou 313000, Zhejiang, China
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Zhang ZF, Min JK, Yang HH, Zhong JM. [Total hip arthroplasty for unstable intertrochanteric fractures with necrosis of the femoral head:a 7-year follow-up]. Zhongguo Gu Shang 2022; 35:630-633. [PMID: 35859372 DOI: 10.12200/j.issn.1003-0034.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To discuss the result and long time follow-up of unstable intertrochanteric fracture combined with avascular necrosis of femoral head treated by total hip arthroplasty. METHODS From March 2008 to October 2014, 23 cases were enrolled and treated by total hip arthroplasty, including 10 males and 13 females, aged 59 to 82 years old with an average of(68.4±10.4) years old. There were 8 cases of type Ⅱa fractures, 6 cases of type Ⅱb fractures, 9 cases of type Ⅲ fractures according to Evans Classification. There were 3 cases of type Ⅱa, 3 cases of type Ⅱb, 9 cases of type Ⅲ, 8 cases type Ⅳaccording to Ficat Classification. The complications were recorded, the joint function was evaluated by Harris score and prosthesis survival rate was analysed. RESULTS Postoperative complications occurred in 2 cases, one patient had acute periprosthetic infection 3 months after operation, and one patient had hip dislocation 3 months after operation. All 23 patients were followed up for 61 to 110 months with an agerage of (85.1±22.9) months. The Harris score at the final follow-up was 83 to 92 months with an average of(89.8±5.2) months, which was significantly different from that before operation (P<0.05). Imaging showed that all patients had bone healing of intertrochanteric fractures. The 7-year survival rate of prosthesis in 23 patients was 95.7%. CONCLUSION The symptoms of unstable intertrochanteric fracture combined with avascular necrosis of femoral head could be solved by total hip arthroplasty, and the long time result was satisfied.
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Affiliation(s)
- Zhan-Feng Zhang
- The First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
| | - Ji-Kang Min
- The First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
| | - Hong-Hang Yang
- The First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
| | - Jian-Ming Zhong
- The First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
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Fang SY, Dai JL, Min JK, Zhang WL. Retraction Note to: Analysis of risk factors related to the re-fracture of adjacent vertebral body after PKP. Eur J Med Res 2022; 27:103. [PMID: 35778725 PMCID: PMC9248093 DOI: 10.1186/s40001-022-00739-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Shen-Yun Fang
- Orthopedics Department, The First People Hospital of Huzhou, The First People's Hospital Affiliated to Huzhou Normal University, Huzhou, 313000, China
| | - Ji-Lin Dai
- Orthopedics Department, The First People Hospital of Huzhou, The First People's Hospital Affiliated to Huzhou Normal University, Huzhou, 313000, China
| | - Ji-Kang Min
- Orthopedics Department, The First People Hospital of Huzhou, The First People's Hospital Affiliated to Huzhou Normal University, Huzhou, 313000, China.
| | - Wei-Li Zhang
- Ophthalmology Department, The First People Hospital of Huzhou, The First People's Hospital Affiliated to Huzhou Normal University, Huzhou, 313000, China.
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Li HD, Zhong L, Min JK, Fang XQ, Jiang LS. Oblique lateral interbody fusion combined with lateral plate fixation for the treatment of degenerative diseases of the lumbar spine: A retrospective study. Medicine (Baltimore) 2022; 101:e28784. [PMID: 35363165 PMCID: PMC9281985 DOI: 10.1097/md.0000000000028784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/20/2022] [Indexed: 01/04/2023] Open
Abstract
Oblique lateral interbody fusion (OLIF) is a minimally invasive decompression technique used in the treatment of lumbar degenerative diseases (LDDs). It is usually combined with posterior pedicle screw fixation to decrease perioperative complications. Few studies have reported the efficacy of OLIF combined with lateral plate instrumentation (OLIF-LP) for the treatment of LDDs.The purpose of this retrospective study was to evaluate the clinical efficacy of OLIF combined with lateral plate instrumentation for the treatment of LDDs.From May 2020 to September 2020, the clinical data of 52 patients who underwent OLIF-LP were analyzed. The operation time, blood loss, and complications were recorded. The radiological parameters, visual analog scale score, and Oswestry Disability Index were evaluated.The average operation time, blood loss, and length of hospital stay were 75.41 ± 11.53 minutes, 39.57 ± 9.22 mL, and 7.22 ± 1.85 days, respectively. The visual analog scale score and Oswestry Disability Index both improved significantly after surgery (7.23 ± 1.26 vs 2.15 ± 0.87; 60.27 ± 7.91 vs 21.80 ± 6.32, P < .01). The postoperative disk height was 13.02 ± 8.83 mm, which was much greater than the preoperative value. The postoperative foraminal height improved significantly (16.18 ± 3.49 vs 21.54 ± 2.12 mm, P < .01), and the cross-sectional area improved from 88.95 ± 14.79 to 126.53 ± 8.83 mm2 (P < .001). The radiological fusion rate was 88% at the last follow-up. No major complications, such as ureteral injury, vascular injury, or vertebral body fracture, occurred.Use of the OLIF-LP technique can help avoid lumbar posterior surgery and minimize the operative time and blood loss. OLIF-LP can achieve 1-stage intervertebral fusion and instrumentation through a single small incision.
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Affiliation(s)
- Hai-Dong Li
- Department of Spine Surgery, The First People's Hospital affiliated to the Huzhou University Medical College, Huzhou, Zhejiang Province, China
| | - Li Zhong
- Department of Critical Care Medicine, The First People's Hospital affiliated to the Huzhou University Medical College, Huzhou, Zhejiang Province, China
| | - Ji-Kang Min
- Department of Spine Surgery, The First People's Hospital affiliated to the Huzhou University Medical College, Huzhou, Zhejiang Province, China
| | - Xiang-Qian Fang
- Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lei-Sheng Jiang
- Department of Spine Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Tang HB, Sun ZG, Weng W, Xu XC, Min JK. [A follow up study on the treatment of tibial fractures with intramedullary interlocking nail through the suprapatellar approach]. Zhongguo Gu Shang 2021; 34:1165-1170. [PMID: 34965636 DOI: 10.12200/j.issn.1003-0034.2021.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To investigate the short-term effect of suprapatellar interlocking intramedullary nail in the treatment of tibial fractures. METHODS Eighty patients with tibial fractures treated from January 2016 to June 2018 were treated with interlocking intramedullary nail, who were divided into observation group (suprapatellar approach) and control group (patellar ligament approach) according to different surgical approaches. There were 40 cases in the observation group, including 28 males and 12 females, aged 28 to 67 years with a mean of (46.70±10.34) years. There were 40 cases in the control group, including 30 males and 10 females, aged 31 to 69 years with a mean of(49.38±10.74) years. The operation time, incision length, intraoperative C-arm X-ray fluoroscopy times, intraoperative blood loss, fracture healing time, postoperative active straight leg raise (SLR) time, hospital stay, visual analogue scale (VAS), knee pain rate and postoperative Hospital for Special Surgery (HSS) score were recorded and compared between two groups. RESULTS All the patients were followed up, and the duration ranged from 19 to 38 months, with an average of(24.60±4.52) months. In the observation group, the operation time was(53.83± 7.01) min;the incision length was (3.98±0.83) cm;the number of intraoperative C-arm X-ray fluoroscopy was (18.90±1.75) times;the fracture healing time was (10.03±0.89) weeks;the postoperative active SLR time was (1.19±0.25) days;and the hospital stay was(6.73±1.06) days. The above indexes were better than those in the control group (P<0.05). In the latest follow-up, 34 cases got an excellent result, 5 good, 1 fair and 0 poorin the observation group. In the control group, 25 cases got an excellent result, 9 good, 6 fair and 0 poor. The curative effect of the observation group was better than that of the control group(P< 0.05). CONCLUSION The treatment of tibial fractures with suprapatellar interlocking intramedullary nail has the advantages of less trauma and better recovery of knee function. It can obtain more satisfactory clinical results and can be further widely used.
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Affiliation(s)
- Hui-Bin Tang
- Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center in Northern Zhejiang, Huzhou 313000, Zhejiang, China
| | - Zhen-Guo Sun
- Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center in Northern Zhejiang, Huzhou 313000, Zhejiang, China
| | - Wei Weng
- Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center in Northern Zhejiang, Huzhou 313000, Zhejiang, China
| | - Xu-Chun Xu
- Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center in Northern Zhejiang, Huzhou 313000, Zhejiang, China
| | - Ji-Kang Min
- Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center in Northern Zhejiang, Huzhou 313000, Zhejiang, China
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Fang SY, Dai JL, Min JK, Zhang WL. Analysis of risk factors related to the re-fracture of adjacent vertebral body after PKP. Eur J Med Res 2021; 26:127. [PMID: 34717767 PMCID: PMC8556983 DOI: 10.1186/s40001-021-00592-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 09/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aims to investigate the risk factors of vertebral re-fracture after percutaneous kyphoplasty (PKP) for osteoporosis vertebral compression fracture (OVCF), and to provide reference for clinical prevention. MATERIAL AND METHODS A retrospective analysis was performed on 228 OVCF patients admitted on November 6, 2013, solstice, December 14, 2018, which met the inclusion criteria. There were 35 males and 193 females, with a male-to-female ratio of 3:20, and an age of 61-89 years. All patients were treated with PKP surgery with complete clinical data, and the rate of re-fracture was calculated according to whether re-fracture occurred after surgery, divided into the re-fracture group (24 cases) and the non-refracture group (204 cases). May be associated with subsequent fracture factors (gender, age, number of surgical segment vertebral body, whether with degenerative scoliosis, whether to fight osteoporosis) into a single-factor research, then the single-factor analysis was statistically significant risk factors for multiple logistic regression analysis, further defined after PKP holds the vertebral body fracture independent risk factors. Survival analysis was performed using the time of vertebral re-fracture after PKP as the end time of follow-up, the occurrence of re-fracture after PKP as the endpoint event, and the presence or absence of degenerative lateral curvature as a variable factor. RESULTS All 228 vertebroplasty patients were followed up for a period of 1.8 to 63.6 months. The mean follow-up time was (28.8 ± 15.6) months, and the re-fracture rate was 10.5%. There were statistically significant differences between the re-fracture group and the non-refracture group in age, number of operative vertebral bodies, whether there was a combination of degenerative scoliosis and whether there was anti-osteoporosis treatment (P < 0.05). The results of univariate logistic regression analysis after excluding the mutual influence of various factors showed that the number of vertebral bodies and the group with lateral curvature might be the risk factors for PKP re-fracture after surgery. The above possible risk factors were included in multiple logistic regression analysis to show whether there were independent risk factors for scoliosis and vertebral re-fracture. Survival analysis showed that the mean survival time was 42.1 months, the P value was 0.00, and the mean 95% confidence interval was (34.4-49.7 months), indicating that the combination of degenerative lateral bending might be related to the occurrence of re-fracture. CONCLUSIONS Combined scoliosis is an independent risk factor for re-fracture after OVCF laminoplasty and a possible risk factor for re-fracture after surgery.
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Affiliation(s)
- Shen-Yun Fang
- Orthopedics Department, The First People Hospital of Huzhou, The First People's Hospital Affiliated to Huzhou Normal University, Huzhou, 313000, China
| | - Ji-Lin Dai
- Orthopedics Department, The First People Hospital of Huzhou, The First People's Hospital Affiliated to Huzhou Normal University, Huzhou, 313000, China
| | - Ji-Kang Min
- Orthopedics Department, The First People Hospital of Huzhou, The First People's Hospital Affiliated to Huzhou Normal University, Huzhou, 313000, China.
| | - Wei-Li Zhang
- Ophthalmology Department, The First People Hospital of Huzhou, The First People's Hospital Affiliated to Huzhou Normal University, Huzhou, 313000, China.
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Fang SY, Min JK, Zeng ZY, Zhang QH, Zhu T, Weng W, Zhang WL, Shen FY, Xia Y, Ding LY. [Analysis of related risk factors for the refracture of adjacent vertebral body after percutaneous kyphoplasty]. Zhongguo Gu Shang 2021; 34:705-9. [PMID: 34423612 DOI: 10.12200/j.issn.1003-0034.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate the risk factors of vertebral refracture after percutaneous kyphoplasty (PKP) for osteoprotic vertebral compression fractures (OVCFs), and to provide reference for clinical prevention. METHODS A retrospective analysis of 228 OVCFs patients who met the inclusion criteria admitted from November 6, 2013 to December 14, 2018. There were 35 males and 193 females, with a male-to-female ratio of 3∶20, and aged 58 to 91 years with an average of (69.70±7.03) years. All patients were treated with PKP and had complete clinical data. According to whether refracture occurred after operation, they were divided into refracture group (24 cases) and non refracture group (204 cases). Factors that may be related to refracture (including gender, age, surgical segment, number of vertebral bodies in the surgical segment, whether combined with degenerative scoliosis, whether anti-osteoporosis treatment) were included in the univariate analyses, and the single factor analysis of statistically significant risk factors was carried out with multiple Logistic regression analysis to further clarify the independent risk factors for vertebral body refracture after PKP. Survival analysis was performed using the time of vertebral refracture after PKP as the end time of follow up, the occurrence of refracture after PKP as the endpoint event, and the presence or absence of degenerative lateral curvature as a variable factor. RESULTS All 228 patients were followed up for 1.8 to 63.6 months with an average of (28.8±15.6) months, and the refracture rate was 10.5%(24/228). There were statistically significant differences between two groups in age, number of operative vertebral bodies, whether combinedwith degenerative scoliosis and whether anti osteoporosis treatment (P<0.05). Univariate Logistic regression analysis showed that the number of vertebral bodies in the surgical segment and whether combined with degenerative scoliosis may be risk factors for refracture after PKP. Multiple Logistic regression analysis of the above possible risk factors showed that combined scoliosis was an independent risk factor for vertebral refracture of the vertebral body. Survival analysis showed that the mean survival time was 42.1 months, the P value was 0.00, and the mean 95% confidence interval was 34.4-49.7 months, indicating that the combination of degenerative lateral bending might be related to the occurrence of refracture. CONCLUSION Combined scoliosis is an independent risk factor for refracture after OVCFs vertebroplasty, and it is also a possible high-risk factor for refracture after surgery.
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Affiliation(s)
- Shen-Yun Fang
- Orthopedics Center of Huzhou First People's Hospital, Huzhou 313000, Zhejiang, China
| | - Ji-Kang Min
- Orthopedics Center of Huzhou First People's Hospital, Huzhou 313000, Zhejiang, China
| | - Zhong-You Zeng
- Orthopedics Center of Huzhou First People's Hospital, Huzhou 313000, Zhejiang, China
| | - Qiang-Hua Zhang
- Orthopedics Center of Huzhou First People's Hospital, Huzhou 313000, Zhejiang, China
| | - Tao Zhu
- Orthopedics Center of Huzhou First People's Hospital, Huzhou 313000, Zhejiang, China
| | - Wei Weng
- Orthopedics Center of Huzhou First People's Hospital, Huzhou 313000, Zhejiang, China
| | - Wei-Li Zhang
- Orthopedics Center of Huzhou First People's Hospital, Huzhou 313000, Zhejiang, China
| | - Fang-Ying Shen
- Orthopedics Center of Huzhou First People's Hospital, Huzhou 313000, Zhejiang, China
| | - Ying Xia
- Orthopedics Center of Huzhou First People's Hospital, Huzhou 313000, Zhejiang, China
| | - Li-Ying Ding
- Orthopedics Center of Huzhou First People's Hospital, Huzhou 313000, Zhejiang, China
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Deng MJ, Sun ZG, Weng W, Yang HH, Zhang ZF, Min JK. [Value of quantitative CT in vertebroplasty for osteoporotic fracture combined with scoliosis]. Zhongguo Gu Shang 2021; 34:1077-1082. [PMID: 34812028 DOI: 10.12200/j.issn.1003-0034.2021.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To investigate the value of lumbar quantitative CT (QCT) in vertebroplasty for osteoporotic fracture combined with scoliosis. METHODS The clinical data of 60 patients with osteoporotic fractures combined with different degrees of scoliosis treated by vertebroplasty from December 2017 to December 2019 were retrospectively analyzed. There were 18 males and 42 females, aged from 65 to 81 (72.63±3.34)years old. All patients were received QCT examination before surgery. According to the QCT value, the patients were divided into osteopenia group(QCT>80 g/L, 10 cases, 12 vertebrae), osteoporosis group(QCT 40-80 g/L, 35 cases, 48 vertebrae) and severe osteoporosis group(QCT<40 g/L, 15 cases, 22 vertebrae). The dispersion and leakage of bone cement in the injured vertebrae of patients with different degrees of QCT value were observed, and the QCT value in the selection of puncture point, correction of Cobb angle and recovery of vertebral height were analyzed in the patients. RESULTS Among 60 cases of 82 vertebrae, 41 cases of 55 vertebrae were punctured by concave unilateral puncture, according for 67.07%. Among them, there were 2 cases with 2 vertebrae in osteopenia group, 26 cases with 35 vertebrae in osteoporosis group, and 13 cases with 18 vertebrae in severe osteoporosis group. There was significant difference in the number of cases with unilateral or bilateral puncture among the three groups (χ2=13.699, P=0.001); there was no significant difference in the number of cases with bone cement leakage among the three groups (χ2=1.403, P=0.496). The Cobb angle of scoliosis was significantly differentbetween preoperative and postoperative follow-up(P<0.05);the height of injured vertebral body was significantly different between preoperative and postoperative follow-up (P<0.05). CONCLUSION For patients with osteoporotic fracture combined with scoliosis undergoing vertebroplasty, the severity of osteoporosis should be determined according to lumbar QCT detection, and the concave side of scoliosis should be selected for puncture, which is conducive to improving scoliosis, restoring spinal stability and improving surgical safety.
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Affiliation(s)
- Min-Jun Deng
- Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center of Northern Zhejiang, the First Affiliated Hospital of Huzhou Normal University, Huzhou 313000, Zhejiang, China
| | - Zhen-Guo Sun
- Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center of Northern Zhejiang, the First Affiliated Hospital of Huzhou Normal University, Huzhou 313000, Zhejiang, China
| | - Wei Weng
- Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center of Northern Zhejiang, the First Affiliated Hospital of Huzhou Normal University, Huzhou 313000, Zhejiang, China
| | - Hong-Hang Yang
- Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center of Northern Zhejiang, the First Affiliated Hospital of Huzhou Normal University, Huzhou 313000, Zhejiang, China
| | - Zhan-Feng Zhang
- Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center of Northern Zhejiang, the First Affiliated Hospital of Huzhou Normal University, Huzhou 313000, Zhejiang, China
| | - Ji-Kang Min
- Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center of Northern Zhejiang, the First Affiliated Hospital of Huzhou Normal University, Huzhou 313000, Zhejiang, China
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11
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Sun ZG, Weng W, Yang HH, Zhang ZF, Min JK. [Effect of double plate technique combined with autogenous iliac bone graft in the treatment of femoral nonunion after intramedullary nailing]. Zhongguo Gu Shang 2021; 34:288-92. [PMID: 33787177 DOI: 10.12200/j.issn.1003-0034.2021.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate the clinical effect of double plate combined with iliac bone graft in the treatment of femoral nonunion after intramedullary nailing. METHODS From December 2008 to December 2017, double plate combined with autogenous iliac bone graft was used to treat femoral nonunion after intramedullary nailing. There were 11 cases, including 10 males and 1 female, aged 35 to 62 years, and the time from fracture to nonunion was 12 to 20 months. According to Judet classification, there were 8 cases of atrophic nonunion and 3 cases of proliferative nonunion. Regular follow-up was conducted after operation to record the fracture healing time, load-bearing activity time and complications, and to observe the repair effect of double plate fixation combined with iliac bone graft on nonunion after femoral shaft fracture operation. RESULTS All patients were followed up for 12 to 22 months. The operation time was 70 to 130 min and the blood loss was 180 to 350 ml. After operation, 2 cases had knee stiffness, which recovered after passive exercise with CPM machine for 2 weeks;1 case had pain in iliac bone donor area, which was relieved after 3 months. The time of fracture healing was 24 to 40 weeks, and the time of complete weight-bearing activity was 14 to 32 weeks. SF-36 quality of life score at the final follow-up:body pain 70 to 82, activty 70 to 82, social function 72 to 83, the overall health 72 to 82. At the end of the follow-up, there were no complications such as limb shortening, infection, poor wound healing, internal fixation failure (fracture, loosening). CONCLUSION It is an effective method to treat nonunion of femur after intramedullary nailing by using double plate combined with autogenous iliac bone graft.
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Affiliation(s)
- Zhen-Guo Sun
- Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center in Northern Zhejiang, the First Affiliated Hospital of Huzhou Normal University, Huzhou 313000, Zhejiang, China
| | - Wei Weng
- Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center in Northern Zhejiang, the First Affiliated Hospital of Huzhou Normal University, Huzhou 313000, Zhejiang, China
| | - Hong-Hang Yang
- Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center in Northern Zhejiang, the First Affiliated Hospital of Huzhou Normal University, Huzhou 313000, Zhejiang, China
| | - Zhan-Feng Zhang
- Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center in Northern Zhejiang, the First Affiliated Hospital of Huzhou Normal University, Huzhou 313000, Zhejiang, China
| | - Ji-Kang Min
- Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center in Northern Zhejiang, the First Affiliated Hospital of Huzhou Normal University, Huzhou 313000, Zhejiang, China
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Van Diemen PA, Bom MJ, Driessen RS, Everaars H, De Winter RW, Van De Ven PM, Freiman M, Goshen L, Langzam E, Min JK, Leipsic JA, Raijmakers PG, Van Rossum AC, Danad I, Knaapen P. Pericoronary adipose tissue attenuation leads to improved prognostication beyond atherosclerotic burden and high-risk plaques in patients with suspected coronary artery disease. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Inflammation is a key component in the atherosclerotic process, initiating and sustaining plaques and serving as a trigger for plaque rupture leading to myocardial infarction. Coronary computed tomography angiography (CCTA) derived pericoronary adipose tissue attenuation (PCATa) has been proposed as surrogate marker for coronary inflammation and might improve risk assessment on top of CCTA derived cardiovascular risk-factors: atherosclerotic burden and plaque vulnerability.
Purpose
To assess the prognostic value of PCATa beyond atherosclerotic burden and high-risk plaques (HRPs).
Methods
A total of 543 patients who underwent CCTA because of suspected CAD were included. CCTA assessment comprised coronary artery calcium score (CACS), presence of obstructive CAD (≥50% stenosis) and HRPs, total plaque volume (TPV), non-calcified plaque volume (NCPV), and PCATa. The endpoint was a composite of death and non-fatal myocardial infarction (MI). Prognostic thresholds were determined for quantitative CCTA variables.
Results
During a median follow-up of 6.6 [interquartile range: 4.7-7.8] years, the endpoint was observed in 42 (20 MI/22 death) patients. CACS >83, obstructive CAD, HRPs, TPV >269mm3, and NCPV >83mm3 were associated with shorter time to the endpoint with unadujsted hazard ratio’s (HR) of 5.37 (95% confidence interval (CI): 2.56-11.29), 5.70 (95% CI: 2.40-13.55), 3.31 (95% CI: 1.80-6.07), 7.76 (95% CI: 3.59-16.81), and 6.77 (95% CI: 3.24-14.16), respectively (p < 0.001 for all). PCATa of the RCA >-74.4 Hounsfield units was associated with worse prognosis (unadjusted HR: 1.99, 95% CI: 1.04-3.79, p = 0.037), whereas PCATa of the LAD and Cx were not associated with prognosis. PCATa of the RCA remained a significant predictor of death and non-fatal MI corrected for CCTA variables and clincal chacteristics associated with the endpoint (adjusted HR: 2.11, 95% CI: 1.11-4.04, p = 0.024).
Conclusion
Coronary inflammation determined by PCATa of the RCA provides incremental prognostic value beyond clinical characteristics and comprehensive CCTA assessment.
Abstract Figure. Take-home figure
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Affiliation(s)
- PA Van Diemen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Cardiology, Amsterdam, Netherlands (The)
| | - MJ Bom
- Amsterdam UMC, Vrije Universiteit Amsterdam, Cardiology, Amsterdam, Netherlands (The)
| | - RS Driessen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Cardiology, Amsterdam, Netherlands (The)
| | - H Everaars
- Amsterdam UMC, Vrije Universiteit Amsterdam, Cardiology, Amsterdam, Netherlands (The)
| | - RW De Winter
- Amsterdam UMC, Vrije Universiteit Amsterdam, Cardiology, Amsterdam, Netherlands (The)
| | - PM Van De Ven
- Amsterdam UMC, Vrije Universiteit Amsterdam, Cardiology, Amsterdam, Netherlands (The)
| | - M Freiman
- Philips Healthcare, Best, Netherlands (The)
| | - L Goshen
- Philips Healthcare, Best, Netherlands (The)
| | - E Langzam
- Philips Healthcare, Best, Netherlands (The)
| | - JK Min
- Weill Cornell Medical College, Institute of Cardiovascular Imaging, New York, United States of America
| | - JA Leipsic
- University of British Columbia, Medicine and Radiology, Vancouver, Canada
| | - PG Raijmakers
- Amsterdam UMC, Vrije Universiteit Amsterdam, Nuclear Medicine, Amsterdam, Netherlands (The)
| | - AC Van Rossum
- Amsterdam UMC, Vrije Universiteit Amsterdam, Cardiology, Amsterdam, Netherlands (The)
| | - I Danad
- Amsterdam UMC, Vrije Universiteit Amsterdam, Cardiology, Amsterdam, Netherlands (The)
| | - P Knaapen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Cardiology, Amsterdam, Netherlands (The)
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13
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Abstract
To analyze magnetic resonance imaging features of nodular fasciitis and redefine the system for classifying this class of lesions.Twenty-seven patients with nodular fasciitis and 71 patients with other soft tissue lesions who underwent surgery or biopsy were retrospectively analysed. Demographic information, medical history, and magnetic resonance imaging features were collected. Classification of nodular fasciitis was performed based on a redefined system. Comparison between 2 groups was performed with Chi-square or Fisher exact test.For nodular fasciitis, the longest average lesion diameter was 1.87 cm (range, 0.52-5.46 cm), and 40.7% of lesions were located in the upper extremities, while 29.6% were located in the head and neck. Compared with skeletal muscle, most lesions exhibited isointensity on T1-weighted imaging and hyperintensity on T2-weighted imaging, and 45.5% of the lesions exhibited rim enhancement, 40.9% showed obvious homogenous enhancement, while 13.6% showed no enhancement or slight enhancement. The subcutaneous type accounted for 25.9% of cases, the fascial type 25.9%, the intramuscular type 29.6%, and the unclassified type 18.5%. The "fascia tail sign" was more frequently observed in nodular fasciitis than in other soft tissue lesions (P < .001). Nodular fasciitis was slightly more likely to present with the "inverted target sign" and "solar halo sign" than other soft tissue lesions (P > .05). The "cloud sign" only appeared in nodular fasciitis (P < .05).The "fascia tail sign" and "cloud sign" could help differentiate nodular fasciitis from other soft tissue lesions. A new classification may improve understanding about nodular fasciitis.
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Affiliation(s)
- Shi-Yong Wu
- Department of Radiology, The First Affiliated Hospital of Huzhou University, Huzhou
| | - Jin Zhao
- Department of Radiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou
| | - Hai-Yan Chen
- Department of Radiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou
| | - Miao-Miao Hu
- Department of Radiology, The First Affiliated Hospital of Huzhou University, Huzhou
| | - Yin-Yuan Zheng
- Department of Radiology, The First Affiliated Hospital of Huzhou University, Huzhou
| | - Ji-Kang Min
- Department of Orthopedics, The First Affiliated Hospital of Huzhou University, Huzhou, China
| | - Ri-Sheng Yu
- Department of Radiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou
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Deng MJ, Sun ZG, Min JK, Yang HH, Li H. [Medium-term efficacy of bio-lengthened stem arthroplasty in the treatment of unstable intertrochanteric femoral fractures in elderly patients]. Zhongguo Gu Shang 2020; 33:322-6. [PMID: 32351085 DOI: 10.12200/j.issn.1003-0034.2020.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To explore the clinical effect of bio lengthened stem arthroplasty replacement in the treatment of unstable intertrochanteric fractures in the elderly. METHODS From January 2015 to January 2018, 64 elderly patients with unstable intertrochanteric fractures were analyzed retrospectively. According to the surgical treatment, patients were divided into arthroplasty replacement group (bio-lengthened stem arthroplasty replacement) and internal fixation group (PFNA). In the arthroplasty group, there were 34 cases, including 19 males and 15 females, with an average age of (81.32±3.81) years old. The Evans classification of fracture was type Ⅲ in 15 cases, type Ⅳ in 16 cases and type Ⅴ in 3 cases. In the internal fixation group, there were 30 cases, including 14 males and 16 females, with an average age of (79.90±3.61) years old. The Evans classification of fracture was type Ⅲ in 10 cases, type Ⅳ in 15 cases and type V in 5 cases. X ray and CT showed unstable intertrochanteric fracture of femur. The operation time, intraoperative blood loss and complications were observed. Harris hip function score and SF-36 life quality score were used to evaluate the clinical effect. RESULTS All the incisions healed in stage Ⅰ. All patients were followed up for 13 to 39 months with an average of 23.4 months. The operation time and bleeding volume of the patients in the arthroplasty replacement group were more than those in the internal fixation group (P<0.05). At the final follow-up, Harris function score of hip joint in the arthroplasty group was better than that in the internal fixation group (P< 0.05);SF-36 life quality score in the arthroplasty group was better than that in the internal fixation group (P<0.05). CONCLUSION The treatmentof unstable intertrochanteric fractures with bio-lengthened stem arthroplasty replacement and internal fixation can achieve good clinical results, but with bio-lengthened stem arthroplasty replacement, the postoperative complications are less, the function of hip joint is better, and the life quality and satisfaction of patients are higher.
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Affiliation(s)
- Min-Jun Deng
- Department of Orthopaedics, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
| | - Zhen-Guo Sun
- Department of Orthopaedics, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
| | - Ji-Kang Min
- Department of Orthopaedics, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
| | - Hong-Hang Yang
- Department of Orthopaedics, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
| | - Heng Li
- Department of Orthopaedics, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
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15
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Sun ZG, Yang HH, Li H, Weng W, Min JK. [Guiding significance of lumbar quantitative computed tomography in percutaneous vertebroplasty for osteoporotic vertebral compression fractures]. Zhongguo Gu Shang 2020; 33:111-5. [PMID: 32133807 DOI: 10.12200/j.issn.1003-0034.2020.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate the guiding significance of lumbar quantitative computed tomography (QCT) in percutaneous vertebroplasty (PKP) for osteoporotic vertebral compression fractures (OVCF). METHODS The clinical data of 90 patients with OVCF underwent PKP from December 2017 to December 2018 were retrospectively analyzed. There were 24 femalesand66males, withanaverage agedof (74.47±6.60) yearsold. Allpatientswere received QCT examination before surgery, andaccording to the QCT value oflumbarspine, the patientswere dividedinto osteopenia decrease group (80 to 120 g/L, 17 cases, 30 vertebrae), osteoporosis group (40 to 80 g/L, 44 cases, 66 vertebrae) and severe osteoporosis group (<40 g/L, 29 cases, 39 vertebrae). Bone cement was injected into vertebral body, AP and lateral X-rays were done during operation. The diffusion and leakage of bone cement in injured vertebrae of patients with different QCT values were observed. Unilateral approach was used for patients whose bone cement diffused beyond the midline of the vertebral body, otherwise, and bilateral approach was adopted, and guiding significance of QCT in PKP for OVCF was analyzed. RESULTS In 90 cases of 135 vertebrae, 72 cases of 98 vertebral bone cement diffused beyond the midline, accounting for 72.59%. Unilateral approach was used for the 72 patients whose bone cement diffused beyond the midline of the vertebral body, among them, there were 5 cases with 8 vertebrae in osteopenia group, 40 cases with 55 vertebrae in osteoporosis group and 27 cases with 35 vertebrae in severe osteoporosis group. There was significant difference in the bone cement dispersion between three groups (χ2=41.397, P=0.000). Moreover, no bone cement leakage occurred in osteopenia group, 3 cases of 4 vertebrae occurred in osteoporosis group and 2 cases of 3 vertebrae in severe osteoporosis group. However, none of the patients with bone cement leakage caused nerve injury and other symptoms, and there was no significant difference in bone cement leakage between the three groups (χ2=2.242, P=0.326). CONCLUSION According to the QCT examination of lumbar spine, defining the degree of osteoporosis and guiding the puncture method can shorten the operation time, reduce the number of fluoroscopy, and effectively improve the safety of vertebroplasty.
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Affiliation(s)
- Zhen-Guo Sun
- Department of Orthopaedics, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
| | - Hong-Hang Yang
- Department of Orthopaedics, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
| | - Heng Li
- Department of Orthopaedics, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
| | - Wei Weng
- Department of Orthopaedics, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
| | - Ji-Kang Min
- Department of Orthopaedics, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
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van Diemen PA, Driessen RS, Stuijfzand WJ, Raijmakers PG, Schumacher SP, Bom MJ, Everaars H, Min JK, Leipsic JA, Knuuti J, Underwood SR, van de Ven PM, van Rossum AC, Danad I, Knaapen P. Data on the impact of scan quality on the diagnostic performance of CCTA, SPECT, and PET for diagnosing myocardial ischemia defined by fractional flow reserve on a per vessel level. Data Brief 2019; 27:104584. [PMID: 31687432 PMCID: PMC6820078 DOI: 10.1016/j.dib.2019.104584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 09/09/2019] [Accepted: 09/23/2019] [Indexed: 11/30/2022] Open
Abstract
Scan quality directly impacts the diagnostic performance of non-invasive imaging modalities as reported in a substudy of the PACIFC-trial: “Impact of Scan Quality on the Diagnostic Performance of CCTA, SPECT, and PET for Diagnosing Myocardial Ischemia Defined by Fractional Flow Reserve” [1]. This Data-in-Brief paper supplements the hereinabove mentioned article by presenting the diagnostic performance of CCTA, SPECT, and PET on a per vessel level for the detection of hemodynamic significant coronary artery disease (CAD) when stratified according to scan quality and vascular territory.
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Affiliation(s)
- P A van Diemen
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - R S Driessen
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - W J Stuijfzand
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - P G Raijmakers
- Department of Radiology, Nuclear Medicine & PET Research, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - S P Schumacher
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - M J Bom
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - H Everaars
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - J K Min
- Institute for Cardiovascular Imaging, Weill-Cornell Medical College, New York-Presbyterian Hospital, New York, United States of America
| | - J A Leipsic
- Department of Medicine and Radiology, University of British Columbia, Vancouver, Canada
| | - J Knuuti
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - S R Underwood
- Department of Nuclear Medicine, Royal Brompton Hospital, London, United Kingdom
| | - P M van de Ven
- Department of Epidemiology & Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - A C van Rossum
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - I Danad
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - P Knaapen
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Van Diemen PAA, Driessen RS, Kooistra RA, Stuijfzand WJ, Raijmakers PG, Schumacher SP, Bom MJ, Everaars H, Min JK, Leipsic JA, Knuuti J, Underwood SR, Van Rossum AC, Danad I, Knaapen P. 1268A comparison between the diagnostic performance of quantitative flow ratio and non-invasive imaging modalities for diagnosing myocardial ischemia defined by FFR, a PACIFIC-trial interim analysis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Quantitative flow ratio (QFR) uses fast computational algorithms based on 3-dimensional quantitative coronary angiography and estimation of contrast flow velocity during invasive coronary angiography (ICA) to obtain QFR values equivalent to fractional flow reserve (FFR).
Objective
To compare the diagnostic performance of QFR with coronary computed tomography angiography (CCTA), single-photon emission tomography (SPECT), and positron emission tomography (PET) for diagnosing myocardial ischemia defined by FFR.
Method
QFR computation was attempted in 109 patients (286 vessels without a subtotal/total lesion) of the 208 patients included in the PACIFIC-trial. Patients underwent 256-slice CCTA, Tetrofosmin SPECT, and [15O]H2O PET prior to ICA in conjunction with 3 vessel FFR measurements. ICA images were obtained without the use of a dedicated QFR acquistion protocol. QFR was calculated using a fixed empiric hyperemic flow velocity (fQFR) as well as using a patient specific flow velocity based on contrast passage through the coronary (cQFR). All analysis were performed on a per vessel level.
Results
Fixed QFR computation succeeded in 152 (53%) vessels while cQFR analysis was successful in 140 (49%) vessels. A good correlation between FFR and fQFR/cQFR was observed (R=0.774, p<0.001/R=0.790, p<0.001). The diagnostic performance in terms of sensitivity, specificity, negative predictive value, positive predictive value, and accuracy is presented in table 1. In total, 133 vessels with matched FFR, fQFR, cQFR, CCTA, SPECT, and PET results were available for the comparative C-statistic analysis, figure 1. The diagnostic performance of fQFR and cQFR was comparable (p=0.451) and superior to CCTA (p=0.004/p=0.003), SPECT (p<0.001/p<0.001), and PET (p=0.008/p=0.006), figure 1. CCTA, and PET performed alike (p=0.568) and outperformed SPECT (p=0.023, p=0.002).
Table 1 % (95% Confidence Interval) fQFR n=152 cQFR (n=140) CCTA (n=152) SPECT (n=150) PET (n=149) Sensitivity 76 (59–89) 71 (53–86) 70 (51–84) 30 (16–49) 76 (58–89) Specificity 94 (88–98) 93 (86–97) 73 (64–81) 96 (90–99) 80 (72–87) Negative Predictive Value 93 (88–96) 92 (86–95) 90 (84–94) 83 (79–86) 92 (86–96) Positive Predictive Value 79 (64–89) 74 (59–85) 42 (33–51) 67 (42–84) 52 (42–62) Accuracy 90 (84–94) 88 (81–93) 72 (65–79) 81 (74–87) 79 (72–85)
Figure 1.
Conclusion
Fixed QFR and cQFR correlate well with FFR with a high diagnostic accuracy as result. QFR outperformed CCTA, SPECT, and PET for the diagnosis of myocardial ischemia on a per vessel basis with the important footnote that fQFR and cQFR could only be computed in 53%, and 49% of the vessels.
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Affiliation(s)
- P A A Van Diemen
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
| | - R S Driessen
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
| | - R A Kooistra
- Medis Medical Imaging Systems, Leiden, Netherlands (The)
| | - W J Stuijfzand
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
| | - P G Raijmakers
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
| | - S P Schumacher
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
| | - M J Bom
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
| | - H Everaars
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
| | - J K Min
- Weill Cornell Medical College, Cardiovascular Imaging, New York, United States of America
| | - J A Leipsic
- University of British Columbia, Medicine and Radiology, Vancouver, Canada
| | - J Knuuti
- Turku University Hospital, PET centre, Turku, Finland
| | - S R Underwood
- Royal Brompton Hospital, Nuclear Medicine, London, United Kingdom
| | - A C Van Rossum
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
| | - I Danad
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
| | - P Knaapen
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
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18
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Van Diemen PA, Schumacher SP, Bom MJ, Driessen RS, Everaars H, Stuijfzand WJ, Raijmakers PG, Van De Ven PM, Min JK, Leipsic JA, Knuuti J, Boellaard PR, Van Rossum AC, Danad I, Knaapen P. P6181The association of coronary lumen volume to left ventricle mass ratio with myocardial blood flow and fractional flow reserve. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
A low coronary lumen volume to left ventricle mass ratio (V/M) derived from coronary computed tomography angiography (CCTA) has been proposed as a factor contributing to impaired myocardial blood flow (MBF) even in the absence of obstructive coronary artery disease (CAD).
Objective
To elucidate the association of V/M with non-invasively obtained MBF parameters by means of [15O]H2O positron emission tomography (PET), as well as its correlations with invasively measured fractional flow reserve (FFR), overall and specifically in vessel with non-obstructive CAD.
Methods
This is a substudy of the PACIFIC trial, in which 208 patients underwent CCTA, and [15O]H2O PET prior to invasive coronary angiography (ICA) in conjunction with 3 vessel FFR measurements. Patient specific V/M was calculated for 152 patients. Matched vessel specific hyperemic MBF (hMBF), coronary flow reserve (CFR), FFR, and patient specific V/M were available for 431 vessels. The median V/M (20.71 mm3/g) was used to divide the study population into a group with a low V/M (<20.71 mm3/g) and a high V/M (≥20.71 mm3/g). Non-obstructive CAD was defined as a ≤50% stenosis grade on ICA.
Results
Overall, a higher percentage of vessels with an abnormal hMBF (34% vs. 19%, p=0.009), lower FFR values (0.93 [interquartile range: 0.85–0.97] vs. 0.95 [0.89–0.98], p=0.016), and a higher number of positive FFR values (20% vs. 9%, p=0.004) were observed among vessels in the low V/M group. Furthermore, a weak correlation between V/M, global hMBF (R=0.179, p=0.027), and global CFR (R=0.163, p=0.045) as well as a weak significant association with vessel specific hMBF (p=0.027), and FFR (p<0.001) was observed (figure 1). V/M was not independently predictive of vessels specific MBF parameters or FFR. Among vessels with non-obstructive CAD (361 vessels), an abnormal hMBF tended to be more frequently observed in vessels with a low patient specific V/M (21% vs. 13%, p=0.056). Globally, there was no correlation between V/M and hMBF nor CFR. Patient specific V/M tended to be weakly associated with vessel specific hMBF (p=0.083) and was associated with FFR (p=0.027) (figure 1). Lastly, patient specific V/M tended to be independently predictive of FFR in this specific group.
Conclusion
Overall, vessels with an abnormal hMBF, and positive FFR measurements were more frequently observed in patients with a low V/M compared to those with a high V/M. Furthermore, V/M weakly correlated with global hMBF as well as with CFR and was associated with vessel specific hMBF and FFR. However, there was no correlation between V/M and global nor vessel specific blood flow parameters in the absence of obstructive CAD, notwithstanding a weak association of V/M with FFR within this group was noted.
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Affiliation(s)
- P A Van Diemen
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
| | - S P Schumacher
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
| | - M J Bom
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
| | - R S Driessen
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
| | - H Everaars
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
| | - W J Stuijfzand
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
| | - P G Raijmakers
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
| | - P M Van De Ven
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
| | - J K Min
- Weill Cornell Medical College, Cardiovascular Imaging, New York, United States of America
| | - J A Leipsic
- University of British Columbia, Medicine and Radiology, Vancouver, Canada
| | - J Knuuti
- Turku University Hospital, PET centre, Turku, Finland
| | - P R Boellaard
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
| | - A C Van Rossum
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
| | - I Danad
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
| | - P Knaapen
- Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands (The)
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19
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Gianni U, Van Rosendael AR, Van Den Hoogen IJ, Al Hussein Alawamlh O, Stuijfzand W, Al'aref SJ, Pena JM, Lu Y, Chang HJ, Berman DS, Shaw LJ, Min JK, Lin FY. P861A quantitative CCTA evaluation in non-obstructive coronary artery disease for the diagnosis of vessel-specific ischemia: results from the prospective, multicenter, international CREDENCE trial. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Aim
To improve the diagnosis of coronary vessel-specific ischemia in non-obstructive coronary artery disease (CAD) using a quantitative whole-heart coronary computed tomography angiography (CCTA) evaluation. To date, predictors of ischemia in non-obstructive CAD remain underexplored.
Methods
Within the CREDENCE trial, 612 patients with suspected CAD at 13 sites (64±10 years, 70% men) underwent coronary computed tomography angiography (CCTA) and invasive coronary angiography with 3-vessel fractional flow reserve (FFR) measurements. For this specific analysis, only vessels with non-obstructive plaque (1–49% maximal diameter stenosis) by CCTA were included. The primary endpoint was coronary vessel-specific ischemia which was defined as FFR ≤0.80 (or ≥90% stenosis). Multivariable logistic regression modeling was performed to evaluate the effect of quantitative CCTA features beyond coronary stenosis on the prevalence of vessel-specific ischemia.
Results
FFR ≤0.80 (or ≥90% stenosis) was prevalent in 22.8% of 1,102 vessels with non-obstructive plaque. Using a step-wise approach, in addition to diameter stenosis (χ2=72), non-calcified PAV (χ2=126, P<0.001), lumen volume (χ2=175, P<0.001) and number of lesions with >30% stenosis (χ2=187, P=0.001) were independent CCTA-predictors of coronary vessel-specific ischemia (Figure 1). In the final model, diameter stenosis was no longer significantly associated with ischemia (P=0.236).
Figure 1
Conclusion
In vessels with non-obstructive plaque on CCTA, ischemia was present in approximately 20%. Measures of overall non-calcified plaque burden and smaller lumen volume were more important determinants of vessel-specific ischemia than maximal diameter stenosis.
Acknowledgement/Funding
NIH R01-HLL118019; Dalio Foundation and Michael J. Wolk Foundation
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Affiliation(s)
- U Gianni
- Weill Cornell Medical College, New York, United States of America
| | | | | | | | - W Stuijfzand
- Weill Cornell Medical College, New York, United States of America
| | - S J Al'aref
- Weill Cornell Medical College, New York, United States of America
| | - J M Pena
- Weill Cornell Medical College, New York, United States of America
| | - Y Lu
- Weill Cornell Medical College, New York, United States of America
| | - H J Chang
- Severance Hospital, Cardiology, Seoul, Korea (Republic of)
| | - D S Berman
- Cedars-Sinai Medical Center, Imaging and Medicine, Los Angeles, United States of America
| | - L J Shaw
- Weill Cornell Medical College, New York, United States of America
| | - J K Min
- Weill Cornell Medical College, New York, United States of America
| | - F Y Lin
- Weill Cornell Medical College, New York, United States of America
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20
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Lee SE, Andreini D, Budoff MJ, Cademartiri F, Hadamitzky M, Marques H, Leipsic JA, Stone PH, Samady H, Narula J, Berman DS, Shaw LJ, Bax JJ, Min JK, Chang HJ. P6165Sex differences in compositional plaque volume progression in patients with stable coronary artery disease: observations from a serial CCTA registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
It is unclear whether sex impacts the plaque volume (PV) progression in patients with stable coronary artery disease (CAD).
Purpose
To explore whether the total and compositional PV progression rate differ according to sex.
Methods
We performed a prospective multinational registry of consecutive patients who underwent serial CCTA at ≥2-year interval. Total and compositional PV at baseline and follow-up were quantitatively analysed and normalized using the analysed total vessel length. Multivariate linear regression models were constructed for each women and men.
Results
Of the 1,255 patients included (median CT interval 3.8 years), 543 were women and 712 were men. Women were older (62±9 years vs. 59±9 years, p<0.001) and had higher total cholesterol level (195±41mg/dL vs. 187±39mg/dL, p=0.002). Prevalence of hypertension, diabetes, and family history of CAD were not different (all p>0.05).
At baseline, men possessed greater total PV (131.5±230.5mm3 vs. 97.7±193.6mm3, p=0.005) and a higher prevalence of high-risk plaques (HRP) than women (31% vs. 20%, p<0.001). Annual total PV progression rate was greater in men, driven by the greater non-calcified PV progression (TABLE).
In multivariate analysis (TABLE), although total PV progression rate was not different, women were associated with greater calcified PV progression (β=2.83, p=0.004) but slower non-calcified PV progression (β=-3.39, p=0.008) and less development of HRP (β=-0.18, p=0.049) than men.
CCTA findings according to sex Univariate analysis Female Sex in Multivariable Analysis Women (n=543) Men (n=712) P β SE P Agatston CACS, /year 0.44±0.7 0.4±0.7 0.332 0.106 0.04 0.006 Total PVnormalized, mm3/year 14.7±23.4 17.8±26.2 0.026 -0.56 1.33 0.677 Calcified PVnormalized, mm3/year 10.5±21.5 10.0±19.1 0.670 2.83 0.98 0.004 Non-calcified PVnormalized, mm3/year 4.2±17.3 7.8±21.2 0.001 -3.39 1.28 0.008 Development of high-risk plaque*, n (%) 86 (15.8) 139 (19.5) 0.092 -0.18 0.09 0.049 In linear multivariate regression analysis adjusted with age, race, HTN, DM, family history, smoking, LDL, statin, anti-platelets, beta-blockers, and PV at baseline, women were associated with greater calcified PV progression and slower non-calcified PV progression. (High-risk plaque was defined as ≥2 of low-attenuation plaque, spotty calcification, and positive remodelling.)
Conclusion
In this large CCTA cohort, we found that the compositional PV progression differs according to sex. These findings, which are hypothesis generating, suggest that comprehensive plaque evaluation may contribute to further refine risk stratification according to sex.
Acknowledgement/Funding
This work was supported by the National Research Foundation of Korea funded by the Ministry of Science and ICT (Grant No. 2012027176).
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Affiliation(s)
- S E Lee
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - D Andreini
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - M J Budoff
- University of California Los Angeles, Los Angeles, United States of America
| | | | | | | | | | - P H Stone
- Brigham and Womens Hospital, Boston, United States of America
| | - H Samady
- Emory University School of Medicine, Atlanta, United States of America
| | - J Narula
- Mount Sinai School of Medicine, New York, United States of America
| | - D S Berman
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - L J Shaw
- Weill Cornell Medical College, New York, United States of America
| | - J J Bax
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - J K Min
- Weill Cornell Medical College, New York, United States of America
| | - H J Chang
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
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21
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Bom MJ, Driessen RS, Van Diemen PA, Everaars H, Schumacher SP, Van Rossum AC, Raijmakers PG, Lammertsma AA, Knuuti J, Ahmadi A, Min JK, Leipsic JA, Narula J, Danad I, Knaapen P. 5962Incremental prognostic value of hybrid PET-CT assessed myocardial blood flow, coronary stenosis severity and adverse plaque characteristics. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Management of patients with suspected coronary artery disease (CAD) can be optimized with prognostic information derived from non-invasive imaging such as positron emission tomography (PET) perfusion imaging and coronary computed tomography angiography (CCTA). The aim of the present study was to determine the incremental prognostic value of combined functional testing using PET perfusion imaging and anatomical testing using CCTA-derived stenosis severity and morphological assessment of CCTA-derived plaque morphology.
Methods
In this retrospective study, 539 patients referred for hybrid [15O]H2O PET – CCTA imaging because of suspected CAD were investigated. PET perfusion imaging was used to determine hyperemic myocardial blood flow (MBF), whereas CCTA images were evaluated for obstructive stenosis and high-risk plaque morphology. Major adverse coronary events (MACE) included all-cause death, non-fatal myocardial infarction (MI), urgent revascularization and late non-urgent revascularization (i.e. not guided by initial diagnostic work-up with non-invasive imaging). Kaplan Meier analysis and Cox proportional hazard regression were used to evaluate the independent prognostic value of PET-derived MBF, CCTA-derived stenosis and CCTA-derived high-risk plaque.
Results
During a mean follow-up of 6.8 [4.8–7.9] years, 79 (14.7%) patients experienced MACE, including 23 (4.3%) deaths, 19 (3.5%) MIs, 8 (1.5%) urgent revascularizations and 29 (5.4%) late non-urgent revascularizations. Annualized event rates for normal vs. abnormal results of PET perfusion imaging, CCTA-derived stenosis and high-risk plaque morphology were 1.2% vs 4.1%, 0.6% vs 4.4%, and 1.7% vs 5.6%, respectively (p<0.001 for all). The combined use of these three imaging parameters resulted in excellent long-term risk prediction, with a MACE-free survival of 97% in patients with no positive imaging findings. In contrast, MACE-free survival was only 69% in patients in whom all imaging findings were positive (figure 1). Multivariate Cox proportional hazard regression demonstrated incremental prognostic value of PET perfusion imaging, CCTA-derived stenosis and CCTA-derived high-risk plaques for the occurrence of MACE (p<0.05 for all)
MACE-free survival stratified by PET-CT
Conclusion
PET-derived myocardial blood flow and CCTA-derived stenosis severity and high-risk plaque morphology are independent long-term predictors of adverse cardiac events and provide incremental prognostic value. Combined functional, anatomical and morphological assessment may allow for improved risk stratification in patients with suspected CAD.
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Affiliation(s)
- M J Bom
- Amsterdam UMC, location VU University Medical Center, Amsterdam, Netherlands (The)
| | - R S Driessen
- Amsterdam UMC, location VU University Medical Center, Amsterdam, Netherlands (The)
| | - P A Van Diemen
- Amsterdam UMC, location VU University Medical Center, Amsterdam, Netherlands (The)
| | - H Everaars
- Amsterdam UMC, location VU University Medical Center, Amsterdam, Netherlands (The)
| | - S P Schumacher
- Amsterdam UMC, location VU University Medical Center, Amsterdam, Netherlands (The)
| | - A C Van Rossum
- Amsterdam UMC, location VU University Medical Center, Amsterdam, Netherlands (The)
| | - P G Raijmakers
- Amsterdam UMC, location VU University Medical Center, Amsterdam, Netherlands (The)
| | - A A Lammertsma
- Amsterdam UMC, location VU University Medical Center, Amsterdam, Netherlands (The)
| | - J Knuuti
- Turku University Hospital, Turku, Finland
| | - A Ahmadi
- Icahn School of Medicine at Mount Sinai Hospital, New York, United States of America
| | - J K Min
- Weill Cornell Medical College, New York, United States of America
| | - J A Leipsic
- University of British Columbia, Vancouver, Canada
| | - J Narula
- Icahn School of Medicine at Mount Sinai Hospital, New York, United States of America
| | - I Danad
- Amsterdam UMC, location VU University Medical Center, Amsterdam, Netherlands (The)
| | - P Knaapen
- Amsterdam UMC, location VU University Medical Center, Amsterdam, Netherlands (The)
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22
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Lee SE, Pontone G, Gottlieb I, Hadamitzky M, Leipsic JA, Raff G, Stone PH, Samady H, Virmani R, Berman DS, Shaw LJ, Narula J, Bax JJ, Min JK, Chang HJ. P6162Difference in progression to obstructive lesions according to the presence of high-risk plaque features. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
It is still debatable whether the so-called high-risk plaque (HRP) simply represents a certain phase during the natural history of coronary atherosclerotic plaques or the disease progression would differ according to the presence of HRP.
Purpose
We determined whether the pattern of non-obstructive lesion progression into obstructive lesions would differ according to the presence of HRP.
Methods
Patients with non-obstructive coronary artery disease, defined as % diameter stenosis (%DS) ≥50%, were enrolled from a prospective, multinational registry of consecutive patients who underwent serial coronary computed tomography angiography at an inter-scan interval of ≥2 years. HRP was defined as lesions with ≥2 of positive remodelling, spotty calcification, and low-attenuation plaque. The total and compositional percent atheroma volume (PAV) at baseline and annualized PAV change were compared between non-HRP and HRP lesions.
Results
A total of 1,115 non-obstructive lesions were identified from 327 patients (61.1±8.9 years old, 66.0% male). There were 690 non-HRP and 425 HRP lesions. HRP lesions possessed greater PAV and %DS at baseline compared to non-HRP lesions. However, the annualized total and non-calcified PAV change were greater in non-HRP lesions than in HRP lesions. On multivariate analysis, addition of baseline PAV and %DS to clinical risk factors improved the predictive power of the model (Table). When clinical risk factors, PAV, %DS, and HRP were all adjusted on Model 3, only baseline PAV and %DS independently predicted the development of obstructive lesions (hazard ratio (HR) 1.046 [95% confidence interval (CI): 1.026–1.066] and HR 1.087 [95% CI: 1.055–1.119], respectively, all p<0.001), while HRP did not (p>0.05).
Comparison of C-statistics of per-lesion analysis to predict progression to obstructive lesion C-statistics (95% CI) P Model 1: Baseline PAV 0.880 (0.879–0.884) – Model 2: Model 1 + baseline %DS 0.938 (0.937–0.939) vs. Model 1: <0.001 Model 3: Model 2 + HRP 0.935 (0.934–0.937) vs. Model 2: 0.004 Adjusted for age, male sex, hypertension, diabetes mellitus, hyperlipidemia, family history of coronary artery disease, smoking, body mass index, and statin use.
Conclusion
The pattern of individual coronary atherosclerotic plaque progression differed according to the presence of HRP. Baseline PAV was the most important predictor for lesions developing into obstructive lesions rather than the presence of HRP features at baseline.
Acknowledgement/Funding
This work was supported by the National Research Foundation of Korea funded by the Ministry of Science and ICT (Grant No. 2012027176).
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Affiliation(s)
- S E Lee
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - G Pontone
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - I Gottlieb
- National Institute of Cardiology, Rio de Janeiro, Brazil
| | | | | | - G Raff
- William Beaumont Hospital, Royal Oak, United States of America
| | - P H Stone
- Brigham and Womens Hospital, Boston, United States of America
| | - H Samady
- Emory University School of Medicine, Atlanta, United States of America
| | - R Virmani
- CVPath Institute, Gaithersburg, United States of America
| | - D S Berman
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - L J Shaw
- Weill Cornell Medical College, New York, United States of America
| | - J Narula
- Mount Sinai School of Medicine, New York, United States of America
| | - J J Bax
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - J K Min
- Weill Cornell Medical College, New York, United States of America
| | - H J Chang
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
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23
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Won KB, Lee BK, Rizvi A, Hadamitzky M, Budoff MJ, Leipsic JA, Berman DS, Min JK, Chang HJ. P3380Longitudinal assessment of coronary atherosclerosis according to baseline and changes of serum hemoglobin level. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Little is known regarding the impact of serum hemoglobin level changes (Δ hemoglobin) on coronary plaque volume. This study evaluated the association between Δ hemoglobin and coronary plaque volume change (PVC) using serial coronary computed tomographic angiography (CCTA).
Methods
A total of 830 subjects (61±10 years, 51.9% male) who underwent serial CCTA with available hemoglobin levels were analyzed from the Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography IMaging (PARADIGM) registry. The median inter-scan period was 3.2 (2.5 to 4.4) years. Quantitative assessment of coronary plaques was performed at both scans. All participants were stratified into four groups based on the quartile of baseline hemoglobin levels. Annualized PVC was defined as total PVC divided by inter-scan period. Plaque progression (PP) was defined as plaque volume at follow-up minus plaque volume at index >0.
Results
Baseline total plaque volume (mm3) was not different among all groups (group I [lowest]: 34.1 (0.0–127.4) vs. group II: 28.8 (0.0–123.0) vs. group III: 49.9 (5.6–135.0) vs. group IV [highest]: 34.3 (0.0–130.7); p=0.235). During follow-up, Δ hemoglobin was related to annualized PVC (β:−0.114; p=0.001) and PP (odds ratio: 0.868; 95% confidence interval: 0.770–0.978; p=0.020). Multiple linear regression models showed that Δ hemoglobin significantly impacted on annualized PVC in only the composite of I and II groups.
Conclusion
Based on serial CCTA findings, Δ hemoglobin independently impacted on coronary PVC in individuals with low to normal baseline hemoglobin level.
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Affiliation(s)
- K.-B Won
- Ulsan University Hospital, Cardiology, Ulsan, Korea (Republic of)
| | - B K Lee
- Gangnam Severance Hospital, Cardiology, Seoul, Korea (Republic of)
| | - A Rizvi
- Ulsan University Hospital, Cardiology, Ulsan, Korea (Republic of)
| | | | - M J Budoff
- University of California Los Angeles, Los Angeles, United States of America
| | | | - D S Berman
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - J K Min
- Weill Cornell Medical College, New York, United States of America
| | - H.-J Chang
- Yonsei Cardiovascular Center, Cardiology, Seoul, Korea (Republic of)
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24
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Van Den Hoogen IJ, Lin FY, Van Rosendael AR, Gianni U, Al Hussein Alawamlh O, Lee SE, Berman DS, Shaw LJ, Bax JJ, Min JK, Chang HJ. P868Temporal remodeling of coronary arteries during progression of atherosclerosis with serial coronary CT angiography using 3D metrics: results from the PARADIGM study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Aim
To determine compensatory enlargement and luminal reduction of coronary arteries during the progression of atherosclerosis with serial coronary computed tomography angiography (CCTA) by using volumetric measurements. To date, the impact of coronary plaque progression on temporal remodeling, as opposed to the static remodeling, has only been studied with invasive imaging modalities and primarily two-dimensional areas rather than three-dimensional volumes.
Methods
In total, 1,245 patients with suspected coronary artery disease (CAD) at 13 sites (61±9 years, 39% women) underwent serial CCTA with interscan interval of ≥2 years. The primary objective was to assess volumetric temporal remodeling, defined as the linear association between the change in coronary plaque, lumen and vessel volume at follow-up CCTA on a per-segment level. Temporal remodeling was determined in strata of low and high baseline plaque burden as well as different coronary segments at baseline. Linear regression analysis and Pearson's correlation coefficients were calculated to assess associations.
Results
Amongst 1,245 patients with 19,920 segments, the median interscan interval was 3.3 (IQR 2.6–4.8) years. For each 1 mm3 increase in plaque volume, the increase in vessel volume was 0.72 mm3 and the decrease in lumen volume was 0.28 mm3 (Figure 1, both p<0.001). Volumetric temporal remodeling was similar in low versus high PAV [0.70 mm3 vs 0.73 mm3 (p for interaction=0.491)] and left-main arteries versus all other segments [0.78 mm3 vs. 0.72 mm3 (p for interaction=0.336)], but not in proximal versus distal segments at baseline [0.75 mm3 vs. 0.61 mm3 (p for interaction=0.020)].
Figure 1. Volumetric temporal remodeling
Conclusion
In general, coronary plaque grows approximately 70% outward and 30% into the coronary lumen during the progression of atherosclerosis. Volumetric temporal remodeling is not limited by baseline plaque burden, but is potentially dependent on its location within the coronary artery tree.
Acknowledgement/Funding
NRF of Korea (Grant No. 2012027176); Dalio Institute of Cardiovascular Imaging and Michael J. Wolk Foundation
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Affiliation(s)
| | - F Y Lin
- Weill Cornell Medical College, New York, United States of America
| | | | - U Gianni
- Weill Cornell Medical College, New York, United States of America
| | | | - S E Lee
- Severance Hospital, Cardiology, Seoul, Korea (Republic of)
| | - D S Berman
- Cedars-Sinai Medical Center, Imaging and Medicine, Los Angeles, United States of America
| | - L J Shaw
- Weill Cornell Medical College, New York, United States of America
| | - J J Bax
- Leiden University Medical Center, Cardiology, Leiden, Netherlands (The)
| | - J K Min
- Weill Cornell Medical College, New York, United States of America
| | - H J Chang
- Severance Hospital, Cardiology, Seoul, Korea (Republic of)
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25
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Van Rosendael AR, Lin FY, Gransar H, Van Den Hoogen IJ, Gianni U, Al Hussein Alawamlh O, Lu Y, Pena JM, Al'aref SJ, Berman DS, Min JK, Shaw LJ, Bax JJ. 4182Sex specific patterns in the onset and manifestation of coronary atherosclerotic plaque; insights from the multi-center CCTA CONFIRM registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Pathobiologic data support varied atherosclerotic plaque characteristics which uniquely define risk in women as compared to men (i.e., plaque erosion versus rupture). The advent of noninvasive coronary computed tomographic angiography (CCTA) allows for further exploration as to a sex-specific signature of atherosclerotic plaque features unique to women and different from that of men. In this analysis, we compared sex differences in the age of onset of coronary atherosclerosis and varied plaque findings between women and men.
Methods
From the multicenter CONFIRM registry, the Leiden CCTA score (based on segmental plaque extent, location, severity, and composition) was calculated in women and men without prior CAD, with imputation for missing plaque data. First, women and men were matched on the Leiden CCTA score to allow assessment of differences in atherosclerotic profile. Second, the earliest age of women and men to display a median Leiden CCTA score >0, >2, >6, >8 was evaluated. Third, the prognostic value of previously established thresholds of the Leiden CCTA score was examined for all-cause mortality with Cox-proportional hazard analysis, and specifically a sex interaction.
Results
In total, 11,678 women (age 58.5±12.4 years) and 13,272 men (age 55.6±12.5 years) were included. Of the patient subset matched on Leiden CCTA score (10,266 women, score 4.1±6.0 and 10,266 men, Leiden score 4.1±6.0, P=0.589), women were characterized by less obstructive CAD (≥50% stenosis) (17.5% vs 19.1%, P=0.003), more frequent non-obstructive left main plaque (10.1% vs 8.9%, P=0.004) and a lower number of segments with non-calcified or mixed plaque, but an equal number of calcified plaques. The earliest age when women and men have a median Leiden CCTA score above 0, 2, 4, 6, or 8 was consistently 14 to 16 years later for women. A visual representation of the CAD development delay is shown in Figure 1. Adjusted for age, the hazard ratio for death (827 events) for a score 6–20, and >20 (compared with 0–6) was 1.95 (95% CI 1.56–2.42), and 3.44 (95% CI 2.40–4.93) for women, respectively, and 1.63 (95% CI 1.31–2.03), 2.22 (95% CI 1.64–3.00) for men, respectively (P-interaction 0.006). Despite the low number of events, women <50 years with a score >20 were at 12.8 (95% CI 3.58–45.73) times increased risk.
Conclusion
There is an approximate 15-year delay in onset of coronary atherosclerosis for women compared to men. The burden of atherosclerotic plaque is associated with a higher relative hazard for death among women than men. The pattern of more nonobstructive CAD, especially in the left main coronary artery, but also less non-calcified plaque supports a sex-specific plaque signature which may uniquely define risk among women as compared to men.
Acknowledgement/Funding
The research reported in this manuscript was funded, in part, by the National Institute of Health (Bethesda, MD, USA) under award number R01 HL115150.
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Affiliation(s)
| | - F Y Lin
- Weill Cornell Medical College, New York, United States of America
| | - H Gransar
- Cedars-Sinai Medical Center, Imaging and Medicine, Los Angeles, United States of America
| | | | - U Gianni
- Weill Cornell Medical College, New York, United States of America
| | | | - Y Lu
- Weill Cornell Medical College, New York, United States of America
| | - J M Pena
- Weill Cornell Medical College, New York, United States of America
| | - S J Al'aref
- Weill Cornell Medical College, New York, United States of America
| | - D S Berman
- Cedars-Sinai Medical Center, Imaging and Medicine, Los Angeles, United States of America
| | - J K Min
- Weill Cornell Medical College, New York, United States of America
| | - L J Shaw
- Weill Cornell Medical College, New York, United States of America
| | - J J Bax
- Leiden University Medical Center, Leiden, Netherlands (The)
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Abstract
Objectives The aim of this study was to provide a comprehensive understanding of alterations in messenger RNAs (mRNAs), long noncoding RNAs (lncRNAs), and circular RNAs (circRNAs) in cartilage affected by osteoarthritis (OA). Methods The expression profiles of mRNAs, lncRNAs, and circRNAs in OA cartilage were assessed using whole-transcriptome sequencing. Bioinformatics analyses included prediction and reannotation of novel lncRNAs and circRNAs, their classification, and their placement into subgroups. Gene ontology and pathway analysis were performed to identify differentially expressed genes (DEGs), differentially expressed lncRNAs (DELs), and differentially expressed circRNAs (DECs). We focused on the overlap of DEGs and targets of DELs previously identified in seven high-throughput studies. The top ten DELs were verified by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) in articular chondrocytes, both in vitro and in vivo. Results In total, 739 mRNAs, 1152 lncRNAs, and 42 circRNAs were found to be differentially expressed in OA cartilage tissue. Among these, we identified 18 overlapping DEGs and targets of DELs, and the top ten DELs were screened by expression profile analysis as candidate OA-related genes. WISP2, ATF3, and CHI3L1 were significantly increased in both normal versus OA tissues and normal versus interleukin (IL)-1β-induced OA-like cell models, while ADAM12, PRELP, and ASPN were shown to be significantly decreased. Among the identified DELs, we observed higher expression of ENST00000453554 and MSTRG.99593.3, and lower expression of MSTRG.44186.2 and NONHSAT186094.1 in normal versus OA cells and tissues. Conclusion This study revealed expression patterns of coding and noncoding RNAs in OA cartilage, which added sets of genes and noncoding RNAs to the list of candidate diagnostic biomarkers and therapeutic agents for OA patients. Cite this article: H. Li, H. H. Yang, Z. G. Sun, H. B. Tang, J. K. Min. Whole-transcriptome sequencing of knee joint cartilage from osteoarthritis patients. Bone Joint Res 2019;8:290–303. DOI: 10.1302/2046-3758.87.BJR-2018-0297.R1.
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Affiliation(s)
- H Li
- Department of Orthopaedics, The First People's Hospital of Huzhou, The First Affiliated Hospital of Huzhou Teachers College, Huzhou, China
| | - H H Yang
- Department of Orthopaedics, The First People's Hospital of Huzhou, The First Affiliated Hospital of Huzhou Teachers College, Huzhou, China
| | - Z G Sun
- Department of Orthopaedics, The First People's Hospital of Huzhou, The First Affiliated Hospital of Huzhou Teachers College, Huzhou, China
| | - H B Tang
- Department of Orthopaedics, The First People's Hospital of Huzhou, The First Affiliated Hospital of Huzhou Teachers College, Huzhou, China
| | - J K Min
- Department of Orthopaedics, The First People's Hospital of Huzhou, The First Affiliated Hospital of Huzhou Teachers College, Huzhou, China
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Abstract
OBJECTIVE The present study was aimed to investigate the therapeutic potential of neuroglobin in the recovery of spinal cord injury. METHODS The male albino Wistar strain rats were used as an experimental model, and adeno associated virus (AAV) was administered in the T12 section of spinal cord ten days prior to the injury. Basso Beattie Bresnahan (BBB) locomotor rating scale was used to determine the recovery of the hind limb during four weeks post-operation. Malondialdehyde (MDA), catalase and superoxide dismutase (SOD) were determined in the spinal cord tissues. Terminal deoxynucleotidyl transferase (TdT) dUTP Nick-End Labeling (TUNEL) assay was carried out to determine the presence of apoptotic cells. Immunofluorescence analysis was carried out to determine the neuroglobin expression. Western blot analysis was carried out to determine the protein expressions of caspase-3, cytochrome c, bax and bcl-2 in the spinal cord tissues. RESULTS Experimental results showed that rats were recovered from the spinal cord injury due to increased neuroglobin expression. Lipid peroxidation was reduced, whereas catalase and SOD activity were increased in the spinal cord tissues. Apoptosis and lesions were significantly reduced in the spinal cord tissues. Caspase-3, cytochrome c and bax levels were significantly reduced, whereas bcl-2 expression was reduced in the spinal cord tissues. CONCLUSION Taking all these data together, it is suggested that the increased neuroglobin expression could improve the locomotor function.
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Affiliation(s)
- Ji-Lin Dai
- Department of Orthopaedic, Huzhou First People's Hospital of Zhejiang Province, Huzhou City313000, China
| | - Yun Lin
- Department of Editor, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu610072, China
| | - Yong-Jian Yuan
- Department of Orthopaedic, Huzhou First People's Hospital of Zhejiang Province, Huzhou City313000, China
| | - Shi-Tong Xing
- Department of Orthopaedic, Huzhou First People's Hospital of Zhejiang Province, Huzhou City313000, China
| | - Yi Xu
- Department of Orthopaedic, Huzhou First People's Hospital of Zhejiang Province, Huzhou City313000, China
| | - Qiang-Hua Zhang
- Department of Orthopaedic, Huzhou First People's Hospital of Zhejiang Province, Huzhou City313000, China
| | - Ji-Kang Min
- Department of Orthopaedic, Huzhou First People's Hospital of Zhejiang Province, Huzhou City313000, China,Correspondence to: Ji-Kang Min, Department of Orthopaedic, Huzhou First People’s Hospital of Zhejiang Province, No 158 Square posterior Road, Huzhou City 313000, China. Tel 0086-572-2039275,
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Jin ES, Kim JY, Min JK, Jeon SR, Choi KH, Lee MS, Jeong JH. Bilateral ovario-hysterectomy induced osteoporotic rabbit model. J BIOL REG HOMEOS AG 2019; 33:391-396. [PMID: 30915825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- E S Jin
- Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
- Laboratory of Stem Cell Therapy, College of Medicine, Asan Medical Center, University of Ulsan, Ulsan, Republic of Korea
| | - J Y Kim
- Laboratory of Stem Cell Therapy, College of Medicine, Asan Medical Center, University of Ulsan, Ulsan, Republic of Korea
| | - J K Min
- Laboratory of Stem Cell Therapy, College of Medicine, Asan Medical Center, University of Ulsan, Ulsan, Republic of Korea
| | - S R Jeon
- Laboratory of Stem Cell Therapy, College of Medicine, Asan Medical Center, University of Ulsan, Ulsan, Republic of Korea
- Department of Neurological surgery, Asan Medical Center, College of Medicine, University of Ulsan, Ulsan, Republic of Korea
| | - K H Choi
- Laboratory of Stem Cell Therapy, College of Medicine, Asan Medical Center, University of Ulsan, Ulsan, Republic of Korea
- Department of Rehabilitation Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Ulsan, Republic of Korea
| | - M S Lee
- OSTEONIC, Co., Ltd., Seoul, Republic of Korea
| | - J H Jeong
- Laboratory of Stem Cell Therapy, College of Medicine, Asan Medical Center, University of Ulsan, Ulsan, Republic of Korea
- Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Gyunggi-do, Republic of Korea
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Zhang ZF, Min JK, Zhong JM, Feng G, Li H, Zheng Q. [Modified Mclaughlin procedure combined with locking plate for posterior shoulder dislocation with fracture]. Zhongguo Gu Shang 2019; 32:33-37. [PMID: 30813665 DOI: 10.3969/j.issn.1003-0034.2019.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To study clinical effects of modified Mclaughlin procedure combined with locking plate for posterior shoulder dislocation with proximal humeral fracture which area of femoral head injury less than 40%. METHODS From July 2012 to June 2017, 7 patients with posterior shoulder dislocation were treated, including 5 males and 2 females; aged from 37 to 53 years old. Three patients combined with split of humerus head and 4 patients combined with humerus surgical neck fracture. All patients treated with modified Mclaughlin procedure combined with locking plate. Motion of shoulder joint after operation was observed, postoperative UCLA score was used to evaluate clinical effects. RESULTS Seven patients were followed up from 10 to 33 months. The motion of anteflexion and up-lift ranged from 130° to 170°, the motion of extorsion ranged from 45° to 75°, the motion of abduction ranged fron 105° to 150°, and the internal rotation was between L₃ to buttock. UCLA score ranged from 29 to 34; and 1 patient reached excellent, and 6 patients good. CONCLUSIONS The modified Mclaughlin procedure combined with locking plate showed satisfying result for posterior shoulder dislocation combined with fractures. However, the internal rotation of shoulder could be compromised.
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Affiliation(s)
| | - Ji-Kang Min
- Department of Orthopaedics, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China;
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Li HD, Zhang QH, Xing ST, Min JK, Shi JG, Chen XS. A novel revision surgery for treatment of cervical ossification of the posterior longitudinal ligament after initial posterior surgery: preliminary clinical investigation of anterior controllable antidisplacement and fusion. J Orthop Surg Res 2018; 13:215. [PMID: 30157879 PMCID: PMC6114058 DOI: 10.1186/s13018-018-0920-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 08/20/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cervical ossification of the posterior longitudinal ligament (OPLL) is a progressive disease. Posterior decompression surgery is reported to be an effective and comparatively safe procedure with few complications for treatment of patients with myelopathy caused by OPLL. However, some patients require revision surgery because of late neurological deterioration due to OPLL progression or kyphotic changes in cervical alignment. This study reports preliminary clinical results of anterior controllable antidisplacement and fusion (ACAF), a novel revision surgery after initial posterior surgery for OPLL. METHODS From January 2017 to June 2018, ten patients with cervical OPLL who underwent ACAF revision surgery after initial posterior surgery were included in this study. The mean age was 62.1 ± 8.0 years (52-78), and the mean interval between initial posterior surgery and revision was 78.0 ± 48.2 months (5-180). The Japanese Orthopaedic Association (JOA) scales, Neck Disability Index (NDI), visual analog scale (VAS), and surgical complications were recorded. RESULTS The mean surgery time was 179.3 ± 41.8 min (120-240), and the mean blood loss was 432.5 ± 198.3 ml (225-850). The patients were followed up for at least 12 months. The JOA scores improved from 8.7 ± 2.8 to 13.4 ± 2.4; the mean improvement rate was 59.9% ± 16.1%. Postoperative NDI and VAS scores were 13.3 ± 3.7 and 2.0 ± 1.6, respectively, and were significantly improved compared to those before the procedure (P < 0.05). Cervical lordosis improved from 3.8 ± 4.3° to 17 ± 4.6° after revision surgery. There was only one instance of cerebrospinal fluid (CSF) leakage; no instances of postoperative hematoma, C5 root palsy, or hoarseness occurred. CONCLUSIONS The present study demonstrates that excellent postoperative outcomes can be achieved with the ACAF technique for revision treatment of OPLL. Though further study is required to confirm the conclusion, this novel technique has the potential to serve as an alternative surgical technique for revision treatment of OPLL.
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Affiliation(s)
- Hai-Dong Li
- Department of Spine Surgery, First People's Hospital affiliated to the Huzhou University Medical College, 158# GuangChang Hou Road, Huzhou, Zhejiang Province, China.
| | - Qiang-Hua Zhang
- Department of Spine Surgery, First People's Hospital affiliated to the Huzhou University Medical College, 158# GuangChang Hou Road, Huzhou, Zhejiang Province, China
| | - Shi-Tong Xing
- Department of Spine Surgery, First People's Hospital affiliated to the Huzhou University Medical College, 158# GuangChang Hou Road, Huzhou, Zhejiang Province, China
| | - Ji-Kang Min
- Department of Spine Surgery, First People's Hospital affiliated to the Huzhou University Medical College, 158# GuangChang Hou Road, Huzhou, Zhejiang Province, China
| | - Jian-Gang Shi
- Department of Spine Surgery, Changzheng Hospital, 415# Fengyang Road, Huangpu District, Shanghai, China
| | - Xiong-Sheng Chen
- Department of Spine Surgery, Changzheng Hospital, 415# Fengyang Road, Huangpu District, Shanghai, China
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Driessen RS, Danad I, Stuijfzand WJ, Raijmakers PG, Min JK, Leipsic JA, Underwood SR, Van De Ven PM, Van Rossum AC, Van Royen N, Taylor CA, Knaapen P. 1185Head-to-head comparison of FFR-CT against coronary CT angiography and myocardial perfusion imaging for the diagnosis of ischaemia. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- R S Driessen
- VU University Medical Center, Cardiology, Amsterdam, Netherlands
| | - I Danad
- VU University Medical Center, Cardiology, Amsterdam, Netherlands
| | - W J Stuijfzand
- VU University Medical Center, Cardiology, Amsterdam, Netherlands
| | - P G Raijmakers
- VU University Medical Center, Radiology and Nuclear Medicine, Amsterdam, Netherlands
| | - J K Min
- Weill Cornell Medical College, Institute for Cardiovascular Imaging, New York, United States of America
| | - J A Leipsic
- University of British Columbia, Medicine and Radiology, Vancouver, Canada
| | - S R Underwood
- Royal Brompton Hospital, Nuclear Medicine, London, United Kingdom
| | - P M Van De Ven
- VU University Medical Center, Epidemiology and Biostatisctics, Amsterdam, Netherlands
| | - A C Van Rossum
- VU University Medical Center, Cardiology, Amsterdam, Netherlands
| | - N Van Royen
- VU University Medical Center, Cardiology, Amsterdam, Netherlands
| | - C A Taylor
- HeartFlow inc., Redwood City, United States of America
| | - P Knaapen
- VU University Medical Center, Cardiology, Amsterdam, Netherlands
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Driessen RS, Stuijfzand WJ, Raijmakers PG, Danad I, Min JK, Leipsic JA, Ahmadi A, Van De Ven PM, Van Rossum AC, Narula J, Knaapen P. P4200Vulnerable plaques are revealed by fractional flow reserve but not by instantaneous wave-free ratio. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- R S Driessen
- VU University Medical Center, Cardiology, Amsterdam, Netherlands
| | - W J Stuijfzand
- VU University Medical Center, Cardiology, Amsterdam, Netherlands
| | - P G Raijmakers
- VU University Medical Center, Radiology and Nuclear Medicine, Amsterdam, Netherlands
| | - I Danad
- VU University Medical Center, Cardiology, Amsterdam, Netherlands
| | - J K Min
- Weill Cornell Medical College, Institute for Cardiovascular Imaging, New York, United States of America
| | - J A Leipsic
- University of British Columbia, Medicine and Radiology, Vancouver, Canada
| | - A Ahmadi
- Mount Sinai School of Medicine, Cardiology, New York, United States of America
| | - P M Van De Ven
- VU University Medical Center, Epidemiology and Biostatistics, Amsterdam, Netherlands
| | - A C Van Rossum
- VU University Medical Center, Cardiology, Amsterdam, Netherlands
| | - J Narula
- Mount Sinai School of Medicine, Cardiology, New York, United States of America
| | - P Knaapen
- VU University Medical Center, Cardiology, Amsterdam, Netherlands
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Bom MJ, Levin E, Driessen RS, Danad I, Van Kuijk CC, Van Rossum AC, Van Royen N, Min JK, Leipsic JA, Taylor CA, Nieuwdorp M, Koenig W, Groen AK, Stroes ESG, Knaapen P. P822Predictive value of a biomarker panel for coronary plaque morphology in patients with stable coronary artery disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M J Bom
- VU University Medical Center, Cardiology, Amsterdam, Netherlands
| | - E Levin
- Academic Medical Center of Amsterdam, Vascular Medicine, Amsterdam, Netherlands
| | - R S Driessen
- VU University Medical Center, Cardiology, Amsterdam, Netherlands
| | - I Danad
- VU University Medical Center, Cardiology, Amsterdam, Netherlands
| | - C C Van Kuijk
- VU University Medical Center, Radiology & Nuclear Medicine, Amsterdam, Netherlands
| | - A C Van Rossum
- VU University Medical Center, Cardiology, Amsterdam, Netherlands
| | - N Van Royen
- VU University Medical Center, Cardiology, Amsterdam, Netherlands
| | - J K Min
- Weill Cornell Medical College, Institute for Cardiovascular Imaging, New York, United States of America
| | - J A Leipsic
- University of British Columbia, Medicine and Radiology, Vancouver, Canada
| | - C A Taylor
- HeartFlow Inc., Redwood City, United States of America
| | - M Nieuwdorp
- Academic Medical Center of Amsterdam, Vascular Medicine, Amsterdam, Netherlands
| | - W Koenig
- Deutsches Herzzentrum Technische Universitat, Munich, Germany
| | - A K Groen
- Academic Medical Center of Amsterdam, Vascular Medicine, Amsterdam, Netherlands
| | - E S G Stroes
- Academic Medical Center of Amsterdam, Vascular Medicine, Amsterdam, Netherlands
| | - P Knaapen
- VU University Medical Center, Cardiology, Amsterdam, Netherlands
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Lee SE, Hadamitzky M, Kim YJ, Pontone G, Budoff MJ, Gottlieb I, Cademartiri F, Marques H, Leipsic JA, Berman DS, Shaw LS, Narula J, Bax JJ, Min JK, Chang HJ. P2486Differential association between the progression of coronary artery calcium and coronary plaque volume progression according to statins. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S E Lee
- Yonsei University College of Medicine, Seoul, Korea Republic of
| | | | - Y J Kim
- Seoul National University Hospital, Seoul, Korea Republic of
| | - G Pontone
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - M J Budoff
- University of California Los Angeles, Los Angeles, United States of America
| | - I Gottlieb
- Casa de Saude São Jose, Rio de Janeiro, Brazil
| | | | | | - J A Leipsic
- University of British Columbia, Vancouver, Canada
| | - D S Berman
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - L S Shaw
- Emory University School of Medicine, Atlanta, United States of America
| | - J Narula
- Mount Sinai School of Medicine, New York, United States of America
| | - J J Bax
- Leiden University Medical Center, Leiden, Netherlands
| | - J K Min
- Weill Cornell Medical College, New York, United States of America
| | - H J Chang
- Yonsei University College of Medicine, Seoul, Korea Republic of
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Won KB, Lee SE, Lee BK, Sung JM, Park HB, Heo R, Hadamitzky M, Rizvi A, Kim YJ, Conte E, Andreini D, Budoff MJ, Leipsic JA, Min JK, Chang HJ. P2485Longitudinal quantitative assessment of coronary plaque progression related to glycemic status using serial coronary computed tomography angiography. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K B Won
- Ulsan University Hospital, Cardiology, Ulsan, Korea Republic of
| | - S E Lee
- Yonsei Cardiovascular Center, Cardiology, Seoul, Korea Republic of
| | - B K Lee
- Gangnam Severance Hospital, Cardiology, Seoul, Korea Republic of
| | - J M Sung
- Yonsei Cardiovascular Center, Cardiology, Seoul, Korea Republic of
| | - H B Park
- International St. Mary's Hospital, Cardiology, Incheon, Korea Republic of
| | - R Heo
- Weill Cornell Medical College, Cardiovascular Imaging, New York, United States of America
| | - M Hadamitzky
- German Heart Center of Munich, Radiology, Munich, Germany
| | - A Rizvi
- Weill Cornell Medical College, Cardiovascular Imaging, New York, United States of America
| | - Y J Kim
- Seoul National University Hospital, Cardiology, Seoul, Korea Republic of
| | - E Conte
- Cardiology Center Monzino IRCCS, Medicine, Milan, Italy
| | - D Andreini
- Cardiology Center Monzino IRCCS, Medicine, Milan, Italy
| | - M J Budoff
- Harbor UCLA Medical Center, Medicine, Los Angeles, United States of America
| | - J A Leipsic
- St Paul's Hospital, Radiology, Vancouver, Canada
| | - J K Min
- Weill Cornell Medical College, Cardiovascular Imaging, New York, United States of America
| | - H J Chang
- Yonsei Cardiovascular Center, Cardiology, Seoul, Korea Republic of
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Gnanenthiran SR, Naoum C, Leipsic JA, Kritharides L, Min JK. P2487Long term prognostic utility of CT Coronary Angiography (CTCA) in older populations. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - C Naoum
- Concord General Repatriation Hospital, Sydney, Australia
| | - J A Leipsic
- University of British Columbia, Department of Medicine and Radiology, Vancouver, Canada
| | - L Kritharides
- Concord General Repatriation Hospital, Sydney, Australia
| | - J K Min
- Weill Cornell Medical College, Department of Radiology, New York, United States of America
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Xia ZB, Yuan YJ, Zhang QH, Li H, Dai JL, Min JK. Salvianolic Acid B Suppresses Inflammatory Mediator Levels by Downregulating NF-κB in a Rat Model of Rheumatoid Arthritis. Med Sci Monit 2018; 24:2524-2532. [PMID: 29691361 PMCID: PMC5939601 DOI: 10.12659/msm.907084] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Salvianolic acid B (SB) is a major active phyto-component of the plant Radix Salvia miltiorrhiza, which is traditionally used to treat joint pain and arthritis. The present study examined the anti-rheumatoid arthritis efficacy of SB on collagen-induced rheumatoid arthritis (CIA) in a rat model. Material/Methods Forty-eight rats were divided into 4 groups: Control rats treated with saline (Group I), rats subjected to CIA induction by intradermal injection of bovine collagen II type at the tail (Group II), and rats subjected to CIA and supplemented with either 20 or 40 mg/kg of SB for 28 days (group III or IV). Results Paw swelling, edema, arthritis score, thymus and spleen indexes, and neutrophil infiltration were significantly decreased (p<0.01) by treatment with 20 or 40 mg/kg of SB. The levels of inflammatory cytokines (interleukin-1β, -6, and -17, and TNF-α) and anti-collagen II-specific immunoglobulins (IgG1 and IgG2a) were markedly decreased (p<0.01), and those of antioxidant enzymes (SOD, CAT, and GSH) were significantly increased (p<0.01) in SB-treated rats. Administration with SB (20 or 40 mg/kg) resulted in lower phosphorylated IκB-α and NF-κB p65 protein levels and markedly downregulated IκB-α expression. Furthermore, CIA rats revealed the presence of highly diffused polymorphonuclear cells (PMNs) infiltration with eroded cartilage; however, these phenomena were considerably ameliorated by SB. Conclusions SB alleviates oxidative stress and inflammation in CIA rats, thus verifying its anti-rheumatoid arthritis property.
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Affiliation(s)
- Zeng-Bing Xia
- Department of Orthopaedics, The First People's Hospital of Huzhou, Huzhou, Zhejiang, China (mainland)
| | - Yong-Jian Yuan
- Department of Orthopaedics, The First People's Hospital of Huzhou, Huzhou, Zhejiang, China (mainland)
| | - Qiang-Hua Zhang
- Department of Orthopaedics, The First People's Hospital of Huzhou, Huzhou, Zhejiang, China (mainland)
| | - Heng Li
- Department of Orthopaedics, The First People's Hospital of Huzhou, Huzhou, Zhejiang, China (mainland)
| | - Ji-Lin Dai
- Department of Orthopaedics, The First People's Hospital of Huzhou, Huzhou, Zhejiang, China (mainland)
| | - Ji-Kang Min
- Department of Orthopaedics, The First People's Hospital of Huzhou, Huzhou, Zhejiang, China (mainland)
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Driessen RS, Raijmakers PG, Danad I, Stuijfzand WJ, Schumacher SP, Leipsic JA, Min JK, Knuuti J, Lammertsma AA, van Rossum AC, van Royen N, Underwood SR, Knaapen P. Automated SPECT analysis compared with expert visual scoring for the detection of FFR-defined coronary artery disease. Eur J Nucl Med Mol Imaging 2018; 45:1091-1100. [PMID: 29470616 PMCID: PMC5954003 DOI: 10.1007/s00259-018-3951-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 01/16/2018] [Indexed: 01/01/2023]
Abstract
Purpose Traditionally, interpretation of myocardial perfusion imaging (MPI) is based on visual assessment. Computer-based automated analysis might be a simple alternative obviating the need for extensive reading experience. Therefore, the aim of the present study was to compare the diagnostic performance of automated analysis with that of expert visual reading for the detection of obstructive coronary artery disease (CAD). Methods 206 Patients (64% men, age 58.2 ± 8.7 years) with suspected CAD were included prospectively. All patients underwent 99mTc-tetrofosmin single-photon emission computed tomography (SPECT) and invasive coronary angiography with fractional flow reserve (FFR) measurements. Non-corrected (NC) and attenuation-corrected (AC) SPECT images were analyzed both visually as well as automatically by commercially available SPECT software. Automated analysis comprised a segmental summed stress score (SSS), summed difference score (SDS), stress total perfusion deficit (S-TPD), and ischemic total perfusion deficit (I-TPD), representing the extent and severity of hypoperfused myocardium. Subsequently, software was optimized with an institutional normal database and thresholds. Diagnostic performances of automated and visual analysis were compared taking FFR as a reference. Results Sensitivity did not differ significantly between visual reading and most automated scoring parameters, except for SDS, which was significantly higher than visual assessment (p < 0.001). Specificity, however, was significantly higher for visual reading than for any of the automated scores (p < 0.001 for all). Diagnostic accuracy was significantly higher for visual scoring (77.2%) than for all NC images scores (p < 0.05), but not compared with SSS AC and S-TPD AC (69.8% and 71.2%, p = 0.063 and p = 0.134). After optimization of the automated software, diagnostic accuracies were similar for visual (73.8%) and automated analysis. Among the automated parameters, S-TPD AC showed the highest accuracy (73.5%). Conclusion Automated analysis of myocardial perfusion SPECT can be as accurate as visual interpretation by an expert reader in detecting significant CAD defined by FFR. Electronic supplementary material The online version of this article (10.1007/s00259-018-3951-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- R S Driessen
- Department of Cardiology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - P G Raijmakers
- Department of Radiology & Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - I Danad
- Department of Cardiology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - W J Stuijfzand
- Department of Cardiology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - S P Schumacher
- Department of Cardiology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - J A Leipsic
- Department of Radiology, St. Paul's Hospital, Vancouver, Canada
| | - J K Min
- Department of Radiology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, USA
| | - J Knuuti
- Turku University Hospital and University of Turku, Turku, Finland
| | - A A Lammertsma
- Department of Radiology & Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - A C van Rossum
- Department of Cardiology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - N van Royen
- Department of Cardiology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - S R Underwood
- Department of Nuclear Medicine, Royal Brompton Hospital, London, UK
| | - P Knaapen
- Department of Cardiology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
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Zhang ZF, Min JK, Wang D, Zhong JM, Li H. [Analysis on the occult blood loss after unicompartment knee arthroplasty]. Zhongguo Gu Shang 2017; 30:1013-1017. [PMID: 29457392 DOI: 10.3969/j.issn.1003-0034.2017.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To calculate the volume of occult blood loss after unicompartment knee arthroplasty(UKA), and analyze its influential factors by comparing with total knee arthroplasty. METHODS A retrospective study of 130 cases from July 2012 to July 2015 were enrolled, of which and 65 cases were UKA, and 65 cases were TKA. In UKA group there were 27 males and 38 females, and the mean age was (62.3±4.3) years old (ranged, 50 to 82 years old). There were 14 cases older than 70 years old, while 51 cases among 50 to 70 years old. The mean Body mass index (BMI) was (23.9±2.6) kg/m²(ranged, 18.3 to 30.1 kg/m²). In TKA group there were 23 males and 42 females, and the mean age was (67.4±4.9) years old (ranged, 57 to 81 years old). There were 34 cases older than 70 years old, while 31 cases among 50 to 70 years old. The mean BMI was (25.6±2.3) kg/m²(ranged, 20.6 to 33.1 kg/m²). Hidden blood loss was calculated according to Gross equation, and the differences between the two groups including different ages and genders were observed subsequently. The differences of red blood cell change between two groups were observed dynamically postoperatively. RESULTS Postoperative hidden blood loss was (375.25±168.09) ml, HSS score was 87.11±5.39 in UKA group. Hidden blood loss was (898.81±221.47) ml, HSS score was 82.23±3.08 in TKA group. The differences between the two groups were significant. There were no significant differences in ages and genders. There were no significant relationship between hidden blood loss and HSS score or BMI, while the differences of red blood cell change were significant on the second day, the 4th day and the 5th day. There was no allogenic blood transfusion in UKA group, while 3 patients with transfusion in TKA group. CONCLUSIONS Hidden blood loss is part of total blood loss after UKA, and the volume in UKA is less than that in TKA. It could be compensated by the body and rarely affect the knee function. The hidden blood is not a risk factor of transfusion.
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Affiliation(s)
- Zhan-Feng Zhang
- The First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
| | - Ji-Kang Min
- The First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China;
| | - Dan Wang
- The First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
| | - Jian-Ming Zhong
- The First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
| | - Heng Li
- The First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
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Baradaran H, Patel P, Gialdini G, Giambrone A, Lerario MP, Navi BB, Min JK, Iadecola C, Kamel H, Gupta A. Association between Intracranial Atherosclerotic Calcium Burden and Angiographic Luminal Stenosis Measurements. AJNR Am J Neuroradiol 2017; 38:1723-1729. [PMID: 28729297 DOI: 10.3174/ajnr.a5310] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 04/13/2017] [Indexed: 01/24/2023]
Abstract
BACKGROUND AND PURPOSE Calcification of the intracranial vasculature is an independent risk factor for stroke. The relationship between luminal stenosis and calcium burden in the intracranial circulation is incompletely understood. We evaluated the relationship between atherosclerotic calcification and luminal stenosis in the intracranial ICAs. MATERIALS AND METHODS Using a prospective stroke registry, we identified patients who had both NCCT and CTA or MRA examinations as part of a diagnostic evaluation for ischemic stroke. We used NCCTs to qualitatively (modified Woodcock Visual Score) and quantitatively (Agatston-Janowitz Calcium Score) measure ICA calcium burden and used angiography to measure arterial stenosis. We calculated correlation coefficients between the degree of narrowing and calcium burden measures. RESULTS In 470 unique carotid arteries (235 patients), 372 (79.1%) had atherosclerotic calcification detectable on CT compared with 160 (34%) with measurable arterial stenosis on CTA or MRA (P < .001). We found a weak linear correlation between qualitative (R = 0.48) and quantitative (R = 0.42) measures of calcium burden and the degree of luminal stenosis (P < .001 for both). Of 310 ICAs with 0% luminal stenosis, 216 (69.7%) had measurable calcium scores. CONCLUSIONS There is a weak correlation between intracranial atherosclerotic calcium scores and luminal narrowing, which may be explained by the greater sensitivity of CT than angiography in detecting the presence of measurable atherosclerotic disease. Future studies are warranted to evaluate the relationship between stenosis and calcium burden in predicting stroke risk.
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Affiliation(s)
- H Baradaran
- From the Departments of Radiology (H.B., P.P., A. Gupta).,Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (H.B., G.G., M.P.L., B.B.N., C.I., H.K., A. Gupta)
| | - P Patel
- From the Departments of Radiology (H.B., P.P., A. Gupta)
| | - G Gialdini
- Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (H.B., G.G., M.P.L., B.B.N., C.I., H.K., A. Gupta)
| | - A Giambrone
- Healthcare Policy and Research (A. Giambrone)
| | - M P Lerario
- Neurology (M.P.L., B.B.N., C.I., H.K.).,Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (H.B., G.G., M.P.L., B.B.N., C.I., H.K., A. Gupta)
| | - B B Navi
- Neurology (M.P.L., B.B.N., C.I., H.K.).,Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (H.B., G.G., M.P.L., B.B.N., C.I., H.K., A. Gupta)
| | - J K Min
- Dalio Institute of Cardiovascular Imaging (J.K.M.), Weill Cornell Medical College, New York, New York
| | - C Iadecola
- Neurology (M.P.L., B.B.N., C.I., H.K.).,Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (H.B., G.G., M.P.L., B.B.N., C.I., H.K., A. Gupta)
| | - H Kamel
- Neurology (M.P.L., B.B.N., C.I., H.K.).,Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (H.B., G.G., M.P.L., B.B.N., C.I., H.K., A. Gupta)
| | - A Gupta
- From the Departments of Radiology (H.B., P.P., A. Gupta) .,Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (H.B., G.G., M.P.L., B.B.N., C.I., H.K., A. Gupta)
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Zhang ZF, Wang D, Min JK. [Correlation of medial compartmental joint line elevation with femorotibial angle correction and clinical function after unicompartmental arthroplasty]. Zhongguo Gu Shang 2017; 30:309-312. [PMID: 29349978 DOI: 10.3969/j.issn.1003-0034.2017.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To study the correlation of postoperative femorotibial angle with medial compartmental joint line elevation after unicompartmental arthroplasty(UKA), as well as the correlation of joint line elevation with the clinical function by measuring radiological joint line. METHODS A retrospective study of 56 patients from July 2012 to August 2015 was performed. The mean body mass index (BMI) was 23.5 (ranged, 18.3 to 30.1). The standing anteroposterior radiographs of these patients were assessed both pre-and post-operatively, and the knee function was evaluated according to HSS grading. The correlation between postoperative femorotibial angle(FTA) and joint line elevation was analyzed as well as the correlation between joint line elevation and the clinical function. RESULTS The mean medial joint line elevation was (2.2±2.0) mm(ranged, -3.3 to 7.0 mm), and the mean FTA correction was (2.3±3.0)°(ranged, -4.5° to 9.6°). The mean follow-up period was 12.2 months. There was a significant correlation between in joint line elevation and FTA correction(P<0.05), while there was no significant correlation between joint line elevation and the clinical function(P>0.05). CONCLUSIONS There was a significant correlation between medial compartmental joint line elevation and FTA correction after UKA, and the proximal tibial osteotomy was critical during the procedure. There was no significant correlation between joint line elevation and the clinical function, which may be related to the design of UKA prosthesis.
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Affiliation(s)
- Zhan-Feng Zhang
- Department of Orthopaedics, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
| | - Dan Wang
- Department of Orthopaedics, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
| | - Ji-Kang Min
- Department of Orthopaedics, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China;
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Zhang ZF, Min JK, Wang D, Zhong JM. Pinoresinol diglucoside exhibits protective effect on dexamethasone-induced osteoporosis in rats. TROP J PHARM RES 2016. [DOI: 10.4314/tjpr.v15i11.21] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
Objective To investigate how the anatomy of variant atlas vertebra impacts on the strategy used to place pedicle screws used to treat atlantoaxial instability. Methods The study enrolled patients with cervical instability who had a posterior arch pedicle height <3.5 mm at the anchor point, a vertebral artery groove height <3.5 mm, or both. Pedicle screws were fitted according to the anatomy of the variant atlas vertebra. Patients were followed-up to evaluate accuracy of the screw placement and maintenance of cervical stability. Results A total of 28 patients were enrolled. The mean height of the atlas pedicle proximal section was >5.0 mm. For the vertebral artery groove, the height of the lateral region was significantly greater than that of the medial region. Approximately 60% of atlas vertebrae had lateral heights >3.5 mm (34 of 56). The majority of the posterior arch heights were <3.0 mm. There were no perioperative or postoperative complications observed. Conclusions Pedicle screw placement in the lateral pedicle region is the safest and most reliable strategy to treat variant atlas pedicles.
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Affiliation(s)
- Qiang-Hua Zhang
- Department of Orthopaedics, First People's Hospital of Huzhou City, Huzhou City, Zhejiang Province, China
| | - Hai-Dong Li
- Department of Orthopaedics, First People's Hospital of Huzhou City, Huzhou City, Zhejiang Province, China
| | - Ji-Kang Min
- Department of Orthopaedics, First People's Hospital of Huzhou City, Huzhou City, Zhejiang Province, China
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Abstract
The blood loss during total hip arthroplasty is difficult to manage and there is no consensus about the effect of bipolar sealer used during operation. Thus, a systematic review of randomized controlled trials (RCTs) was performed to evaluate the efficacy and safety of blood loss using bipolar sealer after total hip arthroplasty (THA).Relevant literature of comparisons of bipolar sealer after THA for blood loss were searched for in Embase, PubMed, Web of Science, the Cochrane Central Register of Controlled Trials, and Google scholar from their inception to October, 2015. High-quality RCTs were selected to evaluate the need for transfusion, blood loss, and other complications. The software RevMan 5.30 was used for the meta-analysis.Six studies reporting on 6 RCTs comprising 751 patients were included. Compared with standard electrocautery, bipolar sealer was associated with lower rates of need for transfusion (relative risk [RR] = 0.60; 95% confidence interval [CI] 0.39-0.94), estimated blood loss (mean differences [MD] = -127.39; 95% CI -233.32 to -21.46; P = 0.02), and lower total blood loss (MD = -226.57; 95% CI -350.80-102.34; P = 0.0004). There is no significant difference between the hemoglobin drop, blood loss in drainage, intraoperative blood loss, Harris score, and rates of infection.The present meta-analysis indicated that bipolar sealer can decrease the need for transfusion and total blood loss; however, there is no benefit of bipolar sealer from the recovery. It is still need for samples to determine the balance between the economic cost and transfusion.
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Affiliation(s)
- Ji-Kang Min
- From the Department of Orthopaedics, The First People's Hospital of Huzhou, Huzhou, Zhe Jiang Province, China
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45
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Romijn MA, Danad I, Bakkum MJ, Stuijfzand WJ, Tulevski II, Somsen GA, Lammertsma AA, van Kuijk C, van de Ven PM, Min JK, Leipsic J, van Rossum AC, Raijmakers PG, Knaapen P. Incremental diagnostic value of epicardial adipose tissue for the detection of functionally relevant coronary artery disease. Atherosclerosis 2015; 242:161-6. [PMID: 26188540 DOI: 10.1016/j.atherosclerosis.2015.07.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 06/09/2015] [Accepted: 07/02/2015] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIM To determine the incremental diagnostic value of epicardial adipose tissue (EAT) volume in addition to the coronary artery calcium (CAC) score for detecting hemodynamic significant coronary artery disease (CAD). METHODS AND RESULTS 122 patients (mean age 61 ± 10 years, 61% male) without a previous cardiac history underwent a non-contrast CT scan for calcium scoring and EAT volume measurements. Subsequently all patients underwent invasive coronary angiography (ICA) in conjunction with fractional flow reserve (FFR) measurements. A stenosis >90% and/or a FFR ≤0.80 were considered significant. Mean EAT volume and CACscore were 128 ± 51 cm(3) and 418 ± 704, respectively. The correlation between EAT volume and the CACscore was poor (r = 0.11, p = 0.24). Male gender (odds ratio [OR] 2.86, p = 0.01), CACscore ([cut-off value 100] OR 3.31, p = 0.003, and EAT volume ([cut-off value 92 cm(3)] OR 4.28, p = 0.01) were associated with flow-limiting disease. The multivariate model revealed that only male gender (OR 2.50, p = 0.045), CAC score (OR 3.60, p = 0.005), and EAT volume (OR 4.95, p = 0.02) were independent predictors of myocardial ischemia. Using the cut-off values of 100 (CAC score) and 92 cm(3) (EAT volume), sensitivity, specificity, negative predictive value, positive predictive value, and accuracy for detecting functionally relevant CAD as indicated by FFR were 71, 57, 77, 50 and 63% and 91, 29, 85, 44 and 52% for the CACscore and EAT volume, respectively. Adding EAT volume to the CAC score and cardiovascular risk factors did not enhance diagnostic performance for the detection of significant CAD (p = 0.57). CONCLUSION EAT volume measurements have no diagnostic value beyond calcium scoring and cardiovascular risk factors in the detection of hemodynamic significant CAD.
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Affiliation(s)
- M A Romijn
- VU University Medical Center, Department of Cardiology, Amsterdam, The Netherlands
| | - I Danad
- VU University Medical Center, Department of Cardiology, Amsterdam, The Netherlands.
| | - M J Bakkum
- VU University Medical Center, Department of Cardiology, Amsterdam, The Netherlands
| | - W J Stuijfzand
- VU University Medical Center, Department of Cardiology, Amsterdam, The Netherlands
| | - I I Tulevski
- Cardiology Centers of the Netherlands, Amsterdam, The Netherlands
| | - G A Somsen
- Cardiology Centers of the Netherlands, Amsterdam, The Netherlands
| | - A A Lammertsma
- VU University Medical Center, Department of Radiology and Nuclear Medicine, Amsterdam, The Netherlands
| | - C van Kuijk
- VU University Medical Center, Department of Radiology and Nuclear Medicine, Amsterdam, The Netherlands
| | - P M van de Ven
- VU University Medical Center, Department of Epidemiology and Biostatistics, Amsterdam, The Netherlands
| | - J K Min
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medical College and The NewYork-Presbyterian Hospital, New York, NY, United States
| | - J Leipsic
- Department of Medical Imaging and Division of Cardiology, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - A C van Rossum
- VU University Medical Center, Department of Cardiology, Amsterdam, The Netherlands
| | - P G Raijmakers
- VU University Medical Center, Department of Radiology and Nuclear Medicine, Amsterdam, The Netherlands
| | - P Knaapen
- VU University Medical Center, Department of Cardiology, Amsterdam, The Netherlands
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Berman DS, Shaw LJ, Min JK, Hachamovitch R, Abidov A, Germano G, Hayes SW, Friedman JD, Thomson LEJ, Kang X, Slomka P, Rozanski A. SPECT/PET myocardial perfusion imaging versus coronary CT angiography in patients with known or suspected CAD. Q J Nucl Med Mol Imaging 2010; 54:177-200. [PMID: 20592682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Stress SPECT myocardial perfusion imaging (MPI) is the most commonly utilized stress imaging technique for patients with suspected or known coronary artery disease (CAD) and has a robust evidence base including the support of numerous clinical guidelines. Gated SPECT is a well-established noninvasive imaging modalities that is a core element in evaluation of patients with both acute and stable chest pain syndromes. Over the past decade, PET has become increasingly used for the same applications. By comparison, cardiac computed tomography (CT) is a more recently developed method, providing non-invasive approaches for imaging coronary atherosclerosis and coronary artery stenosis. Non-contrast CT for imaging the extent of coronary artery calcification (CAC), in clinical use since the mid-1990's, has a very extensive evidence base supporting its use in CAD prevention. While contrast-enhanced CT for noninvasive CT coronary angiography (CCTA) is relatively new, it has already developed an extensive base of evidence regarding diagnosing obstructive CAD and more recently evidence has emerged regarding its prognostic value. It is likely that non-contrast CT or CCTA for assessment of extent of atherosclerosis will become an increasing part of mainstream cardiovascular imaging practices as a first line test. In some patients, further ischemia testing with MPI will be required. Similarly, MPI will continue to be widely used as a first-line test, and in some patients, further anatomic definition of atherosclerosis with CT will also be appropriate. This review will provide a synopsis of the available literature on imaging that integrates both CT and MPI in strategies for the assessment of asymptomatic patients for their atherosclerotic coronary disease burden and risk as well as symptomatic patients for diagnosis and guiding management. We propose possible strategies through which imaging might be used to identify asymptomatic candidates for more intensive prevention and risk factor modification strategies as well as symptomatic patients who would benefit from referral to invasive coronary angiography for consideration of revascularization.
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Affiliation(s)
- D S Berman
- Department of Imaging, Cedars-Sinai Medical Center, CSMC Burns and Allen Research Institute, Los Angeles, California 90048, USA.
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Xia ZB, Wang D, Yuan YJ, Min JK, Yang WL, Li HC, Xu XC, Mei J. [Repair of soft tissue defects on the lower limbs with the facial pedicled flap with vascular perforating branch of leg]. Zhongguo Gu Shang 2009; 22:853-855. [PMID: 20084947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To investigate the operative techniques and clinical results of the facial pedicled flap with vascular perforating branch of leg. METHODS From May 1998 to January 2009,62 patients with soft tissue defects on the lower limbs were treated by four kinds of flap pedicled with the medial, posterior,anterolateral and posterolateral vascular perforating branches in the leg, included 50 males and 12 females, aged from 7 to 78 years old. There were 23 cases of the facial pedicled flap based on the perforating branch of the tibialis posterior artery, 9 cases of the facial pedicled flap based on the distal perforating branch of peroneal artery, 22 cases of the facial pedicled flap based on the peroneal artery perforator, 8 cases of the facial pedicled flap based on the lateral popliteal cutaneous artery. RESULTS The remaining flaps were completely survived except for 2 cases with epidermal necrosis and scab of distal flap, and 1 case with skin necrosis and skingrafting later. The patients were followed-up for from 1 month to 3 years, the appearance of the flaps were satisfied and the function were good. CONCLUSION The blood supply area of single perforator vascular of the leg is insufficient, so the presence facial pedicled flap of arterial chains will expend obviously the area of perforator flap that be good to blood supply and venous return.
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Affiliation(s)
- Zeng-Bing Xia
- Department of Orthopaedics, the First People s Hospital of Huzhou, Huzhou 313000, Zhejiang, China
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Piao ZH, Yoon SR, Kim MS, Jeon JH, Lee SH, Kim TD, Lee HG, Bae KH, Min JK, Chung SJ, Kim M, Cho YS, Oh DB, Park SY, Chung JW, Choi I. VDUP1 potentiates Ras-mediated angiogenesis via ROS production in endothelial cells. Cell Mol Biol (Noisy-le-grand) 2009; 55 Suppl:OL1096-OL1103. [PMID: 19267992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Accepted: 12/29/2008] [Indexed: 05/27/2023]
Abstract
Vitamin D3 up-regulated protein 1 (VDUP1) is a tumor suppressor of which expression is reduced in a variety of cancer cells, and enforced expression inhibits the tumor cell proliferation. It inhibits the activity of thioredoxin, thus contributing cellular ROS generation. Since ROS is a critical factor for angiogenesis, we investigated the role of VDUP1 in angiogenesis and endothelial proliferation. The expression of VDUP1 was upregulated by overexpression of an oncogene, Ras. Enforced expression of VDUP1 increases ROS production and proliferation of Ras-overexpressing endothelial cells. Overexpression of VDUP1 increases the resistance to the anchorage-dependent cell death and tube formation of the Ras-overexpressing endothelial cell. In addition, the removal of ROS by ROS scavenger attenuates the effect of VDUP1 on tube formation. These results suggest that VDUP1 is involved in Ras-mediated angiogenesis via ROS generation in endothelial cells.
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Affiliation(s)
- Z H Piao
- Korea Research Institute of Bioscience and Biotechnology, Stem Cell Research Center, Daejon, Republic of Korea
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Affiliation(s)
- H H Ho
- Division of Cardiology, New York Presbyterian Hospital, Weill-Cornell Medical Center, Starr Pavillion 4, 520 E 70th St, New York, New York 10021, USA.
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Abstract
Insufficiency fractures occur within weakened bones that are unable to withstand the stress of every day normal activities. The spine, pelvis, and lower long-bone extremities are common sites of insufficiency fractures. Spontaneous sternal insufficiency fracture (SIF) has rarely been reported in elderly patients. To recognise a sternal insufficiency fracture is important in selecting the adequate diagnostic procedures.
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Affiliation(s)
- J K Min
- Division of Rheumatology, Holy Family Hospital, College of Medicine, The Catholic University of Korea, South Korea.
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