Theodore Lee

San Francisco VA Medical Center, San Francisco, CA, USA

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Publications (2)4.99 Total impact

  • Article: Carotid intima-media thickness among human immunodeficiency virus-infected patients without coronary calcium.
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    ABSTRACT: Subjects infected with human immunodeficiency virus (HIV) have increased risk for atherosclerosis. Carotid artery intima-media thickness (IMT) assessed using ultrasound and coronary artery calcium (CAC) detected using computed tomography predict cardiovascular risk in the general population; however, their usefulness and comparability in patients with HIV are less well defined. The purpose of this study was to compare IMT and CAC in the detection of atherosclerosis in subjects with HIV. CAC and IMT were measured in 253 HIV-infected and 58 uninfected adults. Associations among HIV-related factors, traditional risk factors, and CAC and IMT were evaluated. The distribution of IMT among subjects with and without CAC was compared. Among the patients with HIV, 37% had detectable CAC compared to 28% of controls (p = 0.19); 16% of the patients with HIV had CAC >100 compared to 5% of controls (p = 0.03). With either detectable or undetectable CAC, HIV-infected subjects had higher IMT compared to controls (1.02 ± 0.34 vs 0.78 ± 0.12 mm, p <0.0001), even after adjustment for traditional risk factors. Among those with undetectable CAC, 34% of patients with HIV had markedly increased IMT (≥1 mm) compared to no controls (p <0.0001). HIV-related factors were associated with IMT but not with CAC. In conclusion, patients with HIV and controls had similar rates of detectable CAC, while absolute CAC scores were modestly higher in the HIV group. Conversely, carotid IMT detected advanced subclinical atherosclerosis in patients with HIV even in the absence of CAC. Thus, with HIV, IMT is associated with disease-related factors and may be a more sensitive indicator of subclinical atherosclerosis than CAC.
    The American journal of cardiology 12/2011; 109(5):742-7. · 3.58 Impact Factor
  • Article: Mediastinal glomangioma: CT and octreotide scintigraphy appearance, and review of the literature.
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    ABSTRACT: The glomus body is a neuromyovascular, arteriovenous structure primarily found in the skin and, less commonly, other organs, and is involved with thermoregulation. Neoplasms of the glomus organ are most commonly encountered in the skin and soft tissues of the extremities, particularly the subungual region. Glomus tumors are rare vascular neoplasms originating from the glomus body resulting from proliferation of modified muscle cells within this organ. Glomus tumors are commonly subdivided, based on the prominence of glomocytes, vascular structures, and smooth muscle cells, into solid glomus tumors (the most common variant), glomangioma, and glomangiomyoma. Previous reports of intrathoracic glomus tumors have shown that these tumors are most commonly encountered within the tracheobronchial tree or pulmonary parenchyma; mediastinal lesions are exceptionally rare. On the basis of imaging appearance of the glomangioma reported in this case as well as prior reports of tracheobronchial and pulmonary glomus tumors, mediastinal glomus tumors manifest as intensely enhancing masses with circumscribed or poorly defined margins, closely resembling thymic carcinoid tumor, pheochromocytoma, or hypervascular lymphadenopathy. Secretion of catecholamines and tracer uptake on Indium-111 octreotide scintigraphy, as seen in the present case, is probably exceptional. Because glomus tumors may be difficult to diagnose on routine histopathologic specimens, radiologists should be aware of this rare lesion and consider the diagnosis of glomus tumor when an intensely enhancing mediastinal mass is encountered.
    Journal of thoracic imaging 12/2008; 23(4):289-91. · 1.42 Impact Factor