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Asymptomatic Subjects (asymptomatic + subject)
Selected AbstractsNonvisible Insufficient Subcutaneous Reticular Venous Plexus Can Be Observed through the Skin Using a New Illumination MethodDERMATOLOGIC SURGERY, Issue 2010LUIS LOPEZ BUSTOS MD BACKGROUND Insufficient subcutaneous reticular venous plexus (ISRVP) is an overlooked disease because the human eye cannot see many of the insufficient veins. OBJECTIVE To present a total reticular vision (TRV) method that exposes nonvisible ISRVP to normal vision. METHOD & MATERIALS TRV used visual-spectrum white and red light of 700 nm and infrared light of 15 to 850 nm from an ultradigital viewer camera. We studied 124 asymptomatic subjects from the general population without visible ISRVP. Another six patients with ISRVP without other venous pathology were compared with six healthy controls, Very low pressure was applied to the proximal thigh, and minimal volume increments on the medial malleolus were photoplethysmographically registered to validate subcutaneous venous reflux. RESULTS Total reticular vision exposed ISRVP on the lower extremities in 72 of 124 subjects (58%), with observed damaged veins corresponding to more than 90% of nonvisible and 5% of visible portions of ISRVP. Subcutaneous reflux was registered only in patients with ISRVP. CONCLUSION Total reticular vision exposed more than 90% of nonvisible ISRVP, a new pathology, allowing for the study of its relationship with other superficial venous insufficiencies. The authors have indicated no significant interest with commercial supporters. [source] Myocardial perfusion imaging and cardiac events in a cohort of asymptomatic patients with diabetes living in southern FranceDIABETIC MEDICINE, Issue 4 2006A. Sultan Abstract Aims, To assess the association between abnormal stress myocardial perfusion imaging (MPI) and cardiac events (CE) in asymptomatic patients with diabetes and with , 1 additional risk factor. Predictors of abnormal stress MPI were also evaluated. Methods, Four hundred and forty-seven consecutive patients who underwent stress MPI were prospectively followed for 2.1 [0.5,4.1] years for the subsequent occurrence of hard CE (myocardial infarction and sudden or coronary death) and soft CE (unstable angina and ischaemic heart failure requiring hospitalization). Re-vascularization procedures performed as a result of the screening protocol were not included in the analysis. Results, Follow-up was successful in 419 of 447 patients (94%), of whom 71 had abnormal MPI at baseline. Medical therapy was intensified in all subjects and especially in those with abnormal MPI. Twenty-three patients with abnormal MPI underwent a re-vascularization procedure. CEs occurred in 14 patients, including six of 71 patients (8.5%) with abnormal MPI and eight of 348 patients (2.3%) with normal MPI (P < 0.005). Only two patients developed a hard CE and 12 a soft CE. In multivariate analysis, abnormal MPI was the strongest predictor for CEs [odds ratio (OR) (95% CI) = 5.6 (1.7,18.5)]. Low-density lipoprotein cholesterol , 3.35 mmol/l [OR (95% CI) = 7.3; 1.5,34.7] and age > median [OR (95% CI) = 6.0 (1.2,28.6)] were additional independent predictors for CE. The independent predictors for abnormal MPI were male gender, plasma triglycerides , 1.70 mmol/l, creatinine clearance < 60 ml/min and HbA1c > 8%, with male gender the strongest [OR (95% CI) = 4.0 (1.8,8.8)]. Conclusions, Asymptomatic patients with diabetes in this study had a very low hard cardiac event rate over an intermediate period. This could be explained by the effects of intervention or by the low event rate in the background population. Randomized studies of cardiac heart disease screening are required in asymptomatic subjects with diabetes to determine the effectiveness of this intervention. Diabet. Med. (2006) [source] Non- pylori Helicobacteraceae in the Upper Digestive Tract of Asymptomatic Venezuelan Subjects: Detection of Helicobacter cetorum- like and Candidatus Wolinella africanus -like DNAHELICOBACTER, Issue 5 2007M. Alexandra García-Amado Abstract Background: The spectrum of human non- pylori Helicobacter infections is expanding, with species such as H. heilmannii and H. felis occasionally being associated with gastritis. However, the existence of non- pylori Helicobacter colonization in asymptomatic subjects has not been evaluated. The aim of this study was to investigate whether Helicobacter species other than pylori are present in the upper digestive tract of asymptomatic human subjects. Materials and methods: A Helicobacteraceae-specific semi-nested polymerase chain reaction (PCR) assay was used to detect Helicobacter- like organisms in the upper digestive tract of 91 Venezuelan volunteers (aged 18,68 years, 41 females, 50 males). Species were identified by denaturing gradient gel electrophoresis analysis and sequencing of the PCR products. Results: We detected DNA sharing 99,100% sequence identity in over 300,400 bp with the 16S rRNA genes of H. pylori, H. cetorum, and Candidatus Wolinella africanus in 76%, 16%, and 15% of the subjects, respectively. Multiple colonization was documented in 10% of the subjects: H. cetorum and Candidatus W. africanus (4%), H. pylori and Candidatus W. africanus (4%), and H. pylori and H. cetorum (2%). Conclusions: Our results suggest that non- pylori Helicobacteraceae colonization is relatively common in the Venezuelan asymptomatic population. This is the first report documenting the presence of H. cetorum DNA in the human upper digestive tract, and the second report of the recently discovered Candidatus W. africanus. [source] Helicobacter pylori Infection and Gastric Autoimmune Diseases: Is There a Link?HELICOBACTER, Issue 6 2003Fabio Presotto ABSTRACT Background.,Helicobacter pylori is thought to be involved in atrophic body gastritis. We explored the prevalence of H. pylori infection in asymptomatic subjects with gastric parietal cell antibodies, as well as in patients with pernicious anemia, to evaluate a possible role of H. pylori gastric infection in gastric autoimmunity. Patients and Methods., We studied 79 consecutive asymptomatic subjects with parietal cell antibodies, 24 patients with pernicious anemia, and 66 parietal cell antibody-negative controls. All patients underwent gastric biopsies for histology and detection of H. pylori. Red blood cell count and volume, serum levels of gastrin, pepsinogen I, iron, folic acid, vitamin B12, and circulating antibodies to H. pylori and to intrinsic factor were also determined. Results., We found an atrophic body gastritis in 14 of the 79 asymptomatic subjects with parietal cell antibodies (18%) and in 2 of the 66 controls (3%) (p = .01). Mean levels of gastrin were increased (p < .0001), while those of pepsinogen were reduced (p < .001) compared with controls. H. pylori was identified at the gastric level and/or circulating anti- H. pylori antibodies were detected in 46 parietal cell antibody-positive subjects (58%) compared with 26 controls (39%) (p = .03). In patients with pernicious anemia we found an atrophic body gastritis in 18 of 24 cases (75%) (p < .001 vs. controls). Mean levels of gastrin were markedly increased (p < .0001) and those of pepsinogen I decreased (p < .0001) relative to controls. Only five of these patients (21%) had evidence of H. pylori infection compared with 46 of the parietal cell antibody-positive subjects (58%) (p = .003) and 26 of the controls (39%). Considering all patients with gastric autoimmunity (i.e. with parietal cell antibodies and/or with pernicious anemia), H. pylori was found in 44 of 72 of those without atrophy (61%) but in 6 of 31 with gastric body atrophy (19%) (p < .001), indicating that H. pylori infection is greatly reduced when gastric acid secretion decreases. Conclusions., The frequent detection of H. pylori infection in subjects with early gastric autoimmunity, indicated by the presence of parietal cell antibodies, suggests that H. pylori could have a crucial role in the induction and/or the maintenance of autoimmunity at the gastric level. [source] Sonography of the normal greater occipital nerve and obliquus capitis inferior muscleJOURNAL OF CLINICAL ULTRASOUND, Issue 6 2010John Chin Suk Cho DC Abstract Background. To use sonography to measure the cross-sectional area (CSA) of the greater occipital nerve (GON) and the adjacent obliquus capitis inferior muscle (OCI) in normal subjects. Methods. Data from 30 asymptomatic subjects between the ages of 22 and 35 were collected. CSA and circumference of the GON and CSA of OCI were measured using sonography. Interexaminer reliability analysis was performed using the intraclass correlation coefficient. Results. The CSA of the GON and OCI were 2 mm2 ± 1 mm2 and 1.86 cm2 ± 0.51 cm2, respectively. The average circumference of the GON was 4.8 mm ± 1.3 mm. The interexaminer reliability of the measurements was excellent with intraclass correlation coefficient coefficients of 0.91, 0.84, and 0.73 for the GON CSA, GON circumference, and OCI CSA, respectively. Conclusion. We report the normal values of the CSA of the GON and OCI. Knowledge of these normal values may facilitate the diagnosis of GON entrapment and provide outcome measures in therapeutic interventions. © 2010 Wiley Periodicals, Inc. J Clin Ultrasound, 2010 [source] Prevalence and risk of colorectal adenoma in asymptomatic Koreans aged 40,49 years undergoing screening colonoscopyJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 3 2010Su Jin Chung Abstract Background and Aim:, Colorectal cancer screening is recommended for average-risk persons beginning at age 50. However, information about the incidence and risk factors of precursor adenoma in preceding decades is limited. The aim of this study was to determine the prevalence and risk factors of colorectal adenoma in persons aged 40,49 years and to compare the data with those aged 30,39 years and 50,59 years. Methods:, A cross-sectional study of 5254 asymptomatic subjects who underwent screening colonoscopy was conducted. Data were stratified by age into three groups: 608 aged 30,39 years, 1930 aged 40,49 years, and 2716 aged 50,59 years. Results:, Prevalence of overall adenomas was 10.4% in the 30,39 years age group, 22.2% in the 40,49 years age group, and 32.8% in the 50,59 years age group. Advanced adenoma was found in 0.7% of the 30,39 years age group, 2.7% of the 40,49 years age group, and 4.1% of the 50,59 years age group. In the 40,49 years age group, male sex and current smoking habits showed associations with low-risk adenoma after multiple adjustments. Moreover, male sex (odds ratio [OR] = 1.55, 95% confidence interval [CI]: 1.02,3.23), current smoking (OR = 1.58, 95%CI: 1.06,3.50), and family history of colorectal cancer (OR = 2.54, 95%CI: 1.16,5.56) were independent predictors of advanced adenoma in this age group. Conclusions:, Prevalence of adenoma in subjects aged 40,49 years was higher than in previous studies. Male sex and current smoking habits along with a family history of colorectal cancer were associated with advanced adenoma in this age group. [source] Clinical usefulness of carbohydrate antigen 19-9 as a screening test for pancreatic cancer in an asymptomatic populationJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 2 2004JEE-EUN KIM Abstract Background and Aim:, Although the prognosis for pancreatic cancer is generally poor, it is well known that the survival rate for resected pancreatic cancer is much higher than that for more conservative treatment. The importance of early detection is emphasized for resection of pancreatic cancer. Measurement of serum carbohydrate antigen (CA) 19-9 has shown satisfactory sensitivity and predictive value in symptomatic patients, but no available data has been found on healthy asymptomatic subjects. Thus, the authors aimed to determine the clinical usefulness of CA 19-9 as a screening tool for pancreatic cancer in asymptomatic subjects. Methods:, From December 1994 to November 2000, 70 940 asymptomatic persons visiting the Health Promotion Center at the Samsung Medical Center, Seoul, Korea, participated. All subjects underwent abdominal ultrasonography and serum CA 19-9 measurement. The authors analyzed the sensitivity, specificity, and predictive values of CA 19-9 for detecting pancreatic cancer. Also, those subjects who had a serum CA 19-9 level above the cut-off value were followed up using a serial check of CA 19-9, computed tomography, or endoscopic retrograde cholangiopancreatography. Results:, The number of subjects with a level of CA 19-9 above the cutoff of 37 U/mL was 1063 (1.5%), including four cases diagnosed with pancreatic cancer. The prevalence of pancreatic cancer over the age of 30 years is 13.66 per 100 000 population in Korea. Therefore, the sensitivity is 100% and the specificity 98.5%. However, the positive predictive value of CA 19-9 for detecting pancreatic cancer is only 0.9% in the asymptomatic population. Conclusion:, Mass screening for pancreatic cancer using CA 19-9 levels in asymptomatic subjects is ineffective because of a very low positive predictive value, despite its high sensitivity and specificity. [source] Independent association of matrix metalloproteinase-10, cardiovascular risk factors and subclinical atherosclerosisJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 1 2007J. ORBE Summary.,Objectives: Circulating levels of matrix metalloproteinase (MMP)-10 are related to inflammation in asymptomatic subjects with cardiovascular risk factors. Whether MMP-10 is associated with the severity of atherosclerosis remains to be determined. This study examines the relationship of systemic MMP-10 levels with atherosclerotic risk factors and subclinical atherosclerosis. Methods and results: Circulating levels of MMP-1, -9 and -10, and markers of inflammation [fibrinogen, interleukin-6, von Willebrand factor, and high-sensitivity C-reactive protein (hs-CRP)] were measured in 400 subjects (mean age 54.3 years, 77.7% men) with cardiovascular risk factors but free from clinical cardiovascular disease. Subclinical atherosclerosis was evaluated by both the mean carotid intima-media thickness (IMT) and the presence of atherosclerotic plaques with the use of B-mode ultrasound in all subjects. MMP-10 levels were positively correlated with fibrinogen (r = 0.24, P < 0.001), hs-CRP (r = 0.14, P < 0.01) and carotid IMT (r = 0.17, P < 0.01). The association between MMP-10 and IMT remained significant in multiple regression analysis (P < 0.02) when controlling for traditional atherosclerotic risk factors and inflammatory markers. Such an association was not observed for MMP-1 and -9. Subjects in the highest MMP-10 tertile had significantly higher carotid IMT (adjusted odds ratio 6.3, 95% confidence interval 1.3,31.4, P = 0.024). In addition, MMP-10 levels were significantly higher in patients with carotid plaques (n = 78) than in those with no plaques after adjusting for age and sex (P < 0.01). Conclusion: Higher serum MMP-10 levels were associated with inflammatory markers, increased carotid IMT and atherosclerotic plaques in asymptomatic subjects. Circulating MMP-10 may be useful to identify subclinical atherosclerosis in subjects free from cardiovascular disease. [source] T1, MRI quantification of arthroscopically confirmed cartilage degenerationMAGNETIC RESONANCE IN MEDICINE, Issue 5 2010Walter R. T. Witschey Abstract Nine asymptomatic subjects and six patients underwent T1, MRI to determine whether Outerbridge grade 1 or 2 cartilage degeneration observed during arthroscopy could be detected noninvasively. MRI was performed 2-3 months postarthroscopy, using sagittal T1 -weighted and axial and coronal T1, MRI, from which spatial T1, relaxation maps were calculated from segmented T1 -weighted images. Median T1, relaxation times of patients with arthroscopically documented cartilage degeneration and asymptomatic subjects were significantly different (P < 0.001), and median T1, exceeded asymptomatic articular cartilage median T1, by 2.5 to 9.2 ms. In eight observations of mild cartilage degeneration at arthroscopy (Outerbridge grades 1 and 2), mean compartment T1, was elevated in five, but in all observations, large foci of increased T1, were observed. It was determined that T1, could detect some, but not all, Outerbridge grade 1 and 2 cartilage degeneration but that a larger patient population is needed to determine the sensitivity to these changes. Magn Reson Med 63:1376,1382, 2010. © 2010 Wiley-Liss, Inc. [source] Differences in the nearpoint of convergence with target typeOPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 5 2001John Siderov Summary Purpose: The purpose of this study was to determine the effect on measurements of the nearpoint of convergence (NPC) of different target types. In order to assess the influence of accommodation, the NPC was also measured under conditions of varying accommodative demand. Methods: The NPC was measured to the nearest 0.5 cm using three targets: the RAF rule, the sharpened tip of a pencil and the tip of the examiner's index finger. All measurements were performed under the same conditions on two groups of asymptomatic subjects, a group of 14 presbyopic subjects and a group of 14, younger, non-presbyopic subjects. The influence of accommodative demand was assessed in the non-presbyopic group by measuring the NPC while subjects viewed the RAF rule target through +2.00 and ,2.00 lenses held in front of their eyes. Results: For the presbyopic group, the NPC (break) and NPC (recovery) were independent of target type. However, the NPC (break) was significantly less remote than the NPC (recovery). Comparative data for the non-presbyopic group showed that NPC (break) for the RAF target was less remote than for either the pencil tip or finger tip targets. In agreement with the results from the presbyopic group, the NPC (recovery) was independent of target type. Conclusion: For subjects with little or no accommodation, the NPC does not depend on the target used and is the same measured with the RAF rule, a pencil tip or finger tip. In non-presbyopic subjects there appears to be a small accommodative influence on the NPC, which is target dependent. However, the difference is probably not clinically important. [source] The craniocervical flexion test: intra-tester reliability in asymptomatic subjectsPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2010Gill James Abstract Background and Purpose.,The deep neck flexor muscles (DNFs) stabilize the cervical spine and cervicogenic pain appears to adversely affect their endurance capacity. They are inaccessible to direct palpation, thereby making assessment difficult. However, the cranio-cervical flexion test (CCFT) provides an indirect method of assessing the endurance capacity of the DNFs. The purpose of the present study was to evaluate the intratester reliability of the CCFT in asymptomatic subjects.,Method.,The clinical protocol of the CCFT was measured on two occasions with 7 days between measurements. Prior to testing, participants were trained and compensation strategies were corrected. Nineteen asymptomatic participants (mean age 24.9 years; range 22,36) were recruited.,Results.,The test had excellent intratester reliability (intraclass correlation coefficient = 0.983; standard error of the mean = 8.94; smallest real difference = 24.7). A Bland and Altman's limits of agreement analysis confirmed the high reliability of the test.,Conclusion.,The CCFT results demonstrated excellent intra-tester reliability in asymptomatic subjects, thus contributing to the normative data regarding the test. Copyright © 2010 John Wiley & Sons, Ltd. [source] Are cervical physical outcome measures influenced by the presence of symptomatology?PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2002Michele Sterling Abstract Background and Purpose Outcome measures must be repeatable over time to judge changes as a result of treatment. It is unknown whether the presence of neck pain can affect measurement reliability over a time period when some change could be expected as a result of an intervention. The present study investigated the reliability of two measures, active cervical range of movement (AROM) and pressure pain thresholds (PPTs), in symptomatic and asymptomatic subjects. Method A repeated-measures study design with one week between testing sessions was used. Nineteen healthy asymptomatic subjects and 19 subjects with chronic neck pain participated in the study. The neck movements measured were: flexion, extension, right and left lateral flexion, and axial rotation. PPTs were measured over six bilateral sites, both local and remote to the cervical spine. Results The between-week intra-class correlation coefficients (ICCs2,1) for AROM ranged from 0.67 to 0.93 (asymptomatic group) and from 0.64 to 0.88 (chronic neck pain group). Standard error of measurement (SEM) was similar in both groups, from 2.66° to 5.59° (asymptomatic group) and from 2.36° to 6.72° (chronic neck pain group). ICCs2,1 for PPTs ranged from 0.70 to 0.91 (asymptomatic group) and from 0.69 to 0.92 (chronic neck pain group). SEM ranged from 11.14 to 87.71 kPa (asymptomatic group) and from 14.25 to 102.95 kPa (chronic neck pain group). Conclusions The findings of moderate to very high between-week reliability of measures of AROM and PPTs in both asymptomatic and chronic neck pain subjects suggest the presence of symptomatology does not adversely affect reliability of these measures. The results support the use of these measures for monitoring change in chronic neck pain conditions. Copyright © 2002 Whurr Publishers Ltd. [source] Influence of standardized mobilization on the posteroanterior stiffness of the lumbar spine in asymptomatic subjectsPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2001Dr Garry Allison Abstract Background and Purpose Spinal mobilization is commonly used to relieve pain and assist recovery of mobility in individuals with low back pain. Fundamental to this concept is the belief that spinal mobilization will influence the mechanical properties of the symptomatic motion segment. The objective of the present study was to examine the segmental effects of a standardized mobilization procedure on the posteroanterior (PA) stiffness of the lumbar spine. Method Audio and visual feedback was used to train a physiotherapist to perform PA mobilization at a consistent load and frequency. After training, twenty-four subjects without low back pain were recruited for the intervention phase of the study. The spinal posteroanterior mobilization (SPAM) apparatus was used to measure the PA stiffness of the lumbar spine at three measurement sites (L1, L3 and L5). The trained physiotherapist then applied the standardized PA mobilization technique via the L3 spinous process for two minutes. Following mobilization, PA stiffness was measured three times at the three locations. Results The physiotherapist was able to apply a standardized mobilization with a mean force of 146 N (standard deviation (SD) 8 N) at a frequency of 1.5 Hz. The first trial on each assessment demonstrated a pre-condition effect. Two minutes' PA mobilization resulted in no significant change in the PA stiffness of the lumbar spine at the level to which the mobilization was applied, or at the L1 and L5 segments. The 95% confidence intervals (CI) of the difference in PA stiffness before and after testing included zero at each measurement site. Conclusions Clinicians should pre-condition the spine when assessing PA stiffness both before and after interventions. A standardized mobilization of 150 N at 1.5 Hz for two minutes had no segmental effect on spinal PA stiffness. Subsequent studies need to consider other mechanisms that may contribute to the changes that occur after PA spinal mobilization. Copyright © 2001 Whurr Publishers Ltd. [source] Pressure pain thresholds of upper limb peripheral nerve trunks in asymptomatic subjectsPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 4 2000Michele Sterling Abstract Background and Purpose Palpation of peripheral nerve trunks has been advocated as a method of assessing the presence of hyperalgesic nerve tissue as a contributing factor to pain syndromes in musculoskeletal disorders of the upper quadrant. This study investigated, in the first instance, the pressure pain thresholds of the median, radial and ulnar nerve trunks of the upper limb in healthy, asymptomatic subjects. Method Forty-five male and 50 female healthy volunteer subjects participated in this study which involved measurement of pressure pain thresholds by use of pressure algometry bilaterally over the three peripheral nerve trunks in the upper limbs. Results Pressure pain thresholds were shown to be lowest in the median nerve (p=0.001) and lower in female subjects (p=0.001). Laterality (p=0.077) or the age of the subject (p=0.254) did not significantly influence results. Conclusions The study demonstrated differences in pressure pain thresholds in the three nerve trunks of the upper limb. These findings should be taken into account when interpreting the findings of nerve palpation in musculoskeletal upper quadrant disorders. Copyright © 2000 Whurr Publishers Ltd. [source] Emergency Department Chlamydia Screening Through Partnership with the Public Health DepartmentACADEMIC EMERGENCY MEDICINE, Issue 11 2009Charlene Babcock Irvin MD Abstract Background:, The emergency department (ED) serves a population that may benefit from numerous screening initiatives but screening in the ED is challenging due to crowding as well as resource and time constraints. One option may be to collect specimens in the ED and then partner with the public health department (PHD) to analyze the specimens off-site and arrange follow-up treatment. Objectives:, The objective was to explore the feasibility of chlamydia screening in females using a partnership model in which the ED is responsible for urine collection and the PHD is responsible for chlamydia testing, notification, and treatment. Methods:, A collaborative partnership-based chlamydia screening project was initiated at a large (90,000 visits/yr), urban, teaching ED from April 2007 to April 2008. Study information sheets were handed out to a convenience sample of eligible female patients and visitors (15,24 yr of age). Those wishing to participate provided a urine sample and follow-up contact information. The information sheet also asked if they had either lower abdominal pain or vaginal discharge (affirmative answer for either was considered symptomatic). Specimens collected in the ED were retrieved by PHD staff for off-site testing. The PHD contacted those participants testing positive using the patient provided contact information and arranged for treatment. Results:, Of the 633 women offered screening, 296 (47%) agreed to testing and provided samples. Of the 296 tested, 38 (12.8%) were positive for chlamydia infection, and 25 (66%) received follow-up and treatment; 13 could not be contacted through information they provided. A higher percentage of symptomatic subjects (23 of 115, or 20%) tested positive for chlamydia than asymptomatic subjects (15 of 181, or 8.3%; p < 0.01). Conclusions:, This study demonstrates the feasibility of an ED,PHD partnership for chlamydia screening in young women. This model can potentially be applied to other initiatives and may improve public health screening without creating significant additional burdens for crowded EDs. [source] Electrocardiographic Quantitation of Heterogeneity of Ventricular RepolarizationANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 1 2000Peter M. Okin M.D. Background:QT interval dispersion (QTd) measured from the surface ECG has emerged as the most common noninvasive method for assessing heterogeneity of ventricular repolarization. Although QTd correlates with dispersion of monophasic action potential duration at 90% repolarization and with dispersion of recovery time recorded from the epicardium, total T-wave area, representing a summation of vectors during this time interval, has been shown to have the highest correlation with these invasive measures of dispersion of repolarization. However, recent clinical studies suggest that the ratio of the second to first eigenvalues of the spatial T-wave vector using principal component analysis (PCA ratio) may more accurately reflect heterogeneity of ventricular repolarization. Methods:To better characterize the ECG correlates of surface ECG measures of heterogeneity of ventricular repolarization and to establish normal values of these criteria using an automated measurement method, the relations of QRS onset to T-wave offset (QTod) and to T-wave peak (QTpd) dispersion and the PCA ratio to T-wave area and amplitude, heart rate, QRS axis and duration, and the QTo interval were examined in 163 asymptomatic subjects with normal resting ECGs and normal left ventricular mass and function. QTod and QTpd were measured by computer from digitized ECGs as the difference between the maximum and minimum QTo and QTp intervals, respectively. Results:In univariate analyses, a significant correlation was found between the sum of the T-wave area and the PCA ratio (R =,0.46, P < 0.001), but there was no significant correlation of the sum of T-wave area with QTod (R = 0.11, P = NS) or QTpd (R=0.09, P = NS). There were only modest correlations between QTod and QTpd (R = 0.45) and between the PCA ratio and QTod (R = 0.29) and QTpd (R = 0.49) (each P < 0.001). In stepwise multivariate linear regression analyses, the PCA ratio was significantly related to the sum of T-wave area, T-wave amplitude in aVL, and to female gender (overall R = 0.54, P < 0.001), QTod correlated only with the maximum QTo0 interval (R = 0.39, P < 0.001), and QTpd was related to heart rate and QRS axis (overall R = 0.36, P <0.001). In addition, the normal interlead dispersion of repolarization as measured by QTod was significantly greater than dispersion measured by QTod (23.5 ± 11.5 ms vs 18.3 ± 11.2 ms, P < 0.001). Conclusions: These findings provide new information on ECG measures of heterogeneity of repolarization in normal subjects, with a significantly higher intrinsic variability of Q to T-peak than Q to T-offset dispersion and only modest correlation between these wo measures. The independent relation of the PCA ratio to the sum of T-wave area suggests that the PCA ratio may be a more accurate surface ECG reflection of the heterogeneity of ventricular repolarizat on. A.N.E. 2000;5(1):79,87 [source] Pre-clinical Dementia: Does it Exist?AUSTRALASIAN JOURNAL ON AGEING, Issue 1 2001Louise M. Waite Identification of syndromes that will progress to dementia carries immense importance for the management of these diseases when therapies are available and for future research into effective early prevention. Evidence supporting the presence of a preclinical phase for dementia has arisen from a range of different areas. Clinical and epidemiological studies have identified both cognitive and neurological abnormalities which predict the future development of dementia. Similarly, various neuroimaging techniques have identified abnormalities in asymptomatic subjects with significant risk for developing Alzheimer's disease and subjects who show mild cognitive deficits. Neuropathological series are hampered by non-representative study populations and poor antemortem data but in studies where informants have been utilised to provide details of subjects' antemortem cognitive function, evidence indicates that the presence of brain pathology is associated with cognitive deficits. This paper reviews the current literature exploring the presence of a pre-clinical phase for dementia, identifies the weaknesses in this research and provides suggestions for future research. [source] The effect of interocclusal appliances on temporomandibular joints as assessed by 3D reconstruction of MRI scansAUSTRALIAN DENTAL JOURNAL, Issue 1 2001Sandra A. Chu Abstract Magnetic resonance imaging (MRI) enables simulataneous visualization of hard and soft tissues. The aims of the present study were to computer generate three-dimensional (3D) images, reconstructed from MRI scans of normal temporomandibular joints (TMJ), to assess the relative positions of the disc, condyle and articular surface of the temporal bone and to study the effects of two mandibular group function interocclusal appliances (IOAs). Bilateral MRI scans of 2mm slice thickness were generated for the TMJs of 12 asymptomatic subjects with the image acquisition coils orientated in a corrected oblique sagittal plane. MRI scans were generated for all subjects with 3mm interincisal distance IOAs, while a subgroup (n=4) was also scanned with a 5mm interincisal IOA in situ.. An average of 10 slices through each TMJ were generated for the closed mouth and IOA positions. Three-dimensional reconstruction was performed on a 486 IBM compatible computer using a suite of nine programs not commercially available. Three-dimensional images allowed visualization of composite images of joint relationships. Subjective assessment indicated that joint relations in 3D were more informative than multiple separate 2D MRI scans. With the 3mm IOA in situ, the disc was positioned posteriorly and superiorly to the condyle in three of 12 cases. In four of 12 cases the condyle, and in two of 12 cases both the disc and condyle, were positioned anteriorly and inferiorly. With the 5mm IOA changes in condyle/disc and condyle/fossa relationships were more variable. It was concluded that 3D images of TMJs enabled the assessment of the positional changes of the condyle/disc and condyle/fossa relationships as altered by IOAs. However, the role of IOAs on the internal arrangements within the TMJ remains variable and is deserving of further study. [source] Cellular characteristics of non-allergic eosinophilic conjunctivitisACTA OPHTHALMOLOGICA, Issue 2 2010Osmo Kari Abstract. Purpose:, This study examines the histology of conjunctival biopsy samples from patients with persistent allergic eosinophilic conjunctivitis (AEC) or non-allergic eosinophilic conjunctivitis (NAEC). Methods:, Fourteen patients with conjunctivitis and eosinophilia in cytology samples were included in the study. Seven had positive skin-prick tests (the AEC group) and seven had negative skin-prick tests (the NAEC group). Eight asymptomatic subjects with negative skin-prick tests served as a control group. In conjunctival biopsies eosinophils were identified with monoclonal antibodies. Mast cells were identified by specific immunostaining and tryptase-positive granules were counted around them. The percentage of degranulated mast cells was used as a measure of cell activation. Eosinophil and goblet cell numbers were counted, epithelial thickness was measured, and the symptoms were characterized and graded. Results:, The numbers of eosinophils in biopsies were higher in patients with AEC than in healthy controls (p = 0.010). The proportion of activated mast cells tended to be higher in AEC patients (65%) than in NAEC patients (48%) or control subjects (40%). Patients with AEC had more goblet cells than control subjects (p = 0.049) and their epithelial layer was thicker (p = 0.054). Patients with AEC had more severe symptoms than control subjects (p = 0.0005), whereas the symptoms of NAEC patients did not differ statistically from those of controls (p = 0.065). Conclusions:, Patients with NAEC were characterized by mild eosinophilic inflammation and only minor structural conjunctival changes. The condition seems to run a relatively mild but persistent clinical course. [source] | ||||||||||||||||||||||