Objective: We aimed to assess the usefulness of multislice computed tomographic (CT) angiography to detect coronary artery disease (CAD), including myocardial bridging (MB) and left ventricular morphology (LVG), in patients with apical hypertrophic cardiomyopathy (AHCM) who presented with angina and apical asynergy. Materials and Methods: Sixty-four-slice CT angiography was performed in 14 patients with echocardiographically diagnosed AHCM who presented with typical or atypical chest pain. Coronary angiography was performed in 7 patients because of either suspected CAD or echocardiographic apical hypokinesia. We assessed the correlations between coronary anatomy, apical thickness, and LV configuration that were determined by echocardiography, LVG, and 64-slice CT angiography. Results: The multislice CT confirmed the diagnosis of AHCM in 14 patients. The LVGs were all compatible between the 64-slice CT angiography and the LVG in the 7 patients who had "ace-of-spades" configurations, apical sequestrations, and an apical aneurysm. Furthermore, 2 significant CADs and 7 MBs were detected by 64-slice CT angiography. Conclusions: Multislice CT can offer high accuracy for the noninvasive detection of apical wall thickness and left ventricular configuration in patients with AHCM. It also provides additional information about significant coronary stenosis and MB in patients with chest pain. This promising technology has a potential to complement invasive cardiac catheterization in clinical practice.

Since optical WDM networks are becoming one of the alternatives for building up backbones, dynamic routing, and wavelength assignment with delay constraints (DRWA-DC) in WDM networks with sparse wavelength conversions is important for a communication model to route requests subject to delay bounds. Since the NP-hard minimum Steiner tree problem can be reduced to the DRWA-DC problem, it is very unlikely to derive optimal solutions in a reasonable time for the DRWA-DC problem. In this paper, we circumvent to apply a meta-heuristic based upon the ant colony optimization (ACO) approach to produce approximate solutions in a timely manner. In the literature, the ACO approach has been successfully applied to several well-known combinatorial optimization problems whose solutions might be in the form of paths on the associated graphs. The ACO algorithm proposed in this paper incorporates several new features so as to select wavelength links for which the communication cost and the transmission delay of routing the request can be minimized as much as possible subject to the specified delay bound. Computational experiments are designed and conducted to study the performance of the proposed algorithm. Comparing with the optimal solutions found by an ILP formulation, numerical results evince that the ACO algorithm is effective and robust in providing quality approximate solutions to the DRWA-DC problem.

Integrating enterprise IT infrastructure and providing services to the public, SOA (Service Oriented Architecture) has been become the main stream in the field of IT domain. For example, Web Services as well as JMS (Java Message Service) are techniques commonly applied in SOA. In order to make sure that all services on the SOA platform are stably served, SOA Governance has become more important in terms of applying SOA to enterprise. But for various particular governance requirements, it is not an easy task to perform the role of governance well. This document will describe the basic concept of SOA, maturity model, and explore the enterprise solution of integrating applications and management of SOA. Then introduce how the evolution of CHT (Chunghwa Telecom) toward SOA Governance and the major functions of a practical governance system named SOBUS (Service Oriented Bus) which is developed by SOA Governance Evolution Project in CHT.

Because optical wavelength division multiplexing (WDM) networks are expected to be realized for building up backbone in the near future, multicasting in WDM networks needs to be addressed for various network applications. This paper studies an extended multicast routing and wavelength assignment (RWA) problem called multicast routing and wavelength assignment with delay constraint (MRWA-DC) that incorporates delay constraints in WDM networks having heterogeneous light splitting capabilities. The objective is to find a light-forest whose multicast cost, defined as a weighted combination of communication cost and wavelength consumption, is minimum. An integer linear programming (ILP) model is proposed to formulate and solve the problem. Experimental results show that using CPLEX to solve the ILP formulation can optimally deal with small-scale networks. Therefore, we develop a heuristic, near-k-shortest-path heuristic (NKSPH), to solve the problem in large-scale networks. Numerical results indicate that the proposed heuristic algorithm can produce approximate solutions of good quality in an acceptable time.

Eccrine porocarcinoma is an uncommon neoplasm of the sweat gland duct and poses a significant risk of cutaneous, regional lymph node, or visceral metastases. A 62-year-old woman with a history of eccrine porocarcinoma in the left flank area underwent an F-18 FDG PET/CT scan, which revealed increased FDG uptake in left pelvic (SUV 6.34) and left axillary regions (SUV 4.02). Wide excision of left axillary and left pelvic lymph nodes was performed, and histopathologic findings were consistent with eccrine porocarcinoma. PET/CT detects metastases accurately and is helpful in the management of patients with eccrine porocarcinoma.

Because optical WDM networks will be realized as network backbone in the near future, multicasting in WDM networks needs to be supported for various network applications. In this paper, we propose a new dynamic multicast routing problem under delay constraints (DMR-DC) for finding an optimal light-forest with the minimum multicast cost from these links with available wavelengths for routing a multicast request that arrives in random with a given delay bound in a WDM network with heterogeneous light splitting capabilities, where a light-forest is a set of light-trees used to set up switches to route the request. Multicast cost is defined by communication cost ratio and wavelength consumption ratio. The problem is to determine a light-forest with less wavelength consumption and less communication cost. This problem is NP-hard because it can be reduced from the minimum Steiner tree problem. In this paper, we propose an efficient three-phase (generation, refinement, and conversion) solution model to find approximate solutions in a reasonable time.

Because optical WDM networks will become a realistic choice for buildings backbones, multicasting in the WDM network should be supported for various network applications. In this paper, a new multicast problem, Multicast Routing under Delay Constraint Problem (MRDCP), routing a request with delay bound to all destinations in a WDM network with different light splitting is solved by genetic algorithms (GAs), where different light splitting means that nodes in the network can transmit one copy or multiple copies to other nodes by using the same wavelength. The MRDCP can be reduced to the Minimal Steiner Tree Problem (MSTP) which has been shown to be NP-Complete. We propose a destination-oriented representation to represent chromosomes, three general genetic operators (selection, crossover, and mutation), four types of operators (Chromosome Crossover, Individual Crossover, Chromosome Mutation, and Individual Mutation). Four mutation heuristics (Random Mutation (RM), Cost First Mutation (CFM), Delay First Mutation (DFM), and Hybrid Mutation (HM)) are employed in the GA method. Finally, experimental results show that our solution model can obtain a near optimal solution.

Background: Myocardial bridge (MB) is an congenital coronary anomaly resulting in systolic narrowing of coronary artery. It may be seen occasionally during coronary angiography (CAG) examinations and may cause clinical symptoms and/or signs of coronary artery disease (CAD). The symptoms/signs include angina pectoris, myocardial infarction, vasospasm, cardiac arrythmia, and sudden cardiac death. Few previous reports stated about the (superscript 201)TI perfusion defects noted in patients with MB, which probably imply the evidence of myocardial ischemia. The purpose of this study is to do a retrospective analysis of (superscript 201)TI images in patients with MB. Methods: From July, 2000 to June, 2003, 63 patients (30 male; mean age 57±10, and range from 33 to 80 years old), with chest pain and/or chest tightness underwent stress test for CAD. Six patients underwent treadmill exercise with Bruce protocol and 57 patients received dipyridamole as pharmacological stress. All patients were followed by image acquisitions done immediately after stress and 4 h later. All underwent CAG subsequently to identify the severity of CAD. Results: In all of the 63 patients, CAG revealed MB. Fifty patients had MB in left descending artery (LAD) (40 at mid portion; 8 at distal portion; 2 at mid and distal portion), 4 in left circumflex artery (LCX), and 1 in right coronary artery (RCA). Seven patients had MB in both LAD and LCX, and 1 patient had MB in both LAD and RCA. Sixty patients (95%) had (superscript 201)TI perfusion defects in either reverse (R), partial reverse (PR), or reverse redistribution (RR) patterns. In the abnormal (superscript 201)TI SPECTs, 103 abnormal perfusion areas were found including 57 R (55%), 40 PR (39%), and 6 RR (6%). In all vessels with MB, 48 (83%) in LAD could see (superscript 201)TI perfusion defects in anterior, septal, and/or apical areas. In addition, 6 of 11 (55%) in LCX could detect defects in lateral or inferior areas, and 2 of 2 (100%) in RCA could detect defects in inferior areas. Conclusions: Myocardial ischemia with abnormal (superscript 201)TI perfusion image can be detected in most patients with MB. MB with ischemic evidence in (superscript 201)TI perfusion image also may be associated with chest pain and/or chest tightness in our patients. (superscript 201)TI perfusion defect may be presented with R, PR, or RR in patients with MB. The significance of three different perfusion defects patterns (R, PR, and RR) may represent the various severity of perfusion insufficiency induced by MB.

Because optical WDM network will become a real choice to build up backbone in the future, the multicasting in WDM network should be supported for various network applications. In this paper, the new Multicast Routing and Wavelength Assignment with Delay Constraint (MRWA-DC) problem is introduced. Since this problem can be reduced to the Minimal Steiner Tree Problem, an NP-Complete problem, an integrated 2-Level solution model which is an iterative process consisting of Selecting Wavelength Procedure (SWP) with two evaluation functions (MaxE and MinR) and Finding Assigned Light-tree Procedure (WALP) with two heuristics (MaxDepth and MaxDest) is proposed to solve the problem. According to experimental results, the solutions found by the 2- Level solution model are approximated equal to the solutions found by ILP formulation.

Background: Myocardial bridge (MB) is an congenital coronary anomaly resulting in systolic narrowing of coronary artery. It may be seen occasionally during coronary angiography (CAG) examinations and may cause clinical symptoms and/or signs of coronary artery disease (CAD). The symptoms/signs include angina pectoris, myocardial infarction, vasospasm, cardiac arrythmia, and sudden cardiac death. Few previous reports stated about the 201 Tl perfusion defects noted in patients with MB, which probably imply the evidence of myocardial ischemia. The purpose of this study is to do a retrospective analysis of 201 Tl images in patients with MB. (30 male; mean age 57 ± 10, and range from 33 to 80 years old), with chest pain and/or chest tightness underwent stress test for CAD. Six patients underwent treadmill exercise with Bruce protocol and 57 patients received dipyridamole as pharmacological stress. All patients were followed by image acquisitions done immediately after stress and 4 h later. All underwent CAG subsequently to identify the severity of CAD. Results: In all of the 63 patients, CAG revealed MB. Fifty patients had MB in left descending artery (LAD) (40 at mid portion; 8 at distal portion; 2 at mid and distal portion), 4 in left circumflex artery (LCX), and 1 in right coronary artery (RCA). Seven patients had MB in both LAD and LCX, and 1 patient had MB in both LAD and RCA. Sixty patients (95%) had 201 Tl perfusion defects in either reverse (R), partial reverse (PR), or reverse redistribution (RR) patterns. In the abnormal 201 Tl SPECTs, 103 abnormal perfusion areas were found including 57 R (55%), 40 PR (39%), and 6 RR (6%). In all vessels with MB, 48 (83%) in LAD could see 201 Tl perfusion defects in anterior, septal, and/or apical areas. In addition, 6 of 11 (55%) in LCX could detect defects in lateral or inferior areas, and 2 of 2 (100%) in RCA could detect defects in inferior areas. Conclusions: Myocardial ischemia with abnormal 201 Tl perfusion image can be detected in most patients with MB. MB with ischemic evidence in 201 Tl perfusion image also may be associated with chest pain and/or chest tightness in our patients. 201 Tl perfusion defect may be presented with R, PR, or RR in patients with MB. The significance of three different perfusion defects patterns (R, PR, and RR) may represent the various severity of perfusion insufficiency induced by MB.

Received 7/9/2003; revised 7/23/2003; accepted 8/10/2003. For correspondence or reprints contact: Yeh-You Shen, M.D., Department of Nuclear Medicine, Shin Kong Wu Ho-Su Memorial Hospital. 95 Wen-Chang Road, Shih Lin District, Taipei 111, Taiwan. Tel: (886)2-28332211 ext. 2280, Fax: (886)2-28389489, E-mail: M001022@ms.skh.org.tw A 57-year-old female underwent whole-body F-fluorodeoxyglucose positron emission tomography (FDGPET) study for health examination. There is increased FDG uptake in the left scapula, the left side ribs and bilateral femora. Fibrous dysplasia, sexual precocity and hyperthroidism history was then told. She also received thyroidectomy and I radioiodine therapy for hyperthyroidism. She then underwent Tc-MDP bone scintigraphy the next day to evaluate the extent of polyostotic fibrous dysplasia. The location of FDG uptake showed similar pattern as the blood pool phase bone scintigraphy. Discrepancy was noticed in the skull, the left humerus and the right side ribs between FDGPET images and delayed phase bone scintigraphy. The image findings of this patient suggest that FDG uptake within the lesions of fibrous dysplasia is highly related to the blood perfusion status of the lesions.

18 F-fluo- rodeoxyglucose positron emission tomography (FDG- PET) study for health examination. There is increased FDG uptake in the left scapula, the left side ribs and bilateral femora. Fibrous dysplasia, sexual precocity and hyperthroidism history was then told. She also received thyroidectomy and 131 I radioiodine therapy for hyperthyroidism. She then underwent 99m Tc-MDP bone scintigraphy the next day to evaluate the extent of polyostotic fibrous dysplasia. The location of FDG uptake showed similar pattern as the blood pool phase bone scintigraphy. Discrepancy was noticed in the skull, the left humerus and the right side ribs between FDG- PET images and delayed phase bone scintigraphy. The image findings of this patient suggest that FDG uptake within the lesions of fibrous dysplasia is highly related to the blood perfusion status of the lesions.