Fifty-three (96%) of 55 patients with coronary artery stenosis were positive for serum anti-HHV-6 IgG, and 50 (91%) of these patients had anti-HHV-7 IgG. The number of cases sero-positive for HHV-6 and -7 in the 54 age matched control volunteers was 52 (96%) and 53 (98%), respectively. No statistical difference in the sero-prevalence of the viruses existed between the patients and the control group. The mean geometric titer (log10) of anti-HHV-6 IgG in both the patients and controls were the same (1.4) (P = 0.845), whereas anti-HHV-7 titers were 1.4 and 1.5, respectively (P = 0.161). Ten (18%) of the 55 patients had anti-HHV-6 IgM; eight (15%) of the 54 control volunteers were also positive (P = 0.636). Three (5%) of the 55 patients had anti-HHV-7 IgM, whereas 3 (6%) of the 54 control volunteers had detectable serum antibody (P = 0.691). Forty-seven of the 55 patients were examined by follow-up angiographic evaluation to clarify the association between viral infection and restenosis following balloon angioplasty. Fifteen of these patients developed restenosis, as determined by angiography. The mean geometric titer (log10) of anti-HHV-6 IgG were 1.3 and 1.4 in patients with restenosis and those without restenosis, respectively (P = 0.724). The mean geometric titer (log10) of anti-HHV-7 IgG in patients with restenosis was not significantly higher (1.5) than in patients without restenosis (1.3) (P = 0.099). Three (20%) of the 15 patients affected by restenosis had anti-HHV-6 IgM; five (16%) of the 32 control patients also had the antibody (P = 0.965). One (7%) of the 15 patients with restenosis and 2 (6%) of the 32 patients without restenosis had anti-HHV-7 IgM (P = 0.558). The present study demonstrates that HHV-6 and -7 reactivation is not associated with the establishment of coronary artery stenosis and restenosis following balloon angioplasty.
Abstract The Fukushima Daiichi Nuclear Power Plant was severely damaged during the 2011 Great East Japan Earthquake. However, the ongoing decommissioning work has been limited by the complexity of the reactor's internal structure and very high radiation levels; locating radioactive sources is essential for efficient decommissioning. Conventional gamma cameras are mainly designed for low radiation dose (∼mSv/h) and using them under high radiation conditions is difficult (>Sv/h). Therefore, we developed a pinhole gamma camera with a gamma radiation detector consisting of a high-speed YGAG scintillator array and multi-pixel photon counters to locate radioactive sources at high dose rates. The gamma-ray photon signals captured by the developed two-dimensional detector array can be processed at a speed as high as >1 MHz/pixel using the developed large scale integrated circuit. Herein, we report the measurement results of an extremely high radioactivity of 137 Cs (∼34 TBq) using the developed gamma camera. The gamma-ray source position was determined using an angular size of ∼4.6°, with images obtained at 2 m from the radioactive source and at a dose rate of 0.3 Sv/h. The direct gamma rays with a photoelectric peak at 662 keV and scattered component of gamma rays can be distinguished from the measured spectrum. We also characterize the imaging capability of the 137 Cs depending on the detected gamma-ray energies and discuss related details.
Purpose: Now that the technological advances have substantially and favorably allowed reduction in radiation burden both from CT angiography (CTA) and myocardial perfusion imaging (MPI) by single-photon emission computed tomography (SPECT), and because CT-SPECT combination is becoming a mainstream investigative tool, we evaluated the role of combined evaluation of MPI and CTA in coronary artery disease (CAD). For CTA, we evaluated both, the extent of luminal stenosis as also the features of high-risk plaques (HRP, including positive remodeling and low attenuation. Methods: 280 patients (65±11 years, mean f/u: 26 months) underwent both CTA and MPI. Patients without significant stenosis on CTA, or suspected of stenosis by CTA but normal MPI findings were classified as normal, and patients with significant CTA stenosis and reversible defect on MPI were classified as abnormal. On CTA, HRP was also reported regardless of luminal stenosis. Patients were classified into group 1: abnormal CTA and MPI (n=81), group 2: normal CTA and MPI but with HRP (n=25), and group 3: normal by CTA and MPI and also no HRP (n=174). Cardiac events were defined as percutaneous coronary intervention (PCI) or bypass surgery (CABG) after CTA and MPI, and unexpected coronary event. Results: Cardiac event was observed in 56 patients; 43 PCI or CABG, and 13 unexpected events. CTA+MPI showed higher diagnostic accuracy than CTA or MPI (sensitivity, specificity, positive (PPV) and negative predictive value (NPV) were 89, 44, 28, 94%, 83, 69, 37, 91%, and 70, 81, 48, 92%, respectively). The prognosis of group1, 2, and 3 were significantly different (logrank: p<0.0001) (figure). Unexpected events were also more frequent in group1 and 2 than group3 (9%vs16%vs1%, p=0.0006). Conclusion: The combination of CTA and MPI was more accurate than MPI alone for risk stratification in patients suspected CAD. Furthermore, plaque detection by CTA would be the additional valuable information to predict the cardiac event.
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