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Sample records for high absolute coronary

  1. Cryogenic, Absolute, High Pressure Sensor

    NASA Technical Reports Server (NTRS)

    Chapman, John J. (Inventor); Shams. Qamar A. (Inventor); Powers, William T. (Inventor)

    2001-01-01

    A pressure sensor is provided for cryogenic, high pressure applications. A highly doped silicon piezoresistive pressure sensor is bonded to a silicon substrate in an absolute pressure sensing configuration. The absolute pressure sensor is bonded to an aluminum nitride substrate. Aluminum nitride has appropriate coefficient of thermal expansion for use with highly doped silicon at cryogenic temperatures. A group of sensors, either two sensors on two substrates or four sensors on a single substrate are packaged in a pressure vessel.

  2. Absolute eosinophils count and the extent of coronary artery disease: a single centre cohort study.

    PubMed

    Verdoia, Monica; Schaffer, Alon; Cassetti, Ettore; Di Giovine, Gabriella; Marino, Paolo; Suryapranata, Harry; De Luca, Giuseppe

    2015-05-01

    Leukocytes have been involved in the pathogenesis of atherosclerosis, and recent attention has been raised on eosinophils, that have been claimed for a wide number of cardiovascular pathologies, affecting endocardium, myocardium and vascular walls. However, few data have been reported so far on the relationship between absolute eosinophils count (AEC) and the prevalence and extent of coronary artery disease (CAD), that was the aim of present study. Consecutive patients undergoing non-urgent coronary angiography were included. Haematological parameters were measured at admission. Significant CAD was defined as at least 1 vessel stenosis >50 %, while severe CAD as left main and/or trivessel disease, as evaluated by Quantitative Coronary Angiography. Our population is represented by 3,742 patients, divided according to tertiles values of AEC (≤0.1; 0.1-0.2; >0.2 × 10(3)/µl). Higher eosinophils values were significantly associated to male gender, main established cardiovascular risk factors, previous percutaneous or surgical coronary revascularization, antihypertensive and antiplatelet therapy at admission but inversely with acute presentation. Higher AEC was directly related with platelets count (p < 0.001), haemoglobin levels (p = 0.02), white blood cells count (p = 0.02), higher serum creatinine (p < 0.001), triglycerides (p < 0.001) and glycosylated haemoglobin (p < 0.001), while inversely with HDL cholesterol (p < 0.001). AEC was associated with multivessel disease (p = 0.03), chronic occlusions (p = 0.01), in-stent restenosis (p = 0.002), while inversely with the presence of intracoronary thrombus (p < 0.001). A significant relationship was found between AEC and the prevalence of coronary artery disease (p = 0.049), but not for the extent of more severe LM/trivessel CAD (p = 0.31). At multivariate analysis no independent role of eosinophils was found for CAD (adjusted OR [95 % CI] = 1.02 [0.91-1.15], p = 0.70), or severe CAD (adjusted OR [95 % CI] = 0.99 [0

  3. Absolute Value Inequalities: High School Students' Solutions and Misconceptions

    ERIC Educational Resources Information Center

    Almog, Nava; Ilany, Bat-Sheva

    2012-01-01

    Inequalities are one of the foundational subjects in high school math curricula, but there is a lack of academic research into how students learn certain types of inequalities. This article fills part of the research gap by presenting the findings of a study that examined high school students' methods of approaching absolute value inequalities,…

  4. Integration of Quantitative Positron Emission Tomography Absolute Myocardial Blood Flow Measurements in the Clinical Management of Coronary Artery Disease.

    PubMed

    Gewirtz, Henry; Dilsizian, Vasken

    2016-05-31

    In the >40 years since planar myocardial imaging with(43)K-potassium was introduced into clinical research and management of patients with coronary artery disease (CAD), diagnosis and treatment have undergone profound scientific and technological changes. One such innovation is the current state-of-the-art hardware and software for positron emission tomography myocardial perfusion imaging, which has advanced it from a strictly research-oriented modality to a clinically valuable tool. This review traces the evolving role of quantitative positron emission tomography measurements of myocardial blood flow in the evaluation and management of patients with CAD. It presents methodology, currently or soon to be available, that offers a paradigm shift in CAD management. Heretofore, radionuclide myocardial perfusion imaging has been primarily qualitative or at best semiquantitative in nature, assessing regional perfusion in relative terms. Thus, unlike so many facets of modern cardiovascular practice and CAD management, which depend, for example, on absolute values of key parameters such as arterial and left ventricular pressures, serum lipoprotein, and other biomarker levels, the absolute levels of rest and maximal myocardial blood flow have yet to be incorporated into routine clinical practice even in most positron emission tomography centers where the potential to do so exists. Accordingly, this review focuses on potential value added for improving clinical CAD practice by measuring the absolute level of rest and maximal myocardial blood flow. Physiological principles and imaging fundamentals necessary to understand how positron emission tomography makes robust, quantitative measurements of myocardial blood flow possible are highlighted.

  5. Measuring the absolute magnetic field using high-Tc SQUID

    NASA Astrophysics Data System (ADS)

    He, D. F.; Itozaki, H.

    2006-06-01

    SQUID normally can only measure the change of magnetic field instead of the absolute value of magnetic field. Using a compensation method, a mobile SQUID, which could keep locked when moving in the earth's magnetic field, was developed. Using the mobile SQUID, it was possible to measure the absolute magnetic field. The absolute value of magnetic field could be calculated from the change of the compensation output when changing the direction of the SQUID in a magnetic field. Using this method and the mobile SQUID, we successfully measured the earth's magnetic field in our laboratory.

  6. High speed image acquisition system of absolute encoder

    NASA Astrophysics Data System (ADS)

    Liao, Jianxiang; Chen, Xin; Chen, Xindu; Zhang, Fangjian; Wang, Han

    2017-01-01

    Absolute optical encoder as a product of optical, mechanical and electronic integration has been widely used in displacement measuring fields. However, how to improve the measurement velocity and reduce the manufacturing cost of absolute optical encoder is the key problem to be solved. To improve the measurement speed, a novel absolute optical encoder image acquisition system is proposed. The proposed acquisition system includes a linear CCD sensor is applied for capturing coding pattern images, an optical magnifying system is used for enlarging the grating stripes, an analog-digital conversion(ADC) module is used for processing the CCD analogy signal, a field programmable gate array(FPGA) device and other peripherals perform driving task. An absolute position measurement experiment was set up to verify and evaluate the proposed image acquisition system. The experimental result indicates that the proposed absolute optical encoder image acquisition system has the image acquisition speed of more than 9500fp/s with well reliability and lower manufacture cost.

  7. Persistent high fever and systemic inflammation induced by percutaneous coronary intervention-related periaortitis

    PubMed Central

    Kakino, Takamori; Nakayama, Tomohiro; Yamamoto, Hideo

    2009-01-01

    After coronary catheterization, fever sometimes occurs, usually transiently. We report a very rare case that suggests persistent high fever and systemic inflammation might be caused by periaortitis induced by coronary catheterization including percutaneous coronary intervention. PMID:20057898

  8. High blood pressure in pregnancy and coronary calcification.

    PubMed

    Sabour, Siamak; Franx, Arie; Rutten, Annemarieke; Grobbee, Diederick E; Prokop, Mathias; Bartelink, Marie-Louise; van der Schouw, Yvonne T; Bots, Michiel L

    2007-04-01

    A considerable proportion of pregnant women develop high blood pressure in pregnancy. Although it is assumed that this condition subsides after pregnancy, many of these women develop the metabolic syndrome later in life and are at increased risk to develop coronary heart disease. Atherosclerosis development is considered in between risk factors and occurrence of vascular symptoms. We set out to cross-sectionally study the relation of high blood pressure during pregnancy with risk of coronary calcification. The study population was composed 491 healthy postmenopausal women selected from a population-based cohort study. Information on high blood pressure during pregnancy was obtained using a questionnaire. Between 2004 and 2005, the women underwent a multidetector computed tomography (Philips Mx 8000 IDT 16) to assess coronary calcium. The Agatston score, volume, and mass measurements were used to quantify coronary calcium. A total of 30.7% of the women reported to have had high blood pressure in pregnancy. Body mass index (odds ratio [OR]: 1.05; 95% CI: 1.01 to 1.09) and diastolic blood pressure (OR: 1.03; 95% CI: 1.01 to 1.05) were significantly related to a history of high blood pressure in pregnancy. Age was significantly related to increased coronary calcification. Women with a history of high blood pressure during pregnancy had a 57% increased risk of having coronary calcification compared with those women without this condition (OR: 1.57; 95% CI: 1.04 to 2.37). After adjusting for age, the relation did not change (OR: 1.64; 95% CI: 1.07 to 2.53). We concluded that high blood pressure during pregnancy is associated with an increased risk of coronary calcification later in life.

  9. Preserved Coronary Flow Reserve Effectively Excludes High-Risk Coronary Artery Disease on Angiography

    PubMed Central

    Naya, Masanao; Murthy, Venkatesh L.; Taqueti, Viviany R.; Foster, Courtney R.; Klein, Josh; Garber, Mariya; Dorbala, Sharmila; Hainer, Jon; Blankstein, Ron; Resnic, Frederick; Di Carli, Marcelo F.

    2014-01-01

    Myocardial perfusion imaging has limited sensitivity for the detection of high-risk coronary artery disease (CAD). We tested the hypothesis that a normal coronary flow reserve (CFR) would be helpful for excluding the presence of high-risk CAD on angiography. Methods We studied 290 consecutive patients undergoing 82Rb PET within 180 d of invasive coronary angiography. High-risk CAD on angiography was defined as 2-vessel disease (≥70% stenosis), including the proximal left anterior descending artery; 3-vessel disease; or left main CAD (≥50% stenosis). Patients with prior Q wave myocardial infarction, elevated troponin levels between studies, prior coronary artery bypass grafting, a left ventricular ejection fraction of less than 40%, or severe valvular heart disease were excluded. Results Fifty-five patients (19%) had high-risk CAD on angiography. As expected, the trade-off between the sensitivity and the specificity of the CFR for identifying high-risk CAD varied substantially depending on the cutoff selected. In multivariable analysis, a binary CFR of less than or equal to 1.93 provided incremental diagnostic information for the identification of high-risk CAD beyond the model with the Duke clinical risk score (>25%), percentage of left ventricular ischemia (>10%), transient ischemic dilation index (>1.07), and change in the left ventricular ejection fraction during stress (<2) (P = 0.0009). In patients with normal or slightly to moderately abnormal results on perfusion scans (<10% of left ventricular mass) during stress (n = 136), a preserved CFR (>1.93) excluded high-risk CAD with a high sensitivity (86%) and a high negative predictive value (97%). Conclusion A normal CFR has a high negative predictive value for excluding high-risk CAD on angiography. Although an abnormal CFR increases the probability of significant obstructive CAD, it cannot reliably distinguish significant epicardial stenosis from nonobstructive, diffuse atherosclerosis or microvascular

  10. High Take Off Left Main and Abnormal Origin of Right Coronary Artery: A Case Report

    PubMed Central

    Salehi, Negar; Abdi, Seyfollah; Pouraliakba, Hamid Reza; Vakili-Zarch, Anoushiravan

    2013-01-01

    Coronary anomalies are rare congenital disorders with mostly benign course. We report a case of 54-year-old white male who was with stable angina scheduled for coronary angiography. Due to the difficulty of catheterization, patient underwent CT angiography and high take off left main and right coronary arteries were revealed. We conclude that anomalous coronary arteries are important and coronary interventions may be difficult in their presence.

  11. Noninvasive assessment of coronary vasodilation using cardiovascular magnetic resonance in patients at high risk for coronary artery disease

    PubMed Central

    Nguyen, Patricia K; Meyer, Craig; Engvall, Jan; Yang, Phillip; McConnell, Michael V

    2008-01-01

    Background Impaired coronary vasodilation to both endothelial-dependent and endothelial-independent stimuli have been associated with atherosclerosis. Direct measurement of coronary vasodilation using x-ray angiography or intravascular ultrasound is invasive and, thus, not appropriate for asymptomatic patients or for serial follow-up. In this study, high-resolution coronary cardiovascular magnetic resonance (CMR) was used to investigate the vasodilatory response to nitroglycerine (NTG) of asymptomatic patients at high risk for CAD. Methods A total of 46 asymptomatic subjects were studied: 13 high-risk patients [8 with diabetes mellitus (DM), 5 with end stage renal disease (ESRD)] and 33 age-matched controls. Long-axis and cross-sectional coronary artery images were acquired pre- and 5 minutes post-sublingual NTG using a sub-mm-resolution multi-slice spiral coronary CMR sequence. Coronary cross sectional area (CSA) was measured on pre- and post-NTG images and % coronary vasodilation was calculated. Results Patients with DM and ESRD had impaired coronary vasodilation to NTG compared to age-matched controls (17.8 ± 7.3% vs. 25.6 ± 7.1%, p = 0.002). This remained significant for ESRD patients alone (14.8 ± 7.7% vs. 25.6 ± 7.1%; p = 0.003) and for DM patients alone (19.8 ± 6.3% vs. 25.6 ± 7.1%; p = 0.049), with a non-significant trend toward greater impairment in the ESRD vs. DM patients (14.8 ± 7.7% vs. 19.8 ± 6.3%; p = 0.23). Conclusion Noninvasive coronary CMR demonstrates impairment of coronary vasodilation to NTG in high-risk patients with DM and ESRD. This may provide a functional indicator of subclinical atherosclerosis and warrants clinical follow up to determine prognostic significance. PMID:18513419

  12. High resolution study of magnetic ordering at absolute zero.

    PubMed

    Lee, M; Husmann, A; Rosenbaum, T F; Aeppli, G

    2004-05-07

    High resolution pressure measurements in the zero-temperature limit provide a unique opportunity to study the behavior of strongly interacting, itinerant electrons with coupled spin and charge degrees of freedom. Approaching the precision that has become the hallmark of experiments on classical critical phenomena, we characterize the quantum critical behavior of the model, elemental antiferromagnet chromium, lightly doped with vanadium. We resolve the sharp doubling of the Hall coefficient at the quantum critical point and trace the dominating effects of quantum fluctuations up to surprisingly high temperatures.

  13. High quality absolute paleointensity data from Santa Fe, New Mexico

    NASA Astrophysics Data System (ADS)

    Jones, S. A.; Tauxe, L.; Blinman, E.; Genevey, A.

    2015-12-01

    Preliminary paleointensity experiments were conducted using the IZZI protocol on one hundred and fourteen specimens from fifty-seven baked pottery fragments collected from nine archaeological sites near Santa Fe, New Mexico. Twenty of these fragments passed our weakest selection criteria. Seven additional specimens were made from each passing fragment for further paleointensity experiments. The results of these second experiments indicate that the samples are mildly anisotropic, so anisotropy experiments were conducted to correct for this behavior. Experiments to determine the cooling rate correction will be completed to ensure the robustness of the dataset. Stylistic evidence, historical documentation, dendrochronology, and 14C analyses provide age constraints with up to decade resolution for the VADM results. The twenty pottery fragments analyzed span five distinct time periods between 1300 and 1900 AD. Our new results for each fragment differ slightly from those predicted by the cals3k.4b and arch3k models, suggesting the models require refinement. This is expected because there are few archaeomagnetic constraints on the models from this region. Future pottery fragments and burned adobe fragments from the New Mexico area will be analyzed for paleointensity and combined with our pottery fragment data set to create a high-resolution paleointensity curve for the recent archaeological time in the American Southwest.

  14. Absolute measurements of the high-frequency magnetic dynamics in high-{Tc} superconductors

    SciTech Connect

    Hayden, S.M.; Aeppli, G.; Dai, P.; Mook, H.A.; Perring, T.G.; Cheong, S.W.; Fisk, Z.; Dogan, F.; Mason, T.E.

    1997-08-07

    The authors review recent measurements of the high-frequency dynamic magnetic susceptibility in the high-T{sub c} superconducting systems La{sub 2{minus}x}Sr{sub x}CuO{sub 4} and YBa{sub 2}Cu{sub 3}O{sub 6+x}. Experiments were performed using the chopper spectrometers HET and MARI at the ISIS spallation source. The authors have placed their measurements on an absolute intensity scale, this allows systematic trends to be seen and comparisons with theory to be made. They find that the insulating S = 1/2 antiferromagnetic parent compounds show a dramatic renormalization in the spin wave intensity. The effect of doping on the response is to cause broadenings in wave vector and large redistributions of spectral weight in frequency.

  15. Dynamic frequency-domain interferometer for absolute distance measurements with high resolution.

    PubMed

    Weng, Jidong; Liu, Shenggang; Ma, Heli; Tao, Tianjiong; Wang, Xiang; Liu, Cangli; Tan, Hua

    2014-11-01

    A unique dynamic frequency-domain interferometer for absolute distance measurement has been developed recently. This paper presents the working principle of the new interferometric system, which uses a photonic crystal fiber to transmit the wide-spectrum light beams and a high-speed streak camera or frame camera to record the interference stripes. Preliminary measurements of harmonic vibrations of a speaker, driven by a radio, and the changes in the tip clearance of a rotating gear wheel show that this new type of interferometer has the ability to perform absolute distance measurements both with high time- and distance-resolution.

  16. Dynamic frequency-domain interferometer for absolute distance measurements with high resolution

    SciTech Connect

    Weng, Jidong; Liu, Shenggang; Ma, Heli; Tao, Tianjiong; Wang, Xiang; Liu, Cangli; Tan, Hua

    2014-11-15

    A unique dynamic frequency-domain interferometer for absolute distance measurement has been developed recently. This paper presents the working principle of the new interferometric system, which uses a photonic crystal fiber to transmit the wide-spectrum light beams and a high-speed streak camera or frame camera to record the interference stripes. Preliminary measurements of harmonic vibrations of a speaker, driven by a radio, and the changes in the tip clearance of a rotating gear wheel show that this new type of interferometer has the ability to perform absolute distance measurements both with high time- and distance-resolution.

  17. High-precision absolute distance and vibration measurement with frequency scanned interferometry

    SciTech Connect

    Yang, H.-J.; Deibel, Jason; Nyberg, Sven; Riles, Keith

    2005-07-01

    We report high-precision absolute distance and vibration measurements performed with frequency scanned interferometry using a pair of single-mode optical fibers. Absolute distance was determined by counting the interference fringes produced while scanning the laser frequency. A high-finesse Fabry-Perot interferometer was used to determine frequency changes during scanning. Two multiple-distance-measurement analysis techniques were developed to improve distance precision and to extract the amplitude and frequency of vibrations. Under laboratory conditions, measurement precision of {approx}50 nm was achieved for absolute distances ranging from 0.1 to 0.7 m by use of the first multiple-distance-measurement technique. The second analysis technique has the capability to measure vibration frequencies ranging from 0.1 to 100 Hz with an amplitude as small as a few nanometers without a priori knowledge.

  18. High-precision absolute distance and vibration measurement with frequency scanned interferometry.

    PubMed

    Yang, Hai-Jun; Deibel, Jason; Nyberg, Sven; Riles, Keith

    2005-07-01

    We report high-precision absolute distance and vibration measurements performed with frequency scanned interferometry using a pair of single-mode optical fibers. Absolute distance was determined by counting the interference fringes produced while scanning the laser frequency. A high-finesse Fabry-Perot interferometer was used to determine frequency changes during scanning. Two multiple-distance-measurement analysis techniques were developed to improve distance precision and to extract the amplitude and frequency of vibrations. Under laboratory conditions, measurement precision of approximately 50 nm was achieved for absolute distances ranging from 0.1 to 0.7 m by use of the first multiple-distance-measurement technique. The second analysis technique has the capability to measure vibration frequencies ranging from 0.1 to 100 Hz with an amplitude as small as a few nanometers without a priori knowledge.

  19. Misconceptions of High School Students Related to the Conceptions of Absolutism and Constitutionalism in History Courses

    ERIC Educational Resources Information Center

    Bal, Mehmet Suat

    2011-01-01

    The goal of this study is to analyze the 10th grade high school students' misconceptions related to the sense of ruling in the Ottoman State during the absolutist and constitutional periods and to investigate the causes of these misconceptions. The data were collected through eight open-ended questions related to the concepts of absolutism and…

  20. A highly accurate absolute gravimetric network for Albania, Kosovo and Montenegro

    NASA Astrophysics Data System (ADS)

    Ullrich, Christian; Ruess, Diethard; Butta, Hubert; Qirko, Kristaq; Pavicevic, Bozidar; Murat, Meha

    2016-04-01

    The objective of this project is to establish a basic gravity network in Albania, Kosovo and Montenegro to enable further investigations in geodetic and geophysical issues. Therefore the first time in history absolute gravity measurements were performed in these countries. The Norwegian mapping authority Kartverket is assisting the national mapping authorities in Kosovo (KCA) (Kosovo Cadastral Agency - Agjencia Kadastrale e Kosovës), Albania (ASIG) (Autoriteti Shtetëror i Informacionit Gjeohapësinor) and in Montenegro (REA) (Real Estate Administration of Montenegro - Uprava za nekretnine Crne Gore) in improving the geodetic frameworks. The gravity measurements are funded by Kartverket. The absolute gravimetric measurements were performed from BEV (Federal Office of Metrology and Surveying) with the absolute gravimeter FG5-242. As a national metrology institute (NMI) the Metrology Service of the BEV maintains the national standards for the realisation of the legal units of measurement and ensures their international equivalence and recognition. Laser and clock of the absolute gravimeter were calibrated before and after the measurements. The absolute gravimetric survey was carried out from September to October 2015. Finally all 8 scheduled stations were successfully measured: there are three stations located in Montenegro, two stations in Kosovo and three stations in Albania. The stations are distributed over the countries to establish a gravity network for each country. The vertical gradients were measured at all 8 stations with the relative gravimeter Scintrex CG5. The high class quality of some absolute gravity stations can be used for gravity monitoring activities in future. The measurement uncertainties of the absolute gravity measurements range around 2.5 micro Gal at all stations (1 microgal = 10-8 m/s2). In Montenegro the large gravity difference of 200 MilliGal between station Zabljak and Podgorica can be even used for calibration of relative gravimeters

  1. High coronary calcium score and post-procedural CK-MB are noninvasive predictors of coronary stent restenosis

    PubMed Central

    Lee, Jae-Beom; Choi, Yun-Seok; Chung, Woo-Baek; Kwon, Ami; Park, Chul-Soo; Lee, Man-Young

    2017-01-01

    Purpose High coronary calcium score (CCS) and post-procedural cardiac enzyme may be related with poor outcomes in patients with coronary stent implantation. Methods A total of 1,072 patients (63.2% male, mean age: 61.7±10.3 years) who underwent coronary multi-detect computed tomography at index procedure and follow-up coronary angiography (CAG) after drug-eluting stent (DES) were divided into two groups: those with and without target lesion revascularization (TLR; >50% reduction in luminal stent diameter or angina symptoms on follow-up CAG). The CCSs for predicting stent revascularization were elucidated. Results There were no significant differences between the two groups with regard to risk factors. The initial CCS was significantly higher in the TLR group (1,102.4±743.7 vs 345.8±51.05, P=0.04). After adjustment of significant factors for TLR, only CCS and post-procedural creatine kinase MB form (CK-MB) elevation were significant predictors of coronary artery TLR. Receiver operation curve revealed that >800 in CCS had 69% in sensitivity and 88% in specificity about predicting the TLR. Conclusion High CCS with post-procedural CK-MB might be the useful predictors for TLR after DES implantation. PMID:28255235

  2. Easy Absolute Values? Absolutely

    ERIC Educational Resources Information Center

    Taylor, Sharon E.; Mittag, Kathleen Cage

    2015-01-01

    The authors teach a problem-solving course for preservice middle-grades education majors that includes concepts dealing with absolute-value computations, equations, and inequalities. Many of these students like mathematics and plan to teach it, so they are adept at symbolic manipulations. Getting them to think differently about a concept that they…

  3. Teaching Absolute Value Meaningfully

    ERIC Educational Resources Information Center

    Wade, Angela

    2012-01-01

    What is the meaning of absolute value? And why do teachers teach students how to solve absolute value equations? Absolute value is a concept introduced in first-year algebra and then reinforced in later courses. Various authors have suggested instructional methods for teaching absolute value to high school students (Wei 2005; Stallings-Roberts…

  4. Particle visualization in high-power impulse magnetron sputtering. II. Absolute density dynamics

    SciTech Connect

    Britun, Nikolay Palmucci, Maria; Konstantinidis, Stephanos; Snyders, Rony

    2015-04-28

    Time-resolved characterization of an Ar-Ti high-power impulse magnetron sputtering discharge has been performed. The present, second, paper of the study is related to the discharge characterization in terms of the absolute density of species using resonant absorption spectroscopy. The results on the time-resolved density evolution of the neutral and singly-ionized Ti ground state atoms as well as the metastable Ti and Ar atoms during the discharge on- and off-time are presented. Among the others, the questions related to the inversion of population of the Ti energy sublevels, as well as to re-normalization of the two-dimensional density maps in terms of the absolute density of species, are stressed.

  5. High Accuracy, Absolute, Cryogenic Refractive Index Measurements of Infrared Lens Materials for JWST NIRCam using CHARMS

    NASA Technical Reports Server (NTRS)

    Leviton, Douglas; Frey, Bradley

    2005-01-01

    The current refractive optical design of the James Webb Space Telescope (JWST) Near Infrared Camera (NIRCam) uses three infrared materials in its lenses: LiF, BaF2, and ZnSe. In order to provide the instrument s optical designers with accurate, heretofore unavailable data for absolute refractive index based on actual cryogenic measurements, two prismatic samples of each material were measured using the cryogenic, high accuracy, refraction measuring system (CHARMS) at NASA GSFC, densely covering the temperature range from 15 to 320 K and wavelength range from 0.4 to 5.6 microns. Measurement methods are discussed and graphical and tabulated data for absolute refractive index, dispersion, and thermo-optic coefficient for these three materials are presented along with estimates of uncertainty. Coefficients for second order polynomial fits of measured index to temperature are provided for many wavelengths to allow accurate interpolation of index to other wavelengths and temperatures.

  6. Double domain wavelength multiplexed Fizeau interferometer with high resolution dynamic sensing and absolute length detection

    NASA Astrophysics Data System (ADS)

    Antonacci, Julián; Arenas, Gustavo F.; Duchowicz, Ricardo

    2017-04-01

    In this work, we present a simple photonic instrument that has the ability of measuring positions, distances and vibrations with very high resolution by means of two Fizeau interferometers (FI), both using the same optical fiber end as a probe tip itself. On the one hand we have a time domain FI powered with a 1310 nm laser and monitored by an InGaAs detector providing displacement information with resolution around a tenth of nm but regardless of the absolute position of object and of the displacement sense. On the other, a spectral domain FI version based on a super luminescent source (SLED) centred at 800 nm with bandwidth of nearly 40 nm is analysed in real time by means of a digital spectrometer. Each spectrum is acquired in a very small time interval and provides information of both length of the cavity as well as its correct sense of evolution. Resolution of this system is lower than its complementary temporal case, but distance and sense measurements are absolute and can be determined successfully by adequate processing of spectral signal.Both interferometers are optically coupled to a single fiber optic probe and are wavelength modulated.Therefore, combination of both sensors results in a new one which allows the correct knowledge of an object or surfaces under test, i.e. a high resolution of displacement data plus its absolute position and true sense of movement.

  7. High-accuracy absolute distance measurement with a mode-resolved optical frequency comb

    NASA Astrophysics Data System (ADS)

    Voigt, Dirk; van den Berg, Steven A.; Lešundák, Adam; van Eldik, Sjoerd; Bhattacharya, Nandini

    2016-04-01

    Optical interferometry enables highly accurate non-contact displacement measurement. The optical phase ambiguity needs to be resolved for absolute distance ranging. In controlled laboratory conditions and for short distances it is possible to track a non-interrupted displacement from a reference position to a remote target. With large distances covered in field applications this may not be feasible, e.g. in structure monitoring, large scale industrial manufacturing or aerospace navigation and attitude control. We use an optical frequency comb source to explore absolute distance measurement by means of a combined spectral and multi-wavelength homodyne interferometry. This relaxes the absolute distance ambiguity to a few tens of centimeters, covered by simpler electronic distance meters, while maintaining highly accurate optical phase measuring capability. A virtually imaged phased array spectrometer records a spatially dispersed interferogram in a single exposure and allows for resolving the modes of our near infrared comb source with 1 GHz mode separation. This enables measurements with direct traceability of the atomic clock referenced comb source. We observed agreement within 500 nm in comparison with a commercial displacement interferometer for target distances up to 50 m. Furthermore, we report on current work toward applicability in less controlled conditions. A filter cavity decimates the comb source to an increased mode separation larger than 20 GHz. A simple grating spectrometer then allows to record mode-resolved interferograms.

  8. Prognostic Value of Coronary Computed Tomography Imaging in Patients at High Risk Without Symptoms of Coronary Artery Disease.

    PubMed

    Dedic, Admir; Ten Kate, Gert-Jan R; Roos, Cornelis J; Neefjes, Lisan A; de Graaf, Michiel A; Spronk, Angela; Delgado, Victoria; van Lennep, Jeanine E Roeters; Moelker, Adriaan; Ouhlous, Mohamed; Scholte, Arthur J H A; Boersma, Eric; Sijbrands, Eric J G; Nieman, Koen; Bax, Jeroen J; de Feijter, Pim J

    2016-03-01

    At present, traditional risk factors are used to guide cardiovascular management of asymptomatic subjects. Intensified surveillance may be warranted in those identified as high risk of developing cardiovascular disease (CVD). This study aims to determine the prognostic value of coronary computed tomography (CT) angiography (CCTA) next to the coronary artery calcium score (CACS) in patients at high CVD risk without symptoms suspect for coronary artery disease (CAD). A total of 665 patients at high risk (mean age 56 ± 9 years, 417 men), having at least one important CVD risk factor (diabetes mellitus, familial hypercholesterolemia, peripheral artery disease, or severe hypertension) or a calculated European systematic coronary risk evaluation of >10% were included from outpatient clinics at 2 academic centers. Follow-up was performed for the occurrence of adverse events including all-cause mortality, nonfatal myocardial infarction, unstable angina, or coronary revascularization. During a median follow-up of 3.0 (interquartile range 1.3 to 4.1) years, adverse events occurred in 40 subjects (6.0%). By multivariate analysis, adjusted for age, gender, and CACS, obstructive CAD on CCTA (≥50% luminal stenosis) was a significant predictor of adverse events (hazard ratio 5.9 [CI 1.3 to 26.1]). Addition of CCTA to age, gender, plus CACS, increased the C statistic from 0.81 to 0.84 and resulted in a total net reclassification index of 0.19 (p <0.01). In conclusion, CCTA has incremental prognostic value and risk reclassification benefit beyond CACS in patients without CAD symptoms but with high risk of developing CVD.

  9. Relation between high density lipoprotein cholesterol and coronary artery disease in asymptomatic men

    SciTech Connect

    Uhl, G.S.; Troxler, R.G.; Hickman, J.R. Jr.; Clark, D.

    1981-11-01

    The well established inverse relation of high density lipoprotein cholesterol (HDL) and the risk of coronary artery disease was tested in a cross-sectional group of 572 asymptomatic aircrew members who were being screened for risk of coronary artery disease. A battery of tests was performed, including determinations of fasting serum cholesterol, HDL cholesterol and triglycerides and performance of a maximal symptom-limited exercise tolerance test. Of the 572 patients, 132 also had an abnormal S-T segment response to exercise testing or were otherwise believed to have an increased risk of organic heart disease and subsequently underwent coronary angiography. Significant coronary artery disease was found in 16 men and minimal or subcritical coronary disease in 14; coronary angiograms were normal in the remaining 102 men. The remaining 440 men, who were believed to have a 1 percent chance of having coronary artery disease by sequential testing of risk factors and treadmill testing, had a mean cholesterol level of 213 mg/100 ml, a mean HDL cholesterol of 51 mg/100 ml and a mean cholesterol/HDL ratio of 4.4. The mean values of cholesterol, HDL cholesterol and cholesterol/HDL cholesterol did not differ significantly in men with normal angiographic finding and those with subcritical coronary disease. However, 14 of 16 men with coronary artery disease had a cholesterol/HDL ratio of 6.0 or more whereas only 4 men with normal coronary arteries had a ratio of 6.0 or more. Of the classical coronary risk factors evaluated, the cholesterol/HDL ratio of 6.0 or more had the highest odds ratio (172:1). It appears that determination of HDL cholesterol level helps to identify asymptomatic persons with a greater risk of having coronary artery disease.

  10. Routine preoperative insertion of IABP in high-risk off-pump coronary artery bypass grafting.

    PubMed

    Vohra, Hunaid A; Briffa, Norman P

    2005-01-01

    The beneficial effects of intraaortic balloon pump (IABP) in coronary artery bypass graft surgery with cardiopulmonary bypass have been reported. However, whether preoperative insertion of IABP in high-risk off-pump coronary artery bypass grafting (OPCAB) has any beneficial effects remains to be established. We report our experience of preoperative insertion of IABP in OPCAB.

  11. Absolute Helmholtz free energy of highly anharmonic crystals: theory vs Monte Carlo.

    PubMed

    Yakub, Lydia; Yakub, Eugene

    2012-04-14

    We discuss the problem of the quantitative theoretical prediction of the absolute free energy for classical highly anharmonic solids. Helmholtz free energy of the Lennard-Jones (LJ) crystal is calculated accurately while accounting for both the anharmonicity of atomic vibrations and the pair and triple correlations in displacements of the atoms from their lattice sites. The comparison with most precise computer simulation data on sublimation and melting lines revealed that theoretical predictions are in excellent agreement with Monte Carlo simulation data in the whole range of temperatures and densities studied.

  12. High-resolution measurement of absolute {alpha}-decay widths in {sup 16}O

    SciTech Connect

    Wheldon, C.; Ashwood, N. I.; Barr, M.; Curtis, N.; Freer, M.; Kokalova, Tz.; Malcolm, J. D.; Spencer, S. J.; Ziman, V. A.; Faestermann, Th.; Kruecken, R.; Wirth, H.-F.; Hertenberger, R.; Lutter, R.; Bergmaier, A.

    2011-06-15

    By using a large-acceptance position-sensitive silicon detector array in coincidence with the high-resolution Munich Q3D spectrograph, unambiguous measurements have been made of the absolute {alpha}-particle decay widths from excited states in {sup 16}O* in the energy range 13.85 to 15.87 MeV. Carbon targets have been bombarded with 42-MeV {sup 6}Li beams to induce {sub 6}{sup 12}C({sub 3}{sup 6}Li, d){sub 8}{sup 16}O* reactions. The deuteron ejectiles were measured in the Q3D and the results gated by {sup 4}He+{sup 12}C breakup products detected in the silicon array, the efficiency of which was modeled using Monte Carlo simulations. By comparing total population and breakup-gated spectra, the following absolute {alpha}-decay widths have been measured with high resolution: {Gamma}{sub {alpha}}0/{Gamma}{sub tot} = 0.87{+-}0.11 (13.980 MeV), 1.04{+-}0.15 (14.302 MeV), 0.92{+-}0.10 (14.399 MeV), 0.59{+-}0.04 (14.815 MeV), 0.88{+-}0.18 (15.785 MeV), and {Gamma}{sub {alpha}}1/{Gamma}{sub tot}=1.14{+-}0.08 (14.660 MeV), 0.46{+-}0.06 (14.815 MeV).

  13. High-risk coronary angioplasty assisted by active hemoperfusion. A feasibility study.

    PubMed Central

    Angelini, P; Hernandez, C; Ferguson, J J; Leachman, R D; Garcia-Gregory, J A; Benrey, J; Schnee, M J; Fighali, S F; Krajcer, Z

    1996-01-01

    We assessed the effectiveness of distal hemoperfusion support during gradual, prolonged balloon inflation during percutaneous transluminal coronary angioplasty in high-risk patients. The patients were identified as having a poor left ventricular ejection fraction ( < 35%), > 50% of viable myocardium at risk percutaneous coronary balloon angioplasty, or both. A total of 64 procedures were performed in 61 patients. Angiographic success was achieved in 83 of 86 (96.5%) lesions treated with hemoperfusion support. Hospital complications included 1 patient who had a non-Q-wave infarction, 1 who had to undergo redo percutaneous coronary balloon angioplasty, and 5 who required coronary artery bypass operations. The hospital mortality was 7.8% (5 patients). This preliminary study indicates that hemoperfusion support can enable expeditious, simple, economical, and effective percutaneous transluminal coronary balloon angioplasty in a subset of labile patients in whom procedural failure frequently leads to sudden death. PMID:8680269

  14. High susceptibility of atherosclerotic coronary arteries to the onset of vasospasm and angina pectoris-like symptoms due to coronary spasm in WHHLMI rabbits

    PubMed Central

    Koike, Tomonari; Tamura, Shiori; Yu, Ying; Kuniyoshi, Nobue; Shiomi, Masashi

    2016-01-01

    We examined the relationship between atherosclerosis and the provocation of coronary spasm as well as the influence of coronary spasm on the onset of acute ischemic myocardial disease. Coronary spasm was provoked in anesthetized normal Japanese white (JW) rabbits and myocardial infarction-prone Watanabe heritable hyperlipidemic (WHHLMI) rabbits, an animal model for coronary atherosclerosis and myocardial infarction, by injecting ergonovine during the infusion of norepinephrine through a marginal ear vein. A decrease in contrast flow in the left circumflex artery was observed on coronary angiograms. Ischemic changes were observed on the electrocardiograms of 29% (2/7) of JW and 79% (27/34, P=0.007) of WHHLMI rabbits. The frequency of coronary spasm was significantly high in rabbits with severe coronary plaques showing diffuse lesions. Left ventricle motility in vasospasm-positive rabbits, which was evaluated with echocardiograms, was decreased by 29% following the ergonovine injection (P<0.001), and every serum ischemic marker markedly increased 4 h after the provocation of vasospasm. These results demonstrate that atherosclerotic coronary arteries are positively related to the provocation of vasospasm, and vasospasm in severe atherosclerotic coronary segments evokes angina pectoris-like findings and/or non-fatal myocardial infarction. WHHLMI rabbits may be a novel animal model for angina pectoris and acute ischemic heart disease. PMID:27301847

  15. High-precision laser-assisted absolute determination of x-ray diffraction angles

    SciTech Connect

    Kubicek, K.; Braun, J.; Bruhns, H.; Crespo Lopez-Urrutia, J. R.; Mokler, P. H.; Ullrich, J.

    2012-01-15

    A novel technique for absolute wavelength determination in high-precision crystal x-ray spectroscopy recently introduced has been upgraded reaching unprecedented accuracies. The method combines visible laser beams with the Bond method, where Bragg angles ({theta} and -{theta}) are determined without any x-ray reference lines. Using flat crystals this technique makes absolute x-ray wavelength measurements feasible even at low x-ray fluxes. The upgraded spectrometer has been used in combination with first experiments on the 1s2p {sup 1}P{sub 1}{yields} 1s{sup 2} {sup 1}S{sub 0} w-line in He-like argon. By resolving a minute curvature of the x-ray lines the accuracy reaches there the best ever reported value of 1.5 ppm. The result is sensitive to predicted second-order QED contributions at the level of two-electron screening and two-photon radiative diagrams and will allow for the first time to benchmark predicted binding energies for He-like ions at this level of precision.

  16. ABSOLUTE MEASUREMENT OF THE POLARIZATION OF HIGH ENERGY PROTON BEAMS AT RHIC

    SciTech Connect

    MAKDISI,Y.; BRAVAR, A. BUNCE, G. GILL, R.; HUANG, H.; ET AL.

    2007-06-25

    The spin physics program at the Relativistic Heavy Ion Collider (RHIC) requires knowledge of the beam polarization to better than 5%. Such a goal is made the more difficult by the lack of knowledge of the analyzing power of high energy nuclear physics processes. To overcome this, a polarized hydrogen jet target was constructed and installed at one intersection region in RHIC where it intersects both beams and utilizes the precise knowledge of the jet atomic hydrogen beam polarization to measure the analyzing power in proton-proton elastic scattering in the Nuclear Coulomb Interference (CNI) region at the prescribed RHIC proton beam energy. The reverse reaction is used to assess the absolute beam polarization. Simultaneous measurements taken with fast high statistics polarimeters that measure the p-Carbon elastic scattering process also in the CNI region use the jet results to calibrate the latter.

  17. Miniature high-throughput chemosensing of yield, ee, and absolute configuration from crude reaction mixtures

    PubMed Central

    Bentley, Keith W.; Zhang, Peng; Wolf, Christian

    2016-01-01

    High-throughput experimentation (HTE) has emerged as a widely used technology that accelerates discovery and optimization processes with parallel small-scale reaction setups. A high-throughput screening (HTS) method capable of comprehensive analysis of crude asymmetric reaction mixtures (eliminating product derivatization or isolation) would provide transformative impact by matching the pace of HTE. We report how spontaneous in situ construction of stereodynamic metal probes from readily available, inexpensive starting materials can be applied to chiroptical chemosensing of the total amount, enantiomeric excess (ee), and absolute configuration of a wide variety of amines, diamines, amino alcohols, amino acids, carboxylic acids, α-hydroxy acids, and diols. This advance and HTS potential are highlighted with the analysis of 1 mg of crude reaction mixtures of a catalytic asymmetric reaction. This operationally simple assay uses a robust mix-and-measure protocol, is amenable to microscale platforms and automation, and provides critical time efficiency and sustainability advantages over traditional serial methods. PMID:26933684

  18. SYNTAX Score in Patients with High Computed Tomography Coronary Calcium Score

    PubMed Central

    Hegde, Madhav; Rajendran, Ravindran

    2016-01-01

    Objectives: To study the conventional coronary angiogram ( CA) findings in patients with high coronary calcium on multidetector computed tomogram. Materials and Methods: Fifty patients with coronary calcium high enough in its extent and location to interfere with the interpretation of a contrast-filled coronary artery for a significant lesion were studied with conventional CA. Framingham risk score (FRS), computed tomography (CT) coronary calcium score (CCS), and SYNTAX score (SS) from the CA were calculated by separate investigators who were blinded to other scores. Effectively, 250 coronary arteries (left main, left anterior descending, left circumflex, and right coronary artery and posterior descending artery in each subject) with calcium scores were studied for lesions on CA. Results: Thirty-five subjects had high FRS, 10 had intermediate FRS, and 5 had low FRS. Eight subjects of 25 (32%) with CCS between 350 and 1000 had no significant coronary artery disease (CAD). Overall, the CCS and the SS had a strong agreement with each other (r = 0.68, P < 0.01) that persisted in those with very high scores >1000 (r = 0.55, P < 0.01, n = 30), but only a nonsignificant weak correlation with scores between 350 and 1000 (r = 0.1, P = 0.62, n = 20). Individual vessel calcium scores correlated strongly for the presence of any lesion (r = 0.52, P < 0.01) in the same artery but only weakly for a significant lesion (r = 0.29, P = 0.05). Conclusion: High CT CCS in this cohort of intermediate to high (Framingham score) risk patients correlated strongly with the subject's global burden of the CAD as derived by the SS, more so for subjects with very high scores. Similarly, CCS correlated strongly with the presence of any lesion but only weakly for a significant stenosis; also, about one-third of patients with CCS between 350 and 1000 may not have significant disease on conventional CA. PMID:28028450

  19. High-speed coronary rotational angioplasty with the rotablator

    NASA Astrophysics Data System (ADS)

    Zacca, Nadim M.; Kleiman, Neal S.; Asimacopoulos, P. J.

    1992-08-01

    Percutaneous mechanical rotational ablation with the rotablator can be used effectively as a stand alone treatment for coronary arterial lesions, including those with angiographic morphology considered unfavorable for balloon angioplasty (eccentric, at bends, bifurcating, calcified, ulcerated, completely occluded_, as well as for balloon angioplasty procedure failures. The use of single rather than multiple burrs without balloon assistance, the use of fewer passes and of the nitroglycerine infusion through the rotablator catheter have considerably shortened the time necessary to complete a rotational atherectomy. Further, the apparently infrequent occurrence of post procedure abrupt closure makes this technique attractive in the clinical management of patients with complex coronary artery lesions.

  20. Usage tests of oak moss absolutes containing high and low levels of atranol and chloroatranol.

    PubMed

    Mowitz, Martin; Svedman, Cecilia; Zimerson, Erik; Bruze, Magnus

    2014-07-01

    Atranol and chloroatranol are strong contact allergens in oak moss absolute, a lichen extract used in perfumery. Fifteen subjects with contact allergy to oak moss absolute underwent a repeated open application test (ROAT) using solutions of an untreated oak moss absolute (sample A) and an oak moss absolute with reduced content of atranol and chloroatranol (sample B). All subjects were in addition patch-tested with serial dilutions of samples A and B. Statistically significantly more subjects reacted to sample A than to sample B in the patch tests. No corresponding difference was observed in the ROAT, though there was a significant difference in the time required to elicit a positive reaction. Still, the ROAT indicates that the use of a cosmetic product containing oak moss absolute with reduced levels of atranol and chloroatranol is capable of eliciting an allergic reaction in previously sensitised individuals.

  1. High Platelet Reactivity in Patients with Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention: Randomised Controlled Trial Comparing Prasugrel and Clopidogrel

    PubMed Central

    Geisler, Tobias; Booth, Jean; Tavlaki, Elli; Karathanos, Athanasios; Müller, Karin; Droppa, Michal; Gawaz, Meinrad; Yanez-Lopez, Monica; Davidson, Simon J.; Stables, Rod H.; Banya, Winston; Zaman, Azfar; Flather, Marcus; Dalby, Miles

    2015-01-01

    Background Prasugrel is more effective than clopidogrel in reducing platelet aggregation in acute coronary syndromes. Data available on prasugrel reloading in clopidogrel treated patients with high residual platelet reactivity (HRPR) i.e. poor responders, is limited. Objectives To determine the effects of prasugrel loading on platelet function in patients on clopidogrel and high platelet reactivity undergoing percutaneous coronary intervention for acute coronary syndrome (ACS). Patients Patients with ACS on clopidogrel who were scheduled for PCI found to have a platelet reactivity ≥40 AUC with the Multiplate Analyzer, i.e. “poor responders” were randomised to prasugrel (60 mg loading and 10 mg maintenance dose) or clopidogrel (600 mg reloading and 150 mg maintenance dose). The primary outcome measure was proportion of patients with platelet reactivity <40 AUC 4 hours after loading with study medication, and also at one hour (secondary outcome). 44 patients were enrolled and the study was terminated early as clopidogrel use decreased sharply due to introduction of newer P2Y12 inhibitors. Results At 4 hours after study medication 100% of patients treated with prasugrel compared to 91% of those treated with clopidogrel had platelet reactivity <40 AUC (p = 0.49), while at 1 hour the proportions were 95% and 64% respectively (p = 0.02). Mean platelet reactivity at 4 and 1 hours after study medication in prasugrel and clopidogrel groups respectively were 12 versus 22 (p = 0.005) and 19 versus 34 (p = 0.01) respectively. Conclusions Routine platelet function testing identifies patients with high residual platelet reactivity (“poor responders”) on clopidogrel. A strategy of prasugrel rather than clopidogrel reloading results in earlier and more sustained suppression of platelet reactivity. Future trials need to identify if this translates into clinical benefit. Trial Registration ClinicalTrials.gov NCT01339026 PMID:26317618

  2. The high-precision videometrics methods to determining absolute vertical benchmark

    NASA Astrophysics Data System (ADS)

    Liu, Jinbo; Zhu, Zhaokun

    2013-01-01

    The mobile measurement equipment plays an important role in engineering measurement tasks and its measuring device is fixed with the vehicle platform. Therefore, how to correct the measured error in time that caused by swayed platform is a basic problem. Videometrics has its inherent advantages in solving this problem. First of all, videometrics technology is non-contact measurement, which has no effect on the target's structural characteristics and motion characteristics. Secondly, videometrics technology has high precision especially for surface targets and linear targets in the field of view. Thirdly, videometrics technology has the advantages of automatic, real-time and dynamic. This paper is mainly for mobile theodolite.etc that works under the environment of absolute vertical benchmark and proposed two high-precision methods to determine vertical benchmark: Direct-Extracting, which is based on the intersection of plats under the help of two cameras; Benchmark-Transformation, which gets the vertical benchmark by reconstructing the level-plat. Two methods both have the precision of under 10 seconds by digital simulation and physical experiments. The methods proposed by this paper have significance both on the theory and application.

  3. The absolute radiometric calibration of the advanced very high resolution radiometer

    NASA Technical Reports Server (NTRS)

    Slater, P. N.; Teillet, P. M.; Ding, Y.

    1988-01-01

    The need for independent, redundant absolute radiometric calibration methods is discussed with reference to the Thematic Mapper. Uncertainty requirements for absolute calibration of between 0.5 and 4 percent are defined based on the accuracy of reflectance retrievals at an agricultural site. It is shown that even very approximate atmospheric corrections can reduce the error in reflectance retrieval to 0.02 over the reflectance range 0 to 0.4.

  4. An absolute dose determination of helical tomotherapy accelerator, TomoTherapy High-Art II

    SciTech Connect

    Bailat, Claude J.; Buchillier, Thierry; Pachoud, Marc; Moeckli, Raphaeel; Bochud, Francois O.

    2009-09-15

    Purpose: A helical tomotherapy accelerator presents a dosimetric challenge because, to this day, there is no internationally accepted protocol for the determination of the absolute dose. Because of this reality, we investigated the different alternatives for characterizing and measuring the absolute dose of such an accelerator. We tested several dosimetric techniques with various metrological traceabilities as well as using a number of phantoms in static and helical modes. Methods: Firstly, the relationship between the reading of ionization chambers and the absorbed dose is dependent on the beam quality value of the photon beam. For high energy photons, the beam quality is specified by the tissue phantom ratio (TPR{sub 20,10}) and it is therefore necessary to know the TPR{sub 20,10} to calculate the dose delivered by a given accelerator. This parameter is obtained through the ratio of the absorbed dose at 20 and 10 cm depths in water and was measured in the particular conditions of the tomotherapy accelerator. Afterward, measurements were performed using the ionization chamber (model A1SL) delivered as a reference instrument by the vendor. This chamber is traceable in absorbed dose to water in a Co-60 beam to a water calorimeter of the American metrology institute (NIST). Similarly, in Switzerland, each radiotherapy department is directly traceable to the Swiss metrology institute (METAS) in absorbed dose to water based on a water calorimeter. For our research, this traceability was obtained by using an ionization chamber traceable to METAS (model NE 2611A), which is the secondary standard of our institute. Furthermore, in order to have another fully independent measurement method, we determined the dose using alanine dosimeters provided by and traceable to the British metrology institute (NPL); they are calibrated in absorbed dose to water using a graphite calorimeter. And finally, we wanted to take into account the type of chamber routinely used in clinical

  5. Investigations of high-speed optical transmission systems employing Absolute Added Correlative Coding (AACC)

    NASA Astrophysics Data System (ADS)

    Dong-Nhat, Nguyen; Elsherif, Mohamed A.; Malekmohammadi, Amin

    2016-07-01

    A novel multilevel modulation format based on partial-response signaling called Absolute Added Correlative Coding (AACC) is proposed and numerically demonstrated for high-speed fiber-optic communication systems. A bit error rate (BER) estimation model for the proposed multilevel format has also been developed. The performance of AACC is examined and compared against other prevailing On-Off-Keying and multilevel modulation formats e.g. non-return-to-zero (NRZ), 50% return-to-zero (RZ), 67% carrier-suppressed return-to-zero (CS-RZ), duobinary and four-level pulse-amplitude modulation (4-PAM) in terms of receiver sensitivity, spectral efficiency and dispersion tolerance. Calculated receiver sensitivity at a BER of 10-9 and chromatic dispersion tolerance of the proposed system are ˜-28.3 dBm and ˜336 ps/nm, respectively. The performance of AACC is delineated to be improved by 7.8 dB in terms of receiver sensitivity compared to 4-PAM in back-to-back scenario. The comparison results also show a clear advantage of AACC in achieving longer fiber transmission distance due to the higher dispersion tolerance in optical access networks.

  6. Performance of dual-source CT with high pitch spiral mode for coronary stent patency compared with invasive coronary angiography

    PubMed Central

    Yang, Xia; Yu, Qiang; Dong, Wei; Fu, Zhen-Hong; Yang, Jun-Jue; Guo, Jun; Chen, Yun-Dai

    2016-01-01

    Objective To investigate the performance of dual-source computed tomography (DSCT) using high-pitch spiral (HPS) mode for coronary stents patency. Methods We conducted a prospective study on 120 patients with 260 previous stents implanted due to recurred suspicious symptoms of angina scheduled for invasive coronary angiography (ICA), while DSCT were conducted using HPS mode. Results There was no significant impact of age, body mass index or heat rate (HR) on image quality (P > 0.05), while HR variability had a slight impact on that (P < 0.05). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of DSCT in detection of in-stent restenosis (ISR) based per-patient were 92.3%, 96.7%, 88.9%, and 97.8%, respectively. And those based per-stent were 87%, 96.8%, 83.3%, and 97.7% with un-assessment stents, 97.4%, 99.5%, 97.4%, and 99.5% without un-assessment stents. There was significant difference on sensitivity, specificity, PPV and NPV between diameter ≥ 3.0 mm group (93.3%, 97.9%, 87.5%, and 98.9%) and diameter < 3.0 mm group (80%, 93.3%, 80.0%, and 93.3%) (P < 0.05), and that between stent number ≥ 3 group (82.3%, 77.8%, 66.7%, and 60%) with < 3 group (97.3%, 80%, 96.5%, and 75%). The effective dose of DSCT (1.4 ± 0.5 mSv) is significantly less than that by invasive coronary angiography [4.0 ± 0.8 mSv (P < 0.01)]. Conclusion DSCT using HPS mode provides good diagnostic performance on stent patency with lower effective dose in patients with HR < 65 beats/min. PMID:27928222

  7. Renal dysfunction and coronary disease: a high-risk combination.

    PubMed

    Schiele, Francois

    2009-01-01

    Chronic kidney dysfunction is recognized as a risk factor for atherosclerosis and complicates strategies and treatment. Therefore, it is important for cardiologists not only to detect and measure potential kidney dysfunction, but also to know the mechanisms by which the heart and kidney interact, and recognize that in cases of acute coronary syndrome, the presence of renal dysfunction increases the risk of death. The detection and classification of kidney dysfunction into 5 stages is based on the estimated glomerular filtration rate (GFR). The presence of hypertension, endothelial dysfunction, dyslipidemia, inflammation, activation of the renin-angiotensin system and specific calcifications are the main mechanisms by which renal dysfunction can induce or compound cardiovascular disease. The magnitude of renal dysfunction is related to the cardiovascular risk; a linear relation links the extent of GFR decrease and the risk of cardiovascular events. Renal dysfunction and acute coronary syndromes are a dangerous combination: more common comorbidities, more frequent contraindications for effective drugs and higher numbers of drug-related adverse events such as bleeding partially explain the higher mortality in patients with renal dysfunction. In addition, despite higher risk, patients with renal dysfunction often receive fewer guideline-recommended treatments even in the absence of contraindications. Renal dysfunction induces and promotes atherosclerosis by various pathophysiologic pathways and is associated with other cardiovascular risk factors and underuse of appropriate therapy. Therefore, the assessment of renal function is an important step in the risk evaluation of patients with coronary artery disease.

  8. Assignment of absolute configurations of highly flexible linear diterpenes from the brown alga Bifurcaria bifurcata by VCD spectroscopy.

    PubMed

    Merten, Christian; Smyrniotopoulos, Vangelis; Tasdemir, Deniz

    2015-11-21

    Correct assignment of the stereogenic centers of highly flexible linear diterpenes (LDs) is challenging. Herein we report the first application of VCD spectroscopy for the absolute configuration determination of LDs of algal origin and provide experimental and computational procedures, such as a fragmentation approach, which will facilitate the use of VCD spectroscopy for configuration assignments of LDs.

  9. Toward a self-consistent, high-resolution absolute plate motion model for the Pacific

    NASA Astrophysics Data System (ADS)

    Wessel, Paul; Harada, Yasushi; Kroenke, Loren W.

    2006-03-01

    The hot spot hypothesis postulates that linear volcanic trails form as lithospheric plates move relative to stationary or slowly moving plumes. Given geometry and ages from several trails, one can reconstruct absolute plate motions (APM) that provide valuable information about past and present tectonism, paleogeography, and volcanism. Most APM models have been designed by fitting small circles to coeval volcanic chain segments and determining stage rotation poles, opening angles, and time intervals. Unlike relative plate motion (RPM) models, such APM models suffer from oversimplicity, self-inconsistencies, inadequate fits to data, and lack of rigorous uncertainty estimates; in addition, they work only for fixed hot spots. Newer methods are now available that overcome many of these limitations. We present a technique that provides high-resolution APM models derived from stationary or moving hot spots (given prescribed paths). The simplest model assumes stationary hot spots, and an example of such a model is presented. Observations of geometry and chronology on the Pacific plate appear well explained by this type of model. Because it is a one-plate model, it does not discriminate between hot spot drift or true polar wander as explanations for inferred paleolatitudes from the Emperor chain. Whether there was significant relative motion within the hot spots under the Pacific plate during the last ˜70 m.y. is difficult to quantify, given the paucity and geological uncertainty of age determinations. Evidence in support of plume drift appears limited to the period before the 47 Ma Hawaii-Emperor Bend and, apart from the direct paleolatitude determinations, may have been somewhat exaggerated.

  10. High-risk plaque in patients with near normal coronary angiograms.

    PubMed

    Turner, Michael C

    2016-11-01

    The increased use of cardiac computed tomography angiography in the emergency room to triage patients who present with chest pain syndrome has led to the identification of individuals with coronary plaques with high-risk characteristics in the absence of significant stenoses. Anecdotal observations have suggested that the presence of coronary high-risk plaque results in an increased risk of acute coronary syndrome over time. This case presentation represents an example of this subgroup of patients. Intuitively, it would seem that high-dose statin therapy would be the treatment of choice, with percutaneous intervention reserved for the development of flow-limiting lesions; however, a prospective trial to determine outcomes to our knowledge has not been performed.

  11. Diode-laser-based high-precision absolute distance interferometer of 20 m range.

    PubMed

    Pollinger, Florian; Meiners-Hagen, Karl; Wedde, Martin; Abou-Zeid, Ahmed

    2009-11-10

    We present a hybrid absolute distance measurement method that is based on a combination of frequency sweeping, variable synthetic, and two-wavelength, fixed synthetic wavelength interferometry. Both experiments were realized by two external cavity diode lasers. The measurement uncertainty was experimentally and theoretically demonstrated to be smaller than 12 microm at a measurement distance of 20 m.

  12. Enantiomeric high-performance liquid chromatography resolution and absolute configuration of 6β-benzoyloxy-3α-tropanol.

    PubMed

    Muñoz, Marcelo A; González, Natalia; Joseph-Nathan, Pedro

    2016-07-01

    The absolute configuration of the naturally occurring isomers of 6β-benzoyloxy-3α-tropanol (1) has been established by the combined use of chiral high-performance liquid chromatography with electronic circular dichroism detection and optical rotation detection. For this purpose (±)-1, prepared in two steps from racemic 6-hydroxytropinone (4), was subjected to chiral high-performance liquid chromatography with electronic circular dichroism and optical rotation detection allowing the online measurement of both chiroptical properties for each enantiomer, which in turn were compared with the corresponding values obtained from density functional theory calculations. In an independent approach, preparative high-performance liquid chromatography separation using an automatic fraction collector, yielded an enantiopure sample of OR (+)-1 whose vibrational circular dichroism spectrum allowed its absolute configuration assignment when the bands in the 1100-950 cm(-1) region were compared with those of the enantiomers of esters derived from 3α,6β-tropanediol. In addition, an enantiomerically enriched sample of 4, instead of OR (±)-4, was used for the same transformation sequence, whose high-performance liquid chromatography follow-up allowed their spectroscopic correlation. All evidences lead to the OR (+)-(1S,3R,5S,6R) and OR (-)-(1R,3S,5R,6S) absolute configurations, from where it follows that samples of 1 isolated from Knightia strobilina and Erythroxylum zambesiacum have the OR (+)-(1S,3R,5S,6R) absolute configuration, while the sample obtained from E. rotundifolium has the OR (-)-(1R,3S,5R,6S) absolute configuration.

  13. Ground-based lidar and microwave radiometry synergy for high vertical resolution absolute humidity profiling

    NASA Astrophysics Data System (ADS)

    Barrera-Verdejo, María; Crewell, Susanne; Löhnert, Ulrich; Orlandi, Emiliano; Di Girolamo, Paolo

    2016-08-01

    Continuous monitoring of atmospheric humidity profiles is important for many applications, e.g., assessment of atmospheric stability and cloud formation. Nowadays there are a wide variety of ground-based sensors for atmospheric humidity profiling. Unfortunately there is no single instrument able to provide a measurement with complete vertical coverage, high vertical and temporal resolution and good performance under all weather conditions, simultaneously. For example, Raman lidar (RL) measurements can provide water vapor with a high vertical resolution, albeit with limited vertical coverage, due to sunlight contamination and the presence of clouds. Microwave radiometers (MWRs) receive water vapor information throughout the troposphere, though their vertical resolution is poor. In this work, we present an MWR and RL system synergy, which aims to overcome the specific sensor limitations. The retrieval algorithm combining these two instruments is an optimal estimation method (OEM), which allows for an uncertainty analysis of the retrieved profiles. The OEM combines measurements and a priori information, taking the uncertainty of both into account. The measurement vector consists of a set of MWR brightness temperatures and RL water vapor profiles. The method is applied to a 2-month field campaign around Jülich (Germany), focusing on clear sky periods. Different experiments are performed to analyze the improvements achieved via the synergy compared to the individual retrievals. When applying the combined retrieval, on average the theoretically determined absolute humidity uncertainty is reduced above the last usable lidar range by a factor of ˜ 2 with respect to the case where only RL measurements are used. The analysis in terms of degrees of freedom per signal reveal that most information is gained above the usable lidar range, especially important during daytime when the lidar vertical coverage is limited. The retrieved profiles are further evaluated using

  14. Effect of high-dose intravenous eletriptan on coronary artery diameter.

    PubMed

    Goldstein, J A; Massey, K D; Kirby, S; Gibson, M; Hettiarachchi, J; Rankin, A J; Jackson, N C

    2004-07-01

    The goal of this study was to evaluate the coronary vasoconstrictive effects of high doses of eletriptan compared with a standard dose of sumatriptan. Patients with no clinically significant coronary artery disease were randomized to receive high-dose intravenous eletriptan (n = 24) vs a standard dose of sumatriptan (n = 18; 6 mg subcutaneously) vs placebo (n = 18). Serial angiograms were obtained. The primary non-inferiority analysis found equivalence between the mean maximum change in left anterior descending coronary artery diameter for eletriptan, -22%[95% confidence interval (CI) -26, -19], and sumatriptan, -19% (95% CI -22, -16). The change due to placebo was -16% (95% CI -20, -12). No individual cases of clinically significant vasoconstriction were observed. The results confirm that eletriptan has a broad cardiovascular safety margin, with plasma concentrations comparable to three to five times the Cmax of an oral 80-mg dose associated with modest vasoconstriction equivalent to standard therapeutic doses of sumatriptan.

  15. Optimal design of the absolute positioning sensor for a high-speed maglev train and research on its fault diagnosis.

    PubMed

    Zhang, Dapeng; Long, Zhiqiang; Xue, Song; Zhang, Junge

    2012-01-01

    This paper studies an absolute positioning sensor for a high-speed maglev train and its fault diagnosis method. The absolute positioning sensor is an important sensor for the high-speed maglev train to accomplish its synchronous traction. It is used to calibrate the error of the relative positioning sensor which is used to provide the magnetic phase signal. On the basis of the analysis for the principle of the absolute positioning sensor, the paper describes the design of the sending and receiving coils and realizes the hardware and the software for the sensor. In order to enhance the reliability of the sensor, a support vector machine is used to recognize the fault characters, and the signal flow method is used to locate the faulty parts. The diagnosis information not only can be sent to an upper center control computer to evaluate the reliability of the sensors, but also can realize on-line diagnosis for debugging and the quick detection when the maglev train is off-line. The absolute positioning sensor we study has been used in the actual project.

  16. Optimal Design of the Absolute Positioning Sensor for a High-Speed Maglev Train and Research on Its Fault Diagnosis

    PubMed Central

    Zhang, Dapeng; Long, Zhiqiang; Xue, Song; Zhang, Junge

    2012-01-01

    This paper studies an absolute positioning sensor for a high-speed maglev train and its fault diagnosis method. The absolute positioning sensor is an important sensor for the high-speed maglev train to accomplish its synchronous traction. It is used to calibrate the error of the relative positioning sensor which is used to provide the magnetic phase signal. On the basis of the analysis for the principle of the absolute positioning sensor, the paper describes the design of the sending and receiving coils and realizes the hardware and the software for the sensor. In order to enhance the reliability of the sensor, a support vector machine is used to recognize the fault characters, and the signal flow method is used to locate the faulty parts. The diagnosis information not only can be sent to an upper center control computer to evaluate the reliability of the sensors, but also can realize on-line diagnosis for debugging and the quick detection when the maglev train is off-line. The absolute positioning sensor we study has been used in the actual project. PMID:23112619

  17. Coronary blood flow during percutaneous hemopump in patients at high risk for angioplasty

    NASA Astrophysics Data System (ADS)

    Geschwind, Herbert J.; Dubois-Rande, Jean Luc; Dupouy, Patrick J.; Larrazet, Fabrice S.; Kvasnicka, Jan; El-Ghalid, Ahmed; Deleuze, Philippe; Loisance, Daniel

    1995-05-01

    Hemopump is a ventricular assist device which is aimed at improving the management of high- risk patients for PTCA. The aim of the study was to access coronary blood flow velocity during hemopump. The hemopump was inserted percutaneously into the femoral artery. Coronary blood flow was measured with a 12 MHz Doppler-tipped guidewire proximal and distal to the stenosis before, during and after PTCA. Coronary vascular reserve was assessed by intracoronary 12 mg bolus injection of Papaverine. Collateral flow was assessed during balloon occlusion by inverted velocity signals below baseline. Eight patients aged 59 +/- 11 yrs, with unstable angina, a last patent vessel and/or major left ventricular dysfunction (EF < 0.20) had hemopump during PTCA of stenosis (86 +/- 14%) of the LAD (n equals 4) or the LCX (n equals 4). Collateral flow was slightly increased (+25 +/- 18%) by the Hemopump. Hemopump did not strongly affect coronary flow velocity, did not significantly increase collateral flow and increased slightly coronary vascular reserve.

  18. Absolute asymmetric synthesis of enantiopure organozinc reagents, followed by highly enantioselective chlorination.

    PubMed

    Olsson, Susanne; Lennartson, Anders; Håkansson, Mikael

    2013-09-09

    We report the absolute asymmetric synthesis (AAS) of indenylzinc reagents by using total spontaneous resolution followed by enantiospecific conversion into 1-chloroindene. The chiral complex [Zn(dcp)(ind)(tmeda)] (dcp = 2,6-dichlorophenoxy and tmeda = N,N,N',N'-tetramethylethylenediamine) (3) was prepared from the achiral starting materials indene, potassium, zinc chloride, TMEDA, and 2,6-dichlorophenol. The reagent resolved spontaneously on crystallization, and single crystals of 3 react with N-chlorosuccinimide in the presence of benzoquinone in 2-propanol to give 1-chloroindene in >98 % enantiomeric excess. It was found that (R)-3 gave (R)-1-chloroindene upon reaction, indicating an SE 2'-mechanism. Since bulk samples of 3 gave optically active product upon chlorination, total spontaneous resolution must have occurred. This demonstrates that enantiopure products can be obtained through the absolute asymmetric synthesis of organometallic reagents starting from achiral materials. The general absolute asymmetric synthesis (AAS) method offers easy access to both enantiomers and an almost limitless variation in the design of the product.

  19. Effectiveness of music interventions for women with high anxiety during coronary angiographic procedures: a randomized controlled.

    PubMed

    Nilsson, Ulrica

    2012-06-01

    The purpose was to investigate if women with high pre-procedural anxiety reported higher degree of relaxation and comfort if listening to music during coronary angiographic procedures. A prospective randomized controlled trial was used included 68 patients undergoing coronary angiography and/or PCI. The women were allocated to receive calming music and standard care or standard care only. Relaxation, environmental sound and discomfort associated with lying still were assessed. There was significantly more positive impression of the sound environment and less discomfort associated with lying still in women listening to music in comparison to women who received only standard care. No effect in relaxation was found.

  20. Relative atherogenicity and predictive value of non-high-density lipoprotein cholesterol for coronary heart disease

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Although low-density lipoprotein cholesterol (LDL-C) is a well-established atherogenic factor for coronary heart disease, it does not completely represent the risk associated with atherogenic lipoproteins in the presence of high triglyceride (TG) levels. Constituent lipoproteins constituting non–hig...

  1. Method and apparatus for ultra-high-sensitivity, incremental and absolute optical encoding

    NASA Technical Reports Server (NTRS)

    Leviton, Douglas B. (Inventor)

    1999-01-01

    An absolute optical linear or rotary encoder which encodes the motion of an object (3) with increased resolution and encoding range and decreased sensitivity to damage to the scale includes a scale (5), which moves with the object and is illuminated by a light source (11). The scale carries a pattern (9) which is imaged by a microscope optical system (13) on a CCD array (17) in a camera head (15). The pattern includes both fiducial markings (31) which are identical for each period of the pattern and code areas (33) which include binary codings of numbers identifying the individual periods of the pattern. The image of the pattern formed on the CCD array is analyzed by an image processor (23) to locate the fiducial marking, decode the information encoded in the code area, and thereby determine the position of the object.

  2. Severe multivessel coronary artery disease and high-sensitive troponin T

    PubMed Central

    Huziuk, Inga Magdalena

    2015-01-01

    Introduction A key problem in stable coronary artery disease (CAD) is non-invasive identification of patients with severe multivessel CAD. Determination of biomarkers that have pro-inflammatory properties (C-reactive protein – hsCRP) and indicate heart muscle ischemia (high-sensitive troponin T – hsTnT) can contribute to the improvement of stratification in this regard. The aim of the study The aim of the study was to identify factors associated with the presence of multivessel CAD in clinically stable men. Material and methods The study included 92 symptomatic men (mean age 64.05 ± 9.42 years) with preserved left ventricular function, scheduled for elective coronary angiography. Patients were divided and analyzed in two groups: with multivessel coronary artery disease (2-3-vessel disease, n = 46) vs. without multivessel coronary artery disease (n = 46). Results Patients with multivessel CAD had significantly higher levels of hsTnT (0.01 vs. 0.007, p = 0.0021) and fasting glucose (6.0 vs. 5.45, p = 0.0112). Based on the drawn ROC curves, the cut-off points were determined for hsTnT ≥ 0.0085 ng/ml and fasting plasma glucose ≥ 5.85 mmol/l. From multivariate analysis only hsTnT in concentration higher than the cut-off point enhanced the risk of multivessel CAD (OR 4.286, 95% CI: 1.79-10.263, p = 0.001). Conclusions In men with stable CAD, preserved systolic left ventricular function and non-high cardiovascular risk determined from the initial concentration of hsCRP, elevated level of hsTnT was independently associated with the risk of multivessel coronary artery disease. PMID:26336496

  3. Absolute Zero

    NASA Astrophysics Data System (ADS)

    Donnelly, Russell J.; Sheibley, D.; Belloni, M.; Stamper-Kurn, D.; Vinen, W. F.

    2006-12-01

    Absolute Zero is a two hour PBS special attempting to bring to the general public some of the advances made in 400 years of thermodynamics. It is based on the book “Absolute Zero and the Conquest of Cold” by Tom Shachtman. Absolute Zero will call long-overdue attention to the remarkable strides that have been made in low-temperature physics, a field that has produced 27 Nobel Prizes. It will explore the ongoing interplay between science and technology through historical examples including refrigerators, ice machines, frozen foods, liquid oxygen and nitrogen as well as much colder fluids such as liquid hydrogen and liquid helium. A website has been established to promote the series: www.absolutezerocampaign.org. It contains information on the series, aimed primarily at students at the middle school level. There is a wealth of material here and we hope interested teachers will draw their student’s attention to this website and its substantial contents, which have been carefully vetted for accuracy.

  4. Going High with Heart Disease: The Effect of High Altitude Exposure in Older Individuals and Patients with Coronary Artery Disease.

    PubMed

    Levine, Benjamin D

    2015-06-01

    Levine, Benjamin D. Going high with heart disease: The effect of high altitude exposure in older individuals and patients with coronary artery disease. High Alt Med Biol 16:89-96, 2015.--Ischemic heart disease is the largest cause of death in older men and women in the western world (Lozano et al., 2012 ; Roth et al., 2015). Atherosclerosis progresses with age, and thus age is the dominant risk factor for coronary heart disease in any algorithm used to assess risk for cardiovascular events. Subclinical atherosclerosis also increases with age, providing the substrate for precipitation of acute coronary syndromes. Thus the risk of high altitude exposure in older individuals is linked closely with both subclinical and manifest coronary heart disease (CHD). There are several considerations associated with taking patients with CHD to high altitude: a) The reduced oxygen availability may cause or exacerbate symptoms; b) The hypoxia and other associated environmental conditions (exercise, dehydration, change in diet, thermal stress, emotional stress from personal danger or conflict) may precipitate acute coronary events; c) If an event occurs and the patient is far from advanced medical care, then the outcome of an acute coronary event may be poor; and d) Sudden death may occur. Physicians caring for older patients who want to sojourn to high altitude should keep in mind the following four key points: 1). Altitude may exacerbate ischemic heart disease because of both reduced O2 delivery and paradoxical vasoconstriction; 2). Adverse events, including acute coronary syndromes and sudden cardiac death, are most common in older unfit men, within the first few days of altitude exposure; 3). Ensuring optimal fitness, allowing for sufficient acclimatization (at least 5 days), and optimizing medical therapy (especially statins and aspirin) are prudent recommendations that may reduce the risk of adverse events; 4). A graded exercise test at sea level is probably sufficient for

  5. Off-pump coronary artery bypass grafting in high-risk patients: a review

    PubMed Central

    Chivasso, Pierpaolo; Fudulu, Daniel; Rapetto, Filippo; Sedmakov, Christo; Marsico, Roberto; Zakkar, Mustafa; Bryan, Alan J.; Angelini, Gianni D.

    2016-01-01

    The role of off-pump coronary artery bypass (OPCAB) grafting in high risk patients remains controversial. While there have been studies showing the potential benefits of it, there is still a lot to be learned from the application of this technique in this sub-group of patients. The results of the different trials and papers that we reviewed seem to indicate a benefit in the OPCAB group. Despite of the fact that trials were significantly different in methodology, especially when choosing the risk score stratification tool or the cut-off to define high risk the literature seems to suggest a benefit from the use of OPCAB surgery. Here, we present a review which focussed on early and late outcome in high risk patients undergoing on- and off-pump coronary revascularization. PMID:27942397

  6. The ASTEROID trial: coronary plaque regression with high-dose statin therapy.

    PubMed

    Chhatriwalla, Adnan K; Nicholls, Stephen J; Nissen, Steven E

    2006-11-01

    A Study To Evaluate the effect of Rosuvastatin On Intravascular ultrasound-Derived coronary atheroma burden (ASTEROID) investigated the impact of high-dose rosuvastatin therapy on the rate of atheroma progression in patients with coronary artery disease. Serial intravascular ultrasound (IVUS) was performed in 349 patients at baseline and following 24 months of therapy with rosuvastatin 40 mg/day. Rosuvastatin therapy lowered low-density lipoprotein cholesterol to 60.8 mg/dl and raised high-density lipoprotein cholesterol by 14.7%. This was associated with a significant reduction in all IVUS measures of atheroma burden. These results suggest that intensive modification of lipid levels with high-dose statin therapy can promote atheroma regression. Further studies will be required to determine whether this benefit is associated with a reduction in clinical events.

  7. Candidate genetic analysis of plasma high-density lipoprotein-cholesterol and severity of coronary atherosclerosis

    PubMed Central

    Chen, Suet Nee; Cilingiroglu, Mehmet; Todd, Josh; Lombardi, Raffaella; Willerson, James T; Gotto, Antonio M; Ballantyne, Christie M; Marian, AJ

    2009-01-01

    Background Plasma level of high-density lipoprotein-cholesterol (HDL-C), a heritable trait, is an important determinant of susceptibility to atherosclerosis. Non-synonymous and regulatory single nucleotide polymorphisms (SNPs) in genes implicated in HDL-C synthesis and metabolism are likely to influence plasma HDL-C, apolipoprotein A-I (apo A-I) levels and severity of coronary atherosclerosis. Methods We genotyped 784 unrelated Caucasian individuals from two sets of populations (Lipoprotein and Coronary Atherosclerosis Study- LCAS, N = 333 and TexGen, N = 451) for 94 SNPs in 42 candidate genes by 5' nuclease assays. We tested the distribution of the phenotypes by the Shapiro-Wilk normality test. We used Box-Cox regression to analyze associations of the non-normally distributed phenotypes (plasma HDL-C and apo A-I levels) with the genotypes. We included sex, age, body mass index (BMI), diabetes mellitus (DM), and cigarette smoking as covariates. We calculated the q values as indicators of the false positive discovery rate (FDR). Results Plasma HDL-C levels were associated with sex (higher in females), BMI (inversely), smoking (lower in smokers), DM (lower in those with DM) and SNPs in APOA5, APOC2, CETP, LPL and LIPC (each q ≤0.01). Likewise, plasma apo A-I levels, available in the LCAS subset, were associated with SNPs in CETP, APOA5, and APOC2 as well as with BMI, sex and age (all q values ≤0.03). The APOA5 variant S19W was also associated with minimal lumen diameter (MLD) of coronary atherosclerotic lesions, a quantitative index of severity of coronary atherosclerosis (q = 0.018); mean number of coronary artery occlusions (p = 0.034) at the baseline and progression of coronary atherosclerosis, as indicated by the loss of MLD. Conclusion Putatively functional variants of APOA2, APOA5, APOC2, CETP, LPL, LIPC and SOAT2 are independent genetic determinants of plasma HDL-C levels. The non-synonymous S19W SNP in APOA5 is also an independent determinant of plasma

  8. The absolute radiometric calibration of the advanced very high resolution radiometer

    NASA Technical Reports Server (NTRS)

    Slater, P. N.; Teillet, P. M.; Mao, Y.

    1987-01-01

    The early results of an absolute radiometric calibration of the NOAA-9 AVHRR sensor indicate significant degradations in the response of bands 1 and 2 compared to prelaunch values. The results are currently in the process of being verified and it may be that refinements of the methodology will be in order as additional data sets are analyzed. The LANDSAT TM calibration used in this approach is known to be very precise and the Herman radiative transfer code, supplemented by the 5-S code for gaseous transmission, is reliable as well. The extent to which other steps in the analysis procedure give rise to uncertainties in the results is currently under investigation. Particular attention is being given to the geometric matching of the AVHRR and TM imagery, as well as to the spectral redistribution procedure. By taking advantage of a reasonably precise calibration of TM imagery acquired on the same day as the AVHRR data at White Sands, a promising approach to the in-orbit calibration of AVHRR sensors is being developed. Current efforts involve primarily the examination of additional test cases and the investigation of possible simplifications in the procedure through judicious use of atmospheric models.

  9. Coronary collaterals.

    PubMed

    Gorlin, R

    1976-01-01

    Coronary collaterals are probably enlargements of pre-existing channels which respond to local vasodilators and which function whenever pressure differences exist across them. Thus, in human coronary atherosclerosis collaterals are only seen when there is a severe intervening arterial obstruction (in excess of 75%). Coronary collaterals follow epicardial and intramycardial pathways, and the intermediary connections may be at vessels of highly varying caliber. The flow potential of most collateral pathways in man is possibly adequate for segmental myocardial function at lower than normal demands but clearly is inadequate for most, if not all, stressful interventions. In the last analysis, coronary collaterals in man are more an indication of severe regional ischemia (present or potential) than a sign of biological "compensation'' for a perfusion deficit.

  10. Combining sub-Nyquist sampling and chirp decomposition for a high-precision and speed absolute distance measurement method.

    PubMed

    Liu, Guodong; Lu, Cheng; Liu, Bingguo; Chen, Fengdong; Gan, Yu

    2016-12-10

    A high-precision and speed absolute distance measurement based on swept-wavelength interferometry is reported. A powerful method combining sub-Nyquist sampling and chirp decomposition for dispersion mismatch compensation is proposed. A standard deviation of 0.72 μm is obtained for the measurement of a target located at 3.9 m, which is better than the traditional method. The measurement can be completed in 1.9 s when the frequency range is 4.26 THz, which is much better than chirp decomposition without sub-Nyquist sampling.

  11. Absolute Summ

    NASA Astrophysics Data System (ADS)

    Phillips, Alfred, Jr.

    Summ means the entirety of the multiverse. It seems clear, from the inflation theories of A. Guth and others, that the creation of many universes is plausible. We argue that Absolute cosmological ideas, not unlike those of I. Newton, may be consistent with dynamic multiverse creations. As suggested in W. Heisenberg's uncertainty principle, and with the Anthropic Principle defended by S. Hawking, et al., human consciousness, buttressed by findings of neuroscience, may have to be considered in our models. Predictability, as A. Einstein realized with Invariants and General Relativity, may be required for new ideas to be part of physics. We present here a two postulate model geared to an Absolute Summ. The seedbed of this work is part of Akhnaton's philosophy (see S. Freud, Moses and Monotheism). Most important, however, is that the structure of human consciousness, manifest in Kenya's Rift Valley 200,000 years ago as Homo sapiens, who were the culmination of the six million year co-creation process of Hominins and Nature in Africa, allows us to do the physics that we do. .

  12. Association of Serum Pentraxin-3 and High-Sensitivity C-Reactive Protein with the Extent of Coronary Stenosis in Patients Undergoing Coronary Angiography

    PubMed Central

    Vuković-Dejanović, Vesna; Bogavac-Stanojević, Nataša; Spasić, Slavica; Spasojević-Kalimanovska, Vesna; Kalimanovska-Oštrić, Dimitra; Topalović, Mirko; Jelić-Ivanović, Zorana

    2015-01-01

    Summary Background We compared factors of inflammation – high sensitivity C-reactive protein (hsCRP) and pentraxin-3 (PTX3), and we explored their relationship with coronary artery disease (CAD). Also, we tested the usefulness of hsCRP and PTX3 in the risk assessment of coronary stenosis development and the diagnostic ability of these biomarkers to detect disease severity. Methods The study group consisted of 93 CAD patients undergoing coronary angiography. Patients were divided into CAD(0), representing subclinical stenosis, and CAD (1–3), representing significant stenosis in one, two or three vessels. Results We determined the concentration of lipid status parameters, hsCRP and PTX3. We found significantly lower PTX3 and hsCRP concentrations in CAD(0) than in CAD(1–3) group. Concentration of PTX3 showed an increasing trend with the increasing number of vessels affected. The area under ROC curve (AUC) for the combinations of hsCRP and PTX3 with lipid parameters had useful accuracy for detecting CAD(1–3) patients (AUC=0.770, p<0.001). Conclusion PTX3 is a promising independent diagnostic marker for identifying patients with CAD, and a useful indicator of disease progression. In all the analyses PTX3 showed better performance than hsCRP. A combination of PTX3, hsCRP with the lipid status parameters provides risk stratification of the development of coronary stenosis and better classification than their individual application. PMID:28356853

  13. High-density lipoprotein particles, coronary heart disease, and niacin

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In clinical trials, the use of statins in patients with high risk for cardiovascular disease (CVD) has resulted in a 25% to 40% decrease in major clinical events. However, despite a marked reduction (up to 60%) in LDL-C, approximately 50% (or more) of patients continue to have CVD events. This high ...

  14. Absolute Photometry

    NASA Astrophysics Data System (ADS)

    Hartig, George

    1990-12-01

    The absolute sensitivity of the FOS will be determined in SV by observing 2 stars at 3 epochs, first in 3 apertures (1.0", 0.5", and 0.3" circular) and then in 1 aperture (1.0" circular). In cycle 1, one star, BD+28D4211 will be observed in the 1.0" aperture to establish the stability of the sensitivity and flat field characteristics and improve the accuracy obtained in SV. This star will also be observed through the paired apertures since these are not calibrated in SV. The stars will be observed in most detector/grating combinations. The data will be averaged to form the inverse sensitivity functions required by RSDP.

  15. High stability multiplexed fiber interferometer and its application on absolute displacement measurement and on-line surface metrology.

    PubMed

    Lin, Dejiao; Jiang, Xiangqian; Xie, Fang; Zhang, Wei; Zhang, Lin; Bennion, Ian

    2004-11-15

    We propose a self-reference multiplexed fiber interferometer (MFI) by using a tunable laser and fiber Bragg grating (FBG). The optical measurement system multiplexes two Michelson fiber interferometers with shared optical path in the main part of optical system. One fiber optic interferometer is used as a reference interferometer to monitor and control the high accuracy of the measurement system under environmental perturbations. The other is used as a measurement interferometer to obtain information from the target. An active phase tracking homodyne (APTH) technique is applied for signal processing to achieve high resolution. MFI can be utilized for high precision absolute displacement measurement with different combination of wavelengths from the tunable laser. By means of Wavelength-Division-Multiplexing (WDM) technique, MFI is also capable of realizing on-line surface measurement, in which traditional stylus scanning is replaced by spatial light-wave scanning so as to greatly improve the measurement speed and robustness.

  16. Supramolecular spectrally encoded microgels with double strand probes for absolute and direct miRNA fluorescence detection at high sensitivity.

    PubMed

    Causa, Filippo; Aliberti, Anna; Cusano, Angela M; Battista, Edmondo; Netti, Paolo A

    2015-02-11

    We present novel microgels as a particle-based suspension array for direct and absolute microRNA (miRNA) detection. The microgels feature a flexible molecular architecture, antifouling properties, and enhanced sensitivity with a large dynamic range of detection. Specifically, they possess a core-shell molecular architecture with two different fluorescent dyes for multiplex spectral analyses and are endowed with a fluorescent probe for miRNA detection. Encoding and detection fluorescence signals are distinguishable by nonoverlapping emission spectra. Tunable fluorescence probe conjugation and emission confinement on single microgels allow for ultrasensitive miRNA detection. Indeed, the suspension array has high selectivity and sensitivity with absolute quantification, a detection limit of 10(-15) M, a dynamic range from 10(-9) to 10(-15) M, and higher accuracy than qRT-PCR. The antifouling properties of the microgels also permit the direct measurement of miRNAs in serum, without sample pretreatment or target amplification. A multiplexed assay has been tested for a set of miRNAs chosen as cancer biomarkers.

  17. Improved determination of seafloor absolute magnetization from uneven, near-seafloor magnetic measurements and high-resolution bathymetry

    NASA Astrophysics Data System (ADS)

    Szitkar, F.; Dyment, J.; Choi, Y.; Fouquet, Y.

    2012-12-01

    Vector magnetometers installed on deep-sea submersibles offer a unique opportunity to achieve high resolution magnetic investigations at the scale of hundred to thousand meters. Once corrected for the vehicle induced and remanent magnetization, the measurements mostly reflect variations of the topography and the submersible path - i.e. the distance between the sources and the observation points. The interesting parameter, however, is the seafloor magnetization that can be interpreted in terms of geological processes. Here we present methods to compute absolute magnetization of the seafloor by taking advantage of the uneven track of the submersible. In these methods, synthetic anomalies are computed for a unit magnetization assuming the geometry of the experiment, i.e. the source and the submersible path. The absolute magnetization is determined by a comparison between the observed anomalies and the synthetic ones along sliding windows. The coherency between the two signals gives an estimation of the quality of the determination, and the phase provides information on the magnetic polarity, and therefore the age of volcanic features. Such a method has been developed by Honsho et al. (JGR, 2009) using deep-sea submersible data only, i.e. magnetic anomaly, depth and altitude of the submersible. The synthetic anomalies are computed using 2D forward modeling, i.e. assuming the structures to be infinite in the direction perpendicular to the submersible path. The method has been applied with success to linear profiles crossing elongated structures such as mid-ocean ridges, but may fail for structures departing from the 2D assumption. The adaptation of improving multibeam systems to autonomous underwater vehicles (AUVs) has opened the way to the collection of very high resolution bathymetric data (around 2m between each measurement). This development has triggered a new strategy to explore the seafloor using manned submersibles: an AUV is operated during night time to

  18. Coronary Arteries

    MedlinePlus

    ... and animations for grades K-6. The Coronary Arteries Coronary Circulation The heart muscle, like every other ... into two main coronary blood vessels (also called arteries). These coronary arteries branch off into smaller arteries, ...

  19. Absolute neutrino mass scale

    NASA Astrophysics Data System (ADS)

    Capelli, Silvia; Di Bari, Pasquale

    2013-04-01

    Neutrino oscillation experiments firmly established non-vanishing neutrino masses, a result that can be regarded as a strong motivation to extend the Standard Model. In spite of being the lightest massive particles, neutrinos likely represent an important bridge to new physics at very high energies and offer new opportunities to address some of the current cosmological puzzles, such as the matter-antimatter asymmetry of the Universe and Dark Matter. In this context, the determination of the absolute neutrino mass scale is a key issue within modern High Energy Physics. The talks in this parallel session well describe the current exciting experimental activity aiming to determining the absolute neutrino mass scale and offer an overview of a few models beyond the Standard Model that have been proposed in order to explain the neutrino masses giving a prediction for the absolute neutrino mass scale and solving the cosmological puzzles.

  20. Absolute intensity calibration of the Wendelstein 7-X high efficiency extreme ultraviolet overview spectrometer system

    NASA Astrophysics Data System (ADS)

    Greiche, Albert; Biel, Wolfgang; Marchuk, Oleksandr; Burhenn, Rainer

    2008-09-01

    The new high effiency extreme ultraviolet overview spectrometer (HEXOS) system for the stellarator Wendelstein 7-X is now mounted for testing and adjustment at the tokamak experiment for technology oriented research (TEXTOR). One part of the testing phase was the intensity calibration of the two double spectrometers which in total cover a spectral range from 2.5 to 160.0 nm with overlap. This work presents the current intensity calibration curves for HEXOS and describes the method of calibration. The calibration was implemented with calibrated lines of a hollow cathode light source and the branching ratio technique. The hollow cathode light source provides calibrated lines from 16 up to 147 nm. We could extend the calibrated region in the spectrometers down to 2.8 nm by using the branching line pairs emitted by an uncalibrated pinch extreme ultraviolet light source as well as emission lines from boron and carbon in TEXTOR plasmas. In total HEXOS is calibrated from 2.8 up to 147 nm, which covers most of the observable wavelength region. The approximate density of carbon in the range of the minor radius from 18 to 35 cm in a TEXTOR plasma determined by simulating calibrated vacuum ultraviolet emission lines with a transport code was 5.5×1017 m-3 which corresponds to a local carbon concentration of 2%.

  1. Massively parallel digital high resolution melt for rapid and absolutely quantitative sequence profiling

    PubMed Central

    Velez, Daniel Ortiz; Mack, Hannah; Jupe, Julietta; Hawker, Sinead; Kulkarni, Ninad; Hedayatnia, Behnam; Zhang, Yang; Lawrence, Shelley; Fraley, Stephanie I.

    2017-01-01

    In clinical diagnostics and pathogen detection, profiling of complex samples for low-level genotypes represents a significant challenge. Advances in speed, sensitivity, and extent of multiplexing of molecular pathogen detection assays are needed to improve patient care. We report the development of an integrated platform enabling the identification of bacterial pathogen DNA sequences in complex samples in less than four hours. The system incorporates a microfluidic chip and instrumentation to accomplish universal PCR amplification, High Resolution Melting (HRM), and machine learning within 20,000 picoliter scale reactions, simultaneously. Clinically relevant concentrations of bacterial DNA molecules are separated by digitization across 20,000 reactions and amplified with universal primers targeting the bacterial 16S gene. Amplification is followed by HRM sequence fingerprinting in all reactions, simultaneously. The resulting bacteria-specific melt curves are identified by Support Vector Machine learning, and individual pathogen loads are quantified. The platform reduces reaction volumes by 99.995% and achieves a greater than 200-fold increase in dynamic range of detection compared to traditional PCR HRM approaches. Type I and II error rates are reduced by 99% and 100% respectively, compared to intercalating dye-based digital PCR (dPCR) methods. This technology could impact a number of quantitative profiling applications, especially infectious disease diagnostics. PMID:28176860

  2. Massively parallel digital high resolution melt for rapid and absolutely quantitative sequence profiling

    NASA Astrophysics Data System (ADS)

    Velez, Daniel Ortiz; Mack, Hannah; Jupe, Julietta; Hawker, Sinead; Kulkarni, Ninad; Hedayatnia, Behnam; Zhang, Yang; Lawrence, Shelley; Fraley, Stephanie I.

    2017-02-01

    In clinical diagnostics and pathogen detection, profiling of complex samples for low-level genotypes represents a significant challenge. Advances in speed, sensitivity, and extent of multiplexing of molecular pathogen detection assays are needed to improve patient care. We report the development of an integrated platform enabling the identification of bacterial pathogen DNA sequences in complex samples in less than four hours. The system incorporates a microfluidic chip and instrumentation to accomplish universal PCR amplification, High Resolution Melting (HRM), and machine learning within 20,000 picoliter scale reactions, simultaneously. Clinically relevant concentrations of bacterial DNA molecules are separated by digitization across 20,000 reactions and amplified with universal primers targeting the bacterial 16S gene. Amplification is followed by HRM sequence fingerprinting in all reactions, simultaneously. The resulting bacteria-specific melt curves are identified by Support Vector Machine learning, and individual pathogen loads are quantified. The platform reduces reaction volumes by 99.995% and achieves a greater than 200-fold increase in dynamic range of detection compared to traditional PCR HRM approaches. Type I and II error rates are reduced by 99% and 100% respectively, compared to intercalating dye-based digital PCR (dPCR) methods. This technology could impact a number of quantitative profiling applications, especially infectious disease diagnostics.

  3. The orbital motion, absolute mass and high-altitude winds of exoplanet HD 209458b.

    PubMed

    Snellen, Ignas A G; de Kok, Remco J; de Mooij, Ernst J W; Albrecht, Simon

    2010-06-24

    For extrasolar planets discovered using the radial velocity method, the spectral characterization of the host star leads to a mass estimate of the star and subsequently of the orbiting planet. If the orbital velocity of the planet could be determined, the masses of both star and planet could be calculated using Newton's law of gravity, just as in the case of stellar double-line eclipsing binaries. Here we report high-dispersion ground-based spectroscopy of a transit of the extrasolar planet HD 209458b. We see a significant wavelength shift in absorption lines from carbon monoxide in the planet's atmosphere, which we conclude arises from a change in the radial component of the planet's orbital velocity. The masses of the star and planet are 1.00 +/- 0.22M(Sun) and 0.64 +/- 0.09M(Jup) respectively. A blueshift of the carbon monoxide signal of approximately 2 km s(-1) with respect to the systemic velocity of the host star suggests the presence of a strong wind flowing from the irradiated dayside to the non-irradiated nightside of the planet within the 0.01-0.1 mbar atmospheric pressure range probed by these observations. The strength of the carbon monoxide signal suggests a carbon monoxide mixing ratio of (1-3) x 10(-3) in this planet's upper atmosphere.

  4. Massively parallel digital high resolution melt for rapid and absolutely quantitative sequence profiling.

    PubMed

    Velez, Daniel Ortiz; Mack, Hannah; Jupe, Julietta; Hawker, Sinead; Kulkarni, Ninad; Hedayatnia, Behnam; Zhang, Yang; Lawrence, Shelley; Fraley, Stephanie I

    2017-02-08

    In clinical diagnostics and pathogen detection, profiling of complex samples for low-level genotypes represents a significant challenge. Advances in speed, sensitivity, and extent of multiplexing of molecular pathogen detection assays are needed to improve patient care. We report the development of an integrated platform enabling the identification of bacterial pathogen DNA sequences in complex samples in less than four hours. The system incorporates a microfluidic chip and instrumentation to accomplish universal PCR amplification, High Resolution Melting (HRM), and machine learning within 20,000 picoliter scale reactions, simultaneously. Clinically relevant concentrations of bacterial DNA molecules are separated by digitization across 20,000 reactions and amplified with universal primers targeting the bacterial 16S gene. Amplification is followed by HRM sequence fingerprinting in all reactions, simultaneously. The resulting bacteria-specific melt curves are identified by Support Vector Machine learning, and individual pathogen loads are quantified. The platform reduces reaction volumes by 99.995% and achieves a greater than 200-fold increase in dynamic range of detection compared to traditional PCR HRM approaches. Type I and II error rates are reduced by 99% and 100% respectively, compared to intercalating dye-based digital PCR (dPCR) methods. This technology could impact a number of quantitative profiling applications, especially infectious disease diagnostics.

  5. High-resolution imaging spectrometer for recording absolutely calibrated far ultraviolet spectra from laser-produced plasmas

    SciTech Connect

    Brown, Charles M.; Seely, John F.; Feldman, Uri; Holland, Glenn E.; Weaver, James L.; Obenschain, Steven P.; Kjornrattanawanich, Benjawan; Fielding, Drew

    2008-10-15

    An imaging spectrometer was designed and fabricated for recording far ultraviolet spectra from laser-produced plasmas with wavelengths as short as 155 nm. The spectrometer implements a Cassegrain telescope and two gratings in a tandem Wadsworth optical configuration that provides diffraction limited resolution. Spectral images were recorded from plasmas produced by the irradiation of various target materials by intense KrF laser radiation with 248 nm wavelength. Two pairs of high-resolution gratings can be selected for the coverage of two wavebands, one grating pair with 1800 grooves/mm and covering approximately 155-175 nm and another grating pair with 1200 grooves/mm covering 230-260 nm. The latter waveband includes the 248 nm KrF laser wavelength, and the former waveband includes the wavelength of the two-plasmon decay instability at (2/3) the KrF laser wavelength (165 nm). The detection media consist of a complementary metal oxide semiconductor imager, photostimulable phosphor image plates, and a linear array of 1 mm{sup 2} square silicon photodiodes with 0.4 ns rise time. The telescope mirrors, spectrometer gratings, and 1 mm{sup 2} photodiode were calibrated using synchrotron radiation, and this enables the measurement of the absolute emission from the laser-produced plasmas with temporal, spatial, and spectral resolutions. The spectrometer is capable of measuring absolute spectral emissions at 165 nm wavelength as small as 5x10{sup -7} J/nm from a plasma source area of 0.37 mm{sup 2} and with 0.4 ns time resolution.

  6. On Arrival High Blood Glucose Level is Associated With Detrimental and Fatal Hospitalization Outcomes for Acute Coronary Syndrome

    PubMed Central

    Hartopo, Anggoro B.; Setianto, Budi Y.; Gharini, Putrika P.R.; Dinarti, Lucia K.

    2011-01-01

    Background High blood glucose level is frequently encountered in acute coronary syndrome. We investigated the effects of high blood glucose measured on arrival on hospitalization adverse events in acute coronary syndrome. Our study patients were Javanese in ethnicity, which constitute half of population in Indonesia. We hypothesized that elevated blood glucose has detrimental effects on hospitalization for acute coronary syndrome. Methods We designed an observasional cohort study and recruited 148 consecutive patients with acute coronary syndrome. Venous blood was collected on hospital arrival. High blood glucose level was determined as plasma glucose > 140 mg/dL. Adverse hospitalization events were recorded, i.e. mortality, acute heart failure, cardiogenic shock and heart rhythm disorders. Echocardiography examination was performed to determine left ventricular function. Results The prevalence of on arrival high blood glucose among Javanese patients with acute coronary syndrome was considerably high (36%). On arrival high blood glucose was associated with acute heart failure (P < 0.001) and shock cardiogenic (P = 0.02). Heart rhythm disorders were higher in high blood glucose patients (P = 0.004). Left ventricular dysfunction was more prevalent in high blood glucose patients (P = 0.001) and ejection fraction was lower (P = 0.001). On arrival high blood glucose was independently associated with hospitalization adverse events (adjusted odds ratio = 2.3, 95% confidence interval: 1.1-4.9, P = 0.03) and hospital mortality (adjusted odds ratio = 6.9, 95% confidence interval: 1.2-38.6, P = 0.03). Conclusions Our study suggests that on arrival high blood glucose among Javanese patients with acute coronary syndrome is considerably high and is associated with detrimental and fatal hospitalization outcomes.

  7. High-Resolution Variable-Density 3D Cones Coronary MRA

    PubMed Central

    Addy, Nii Okai; Ingle, R. Reeve; Wu, Holden H.; Hu, Bob S.; Nishimura, Dwight G.

    2015-01-01

    Purpose To improve the spatial/temporal resolution of whole-heart coronary MR angiography (CMRA) by developing a variable-density (VD) 3D cones acquisition suitable for image reconstruction with parallel imaging and compressed sensing techniques. Methods A VD 3D cones trajectory design incorporates both radial and spiral trajectory undersampling techniques to achieve higher resolution. This design is used to generate a VD cones trajectory with 0.8 mm/66 ms isotropic spatial/temporal resolution, using a similar number of readouts as our previous fully sampled cones trajectory (1.2 mm/100 ms). Scans of volunteers and patients are performed to evaluate the performance of the VD trajectory, using non-Cartesian L1-ESPIRiT for high-resolution image reconstruction. Results With gridding reconstruction, the high-resolution scans experience an expected drop in signal-to-noise and contrast-to-noise ratios, but with L1-ESPIRiT, the apparent noise is substantially reduced. Compared to 1.2 mm images, in each volunteer, the L1-ESPIRiT 0.8 mm images exhibit higher vessel sharpness values in the right and left anterior descending arteries. Conclusion CMRA with isotropic sub-millimeter spatial resolution and high temporal resolution can be performed with VD 3D cones to improve the depiction of coronary arteries. PMID:26172829

  8. [Pregnancy and coronary artery dissection].

    PubMed

    Martínez-Quintana, Efrén; Rodríguez-González, Fayna

    2015-01-01

    Acute myocardial infarction during pregnancy is associated with high maternal and fetal mortality. Coronary atherosclerosis is the most common cause due to an increase in the age of the patients and the association with cardiovascular risk factors such as smoking, hypertension, diabetes mellitus, preeclampsia, and the existence of family history of coronary disease. However, thrombosis, coronary dissection or coronary vasospasms are other causes that may justify it. We report the case of a 33 weeks pregnant first-time mother, without cardiovascular risk factors, who presented an acute coronary event in the context of atherosclerotic disease and coronary dissection after percutaneous coronary intervention.

  9. Measurement of Absolute Excitation Cross Sections in Highly-Charged Ions Using Electron Energy Loss and Merged Beams

    NASA Technical Reports Server (NTRS)

    Chutjian, A.; Smith, Steven J.; Lozano, J.

    2002-01-01

    There is increasing emphasis during this decade on understanding energy balance and phenomena observed in high electron temperature plasmas. The UV spectral return from FUSE, the X-ray spectral return from the HETG on Chandra and the LETGS 011 XMM-Newton are just beginning. Line emissions are almost entirely from highly-charged ions (HCIs) of C, N, 0, Ne, Mg, S, Si, Ca, and Fe. The Constellation-X mission will provide X-ray spectroscopy up to photon energies of 0.12 nm (10 keV) where primary line emitters will be HCIs. A variety of atomic parameters are required to model the stellar and solar plasma. These include cross sections for excitation, ionization, charge-exchange, X-ray emission, direct and indirect recombination, lifetimes and branching ratios, and dependences on l, m mixing by external E and B fields. In almost all cases the atomic quantities are calculated, and few comparisons to experiment have been carried out. Collision strengths and Einstein A-values are required to convert the observed spectral intensities to electron temperatures and densities in the stellar plasma. The JPL electron energy-loss and merged beam approach has been used to measure absolute collision strengths in a number of ions, with critical comparison made to the best available theories.

  10. High-density lipoprotein and coronary risk factors in normal men.

    PubMed

    Williams, P; Robinson, D; Bailey, A

    1979-01-01

    Serum high-density-lipoprotein cholesterol (H.D.L.) was measured in 2568 men attending a screening centre and registered with a medical practitioner in Great Britain. Serum-total-cholesterol (T.C.), serum-triglyceride, serum-glucose, systolic and diastolic blood-pressures, electrocardiogram, chest X-ray, height, weight, cigarette and alcohol history, and a brief assessment of physical activity were also recorded. H.D.L. was inversely related to cigarette-smoking, relative weight, and serum-triglyceride level, and directly related to physical activity, total-cholesterol level, and alcohol consumption. The ratio of H.D.L. to T.C. (H.D.L./T.C.) showed similar significant relationships to the above variables (except that the ratio was negatively correlated with T.C.). In addition the ratio was inversely related to age. These relationships were independent of the other measured variables. Both the H.D.L. and H.D.L./T.C. were inversely related to coronary risk rating. It is suggested that, despite methodological problems, H.D.L. is a useful biochemical measurement to add to a coronary risk profile.

  11. Diet and the role of lipoproteins, lipases, and thyroid hormones in coronary lesion growth

    NASA Technical Reports Server (NTRS)

    Barth, Jacques D.; Jansen, Hans; Reiber, Johan H. C.; Birkenhager, Jan C.; Kromhout, Daan

    1987-01-01

    The relationships between the coronary lesion growth and the blood contents of lipoprotein fractions, thyroic hormones, and the lipoprotein lipase activity were investigated in male patients with severe coronary atherosclerosis, who participated in a lipid-lowering dietary intervention program. A quantitative computer-assisted image-processing technique was used to assess the severity of coronary obstructions at the beginning of the program and at its termination two years later. Based on absolute coronary scores, patients were divided into a no-lesion growth group (14 patients) and a progression group (21 paients). At the end of the trial, the very-low-density lipoprotein cholesterol and triglycerides were found to be significantly higher, while the high-density lipoprotein cholesterol and hepatic lipase (HL) were lower in the progression group. Multivariate regression analysis showed HL to be the most important determinant of changes in coronary atherosclerotic lesions.

  12. Two-modality laser diode interferometer for high-accuracy measurement of long-range absolute distance

    NASA Astrophysics Data System (ADS)

    Wang, Bofan; Li, Zhongliang; Wang, Xiangzhao; Bu, Peng

    2010-08-01

    This paper presents a two-modality laser diode (LD) interferometer which combine as two-wavelength sinusoidal phase modulating (SPM) interferometer with a wavelength scanning interferometer (WSI) for measurement of distance over long range with high accuracy. Moreover, the intensity modulation due to power changes of LD is suppressed by appropriately choosing the modulation amplitude of injection current (IC) of LD. Triangle wave is used to modulate the IC of one LD with that of the other LD being constant at first. Thus the interferometer works as a wavelength scanning interferometer. An initial estimate of the distance can be obtained from the phase change of the interference signal. Then sinusoidal wave is used for modulating IC of both LDs to realize a two-wavelength SPM interferometer. However, the modulation of the IC of two LDs results in not only the wavelength modulation but also the intensity modulation. This intensity modulation will cause a measured phase error. To eliminate this error, SPM depths are appropriately chosen, therefore the distance to be measured can be accurately obtained with synthetic-wavelength algorithm. Experimental results indicate that an absolute distance measurement accuracy of 1μm can be achieved over the range of 40mm to 100mm.

  13. Pentraxin 3 Is Highly Specific for Predicting Anatomical Complexity of Coronary Artery Stenosis as Determined by the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery Score

    PubMed Central

    Namazi, Mohammad Hasan; Saadat, Habibollah; Safi, Morteza; Vakili, Hossein; Alipourparsa, Saeed; Bozorgmanesh, Mohammadreza

    2014-01-01

    Background and Objectives The aim of this study was to examine the hypothesis that pentraxin 3 (PTX3) can have a diagnostic value for predicting anatomical complexity of coronary artery stenosis as measured by the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score. Subjects and Methods We investigated the association of systemic arterial PTX3 with SYNTAX score among 500 patients with ischemic heart disease assigned to medical treatment (251), percutaneous coronary intervention (PCI) (197), or coronary artery bypass graft (CABG) (52). Results The clinical judgment of the cardiologists was near-perfectly concordant with the SYNTAX score. Mean {99% confidence intervals (CIs)} SYNTAX scores were 5.8 (5.1-6.6), 18.4 (17.1-19.8), and 33.2 (32.8-33.6) in patients assigned to medical therapy, PCI, and CABG, respectively. The AROC (95% CIs) for discriminating between patients with and without a high SYNTAX score (>23) was 0.920 (0.895-0.946) for systemic arterial levels of PTX3. As the systemic arterial level of PTX3 increased, the SYNTAX scores also increased almost in a curvilinear fashion, with the value corresponding to the SYNTAX score of 23 being 0.29 ng · dL-1. This cutpoint achieved a sensitivity of 0.66 (0.57-0.74), a specificity of 0.94 (0.91-0.96), a positive predictive value of 0.79 (0.70-0.87), and a negative predictive value of 0.89 (0.85-0.92). Conclusion We observed that systemic arterial levels of PTX3 were associated with the SYNTAX score in a curvilinear fashion. The discriminatory power of systemic arterial levels of PTX3 for a high SYNTAX score was excellent. The interesting finding of this study was the near perfect concordance between the decisions made by the cardiologists based on their clinical judgment and the SYNTAX score. The systemic arterial PTX3 level of 0.29 ng · dL-1 was highly specific for diagnosing complex coronary artery stenosis. PMID:25089133

  14. Drugs targeting high-density lipoprotein cholesterol for coronary artery disease management.

    PubMed

    Katz, Pamela M; Leiter, Lawrence A

    2012-01-01

    Many patients remain at high risk for future cardiovascular events despite levels of low-density lipoprotein cholesterol (LDL-C) at, or below, target while taking statin therapy. Much effort is therefore being focused on strategies to reduce this residual risk. High-density lipoprotein cholesterol (HDL-C) is a strong, independent, inverse predictor of coronary heart disease risk and is therefore an attractive therapeutic target. Currently available agents that raise HDL-C have only modest effects and there is limited evidence of additional cardiovascular risk reduction on top of background statin therapy associated with their use. It was hoped that the use of cholesteryl ester transfer protein (CETP) inhibitors would provide additional benefit, but the results of clinical outcome studies to date have been disappointing. The results of ongoing trials with other CETP inhibitors that raise HDL-C to a greater degree and also lower LDL-C, as well as with other emerging therapies are awaited.

  15. The role of volume-load in strength and absolute endurance adaptations in adolescent's performing high- or low-load resistance training.

    PubMed

    Steele, James; Fisher, James P; Assunção, Ari R; Bottaro, Martim; Gentil, Paulo

    2017-02-01

    This study compared high- (HL) and low-load (LL) resistance training (RT) on strength, absolute endurance, volume-load, and their relationships in untrained adolescents. Thirty-three untrained adolescents of both sexes (males, n = 17; females, n = 16; 14 ± 1 years) were randomly assigned into either (i) HL (n = 17): performing 3 sets of 4-6 repetitions to momentary concentric failure; or (ii) LL (n = 16): performing 2 sets of 12-15 repetitions to momentary concentric failure. RT was performed for 2×/week for 9 weeks. Change in maximum strength (1 repetition maximum) and absolute muscular endurance for barbell bench press was assessed. Weekly volume-load was calculated as sets (n) × repetitions (n) × load (kg). Ninety-five percent confidence intervals (CIs) revealed that both groups significantly increased in strength and absolute endurance with large effect sizes (d = 1.51-1.66). There were no between-group differences for change in strength or absolute endurance. Ninety-five percent CIs revealed that both groups significantly increased in weekly volume-load with large effect sizes (HL = 1.66, LL = 1.02). There were no between-group differences for change in volume-load though average weekly volume-load was significantly greater for LL (p < 0.001). Significant Pearson's correlations were found for the HL group between average weekly volume-load and both strength (r = 0.650, p = 0.005) and absolute endurance (r = 0.552, p = 0.022) increases. Strength and absolute endurance increases do not differ between HL and LL conditions in adolescents when performed to momentary concentric failure. Under HL conditions greater weekly volume-load is associated with greater strength and absolute endurance increases.

  16. Absolute dose measurements by means of a small cylindrical ionization chamber for very high dose per pulse high energy electron beams

    SciTech Connect

    Karaj, E.; Righi, S.; Di Martino, F.

    2007-03-15

    Very high dose per pulse (3-13 cGy/pulse) high energy electron beams are currently produced by special linear accelerators (linac) dedicated to Intra Operative Radiation Therapy (IORT). The electron beams produced by such linacs are collimated by special Perspex applicators of various size and cylindrically shaped. The biggest problems from the dosimetric point of view are caused by the high dose-per-pulse values and the use of inclined applicators. In this work measurements of absolute dose for the inclined applicators were done by using a small cylindrical ionization chamber, type CC01 (Wellhofer), a parallel plane ionization chamber type Markus (PTW 23343) and radiochromic films type EBT. We show a method which allows calculating the quality correction factors for CC01 chamber with an uncertainty of 1% and the absolute dose value for the inclined applicators using CC01 with an uncertainty of 3.1% for electron beams of energy of 6 and 7 MeV produced by the linac dedicated to IORT Novac7.

  17. Absolute Dating of Strath Terraces along the Western High Plains Reveals Complicated History of Occupation and Incision

    NASA Astrophysics Data System (ADS)

    Foster, M. A.; Anderson, R. S.; Gray, H. J.; Mahan, S.

    2015-12-01

    Gravel-capped strath terraces are preserved along the western High Plains, adjacent to the Colorado Front Range. Terrace elevations appear to connect across the landscape, representing previous levels of the Denver Basin during fluvial exhumation. In this tectonically quiescent region, climatically-driven fluctuations in sediment supply are often interpreted to drive terrace occupation and basin exhumation. We dated a series of strath terraces near Boulder, CO using 10Be/26Al cosmogenic radionuclides (CRNs) and optically stimulated luminescence. Results reveal: (1) a long history of fluvial occupation (0.5-1.0 Myr duration), with recent (<120 ka) fluvial abandonment of the highest surface; (2) a brief occupation of a narrow spillway, abandoned at 97.0 ± 4.2 ka, preserved because the stream was subsequently pirated; and (3) a long period of fluvial occupation of a lower terrace, recorded by the deposition of distinct gravel packages at 50-75 ka and 40.5 ± 5.0 ka. In conjunction with absolute dating on nearby terraces, our study indicates the system is more complex than originally thought. Ages are not consistent among terraces of similar elevations deposited by different stream systems. The link between terrace age and climate is not straightforward, as terraces can be occupied through several glacial-interglacial cycles. When a surface is abandoned, incision to the next level appears to occur quite rapidly through the soft Cretaceous shales. Long-term incision rates may be derived from elevations and ages of high preserved surfaces, but such incision rates reflect long periods of no vertical erosion punctuated with short periods of rapid incision. Such interpretations would not be possible without paired CRNs or combination with other geochronologic techniques. This study therefore represents a cautionary tale for the interpretation of tectonic or climatic processes and process rates from single-method dating of fluvial terraces.

  18. Effects of the high-density lipoprotein mimetic agent CER-001 on coronary atherosclerosis in patients with acute coronary syndromes: a randomized trial†

    PubMed Central

    Tardif, Jean-Claude; Ballantyne, Christie M.; Barter, Philip; Dasseux, Jean-Louis; Fayad, Zahi A.; Guertin, Marie-Claude; Kastelein, John J. P.; Keyserling, Constance; Klepp, Heather; Koenig, Wolfgang; L'Allier, Philippe L.; Lespérance, Jacques; Lüscher, Thomas F.; Paolini, John F.; Tawakol, Ahmed; Waters, David D.; Pfeffer, M.; Brown, V.; Rouleau, J.; Watkins, P.; Wei, L.J.; Gosselin, G.; Chayer, C.; Lanthier, S.; Pelletier, G.B.; Racine, N.; Agarwal, H.; Brilakis, E.; Cannon, L.; Carrié, D.; Corbelli, J.; Coste, P.; de Winter, R.; Diaz, A.; Eisenberg, S.; Ennis, B.; Fajadet, J.; Fam, N.; Fortuin, D.; Gessler, C.; Grines, C.; Guerra, D.; Gum, H.; Haldis, T.; Heestermans, T.; Herrman, J.P.; Huynh, T.; Kedhi, E.; Koren, M.; Kouz, S.; Krolick, M.; Kumkumian, G.; Lavi, S.; Li, R.J.; Masud, ARZ; McAlhany, C.; McGrew, F.A.; O'Shaughnessy, C.; Oude Ophuis, A.J.M.; Parr, K.; Penny, W.; Pesant, Y.; Post, H.; Robinson, S.; Rodes-Cabau, J.; Roy, A.; Schulman, S.; Spence, F.; Stouffer, G.; Stys, T.; Sussex, B.; Tahirkheli, N.; Tardif, J-C.; Grégoire, J.; ten Berg, J.; van Boven, A.J.; von Birgelen, C.; Weinstein, D.

    2014-01-01

    Aim High-density lipoproteins (HDLs) have several potentially protective vascular effects. Most clinical studies of therapies targeting HDL have failed to show benefits vs. placebo. Objective To investigate the effects of an HDL-mimetic agent on atherosclerosis by intravascular ultrasonography (IVUS) and quantitative coronary angiography (QCA). Design and setting A prospective, double-blinded, randomized trial was conducted at 51 centres in the USA, the Netherlands, Canada, and France. Intravascular ultrasonography and QCA were performed to assess coronary atherosclerosis at baseline and 3 (2–5) weeks after the last study infusion. Patients Five hundred and seven patients were randomized; 417 and 461 had paired IVUS and QCA measurements, respectively. Intervention Patients were randomized to receive 6 weekly infusions of placebo, 3 mg/kg, 6 mg/kg, or 12 mg/kg CER-001. Main outcome measures The primary efficacy parameter was the nominal change in the total atheroma volume. Nominal changes in per cent atheroma volume on IVUS and coronary scores on QCA were also pre-specified endpoints. Results The nominal change in the total atheroma volume (adjusted means) was −2.71, −3.13, −1.50, and −3.05 mm3 with placebo, CER-001 3 mg/kg, 6 mg/kg, and 12 mg/kg, respectively (primary analysis of 12 mg/kg vs. placebo: P = 0.81). There was also no difference among groups for the nominal change in per cent atheroma volume (0.02, −0.02, 0.01, and 0.19%; nominal P = 0.53 for 12 mg/kg vs. placebo). Change in the coronary artery score was −0.022, −0.036, −0.022, and −0.015 mm (nominal P = 0.25, 0.99, 0.55), and change in the cumulative coronary stenosis score was −0.51, 2.65, 0.71, and −0.77% (compared with placebo, nominal P = 0.85 for 12 mg/kg and nominal P = 0.01 for 3 mg/kg). The number of patients with major cardiovascular events was 10 (8.3%), 16 (13.3%), 17 (13.7%), and 12 (9.8%) in the four groups. Conclusion CER-001 infusions did not reduce coronary

  19. Local motion-compensated method for high-quality 3D coronary artery reconstruction

    PubMed Central

    Liu, Bo; Bai, Xiangzhi; Zhou, Fugen

    2016-01-01

    The 3D reconstruction of coronary artery from X-ray angiograms rotationally acquired on C-arm has great clinical value. While cardiac-gated reconstruction has shown promising results, it suffers from the problem of residual motion. This work proposed a new local motion-compensated reconstruction method to handle this issue. An initial image was firstly reconstructed using a regularized iterative reconstruction method. Then a 3D/2D registration method was proposed to estimate the residual vessel motion. Finally, the residual motion was compensated in the final reconstruction using the extended iterative reconstruction method. Through quantitative evaluation, it was found that high-quality 3D reconstruction could be obtained and the result was comparable to state-of-the-art method. PMID:28018741

  20. Local motion-compensated method for high-quality 3D coronary artery reconstruction.

    PubMed

    Liu, Bo; Bai, Xiangzhi; Zhou, Fugen

    2016-12-01

    The 3D reconstruction of coronary artery from X-ray angiograms rotationally acquired on C-arm has great clinical value. While cardiac-gated reconstruction has shown promising results, it suffers from the problem of residual motion. This work proposed a new local motion-compensated reconstruction method to handle this issue. An initial image was firstly reconstructed using a regularized iterative reconstruction method. Then a 3D/2D registration method was proposed to estimate the residual vessel motion. Finally, the residual motion was compensated in the final reconstruction using the extended iterative reconstruction method. Through quantitative evaluation, it was found that high-quality 3D reconstruction could be obtained and the result was comparable to state-of-the-art method.

  1. Does Pre-Treatment with High Dose Atorvastatin Prevent Microvascular Dysfunction after Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome?

    PubMed Central

    Lee, Bong-Ki; Nam, Chang-Wook; Doh, Joon-Hyung; Chung, Woo-Young; Cho, Byung-Ryul; Fearon, William F.

    2016-01-01

    Background and Objectives There is controversy surrounding whether or not high dose statin administration before percutaneous coronary intervention (PCI) decreases peri-procedural microvascular injury. We performed a prospective randomized study to investigate the mechanisms and effects of pre-treatment high dose atorvastatin on myocardial damage in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) undergoing PCI. Subjects and Methods Seventy seven patients with NSTE-ACS were randomly assigned to either the high dose group (atorvastatin 80 mg loading 12 to 24 h before PCI with a further 40 mg loading 2 h before PCI, n=39) or low dose group (atorvastatin 10 mg administration 12 to 24 h before PCI, n=38). Index of microcirculatory resistance (IMR) was measured after stent implantation. Creatine kinase-myocardial band (CK-MB) and high sensitivity C-reactive protein (CRP) levels were measured before and after PCI. Results The baseline characteristics were not different between the two patient groups. Compared to the low dose group, the high dose group had lower post PCI IMR (14.1±5.0 vs. 19.2±9.3 U, p=0.003). Post PCI CK-MB was also lower in the high dose group (median: 1.40 ng/mL (interquartile range [IQR: 0.75 to 3.45] vs. 4.00 [IQR: 1.70 to 7.37], p=0.002) as was the post-PCI CRP level (0.09 mg/dL [IQR: 0.04 to 0.16] vs. 0.22 [IQR: 0.08 to 0.60], p=0.001). Conclusion Pre-treatment with high dose atorvastatin reduces peri-PCI microvascular dysfunction verified by post-PCI IMR and exerts an immediate anti-inflammatory effect in patients with NSTE-ACS. PMID:27482255

  2. High platelet reactivity after P2Y12-inhibition in patients with atrial fibrillation and coronary stenting.

    PubMed

    Rilinger, Jonathan; Meyer, Melanie; Schnabel, Katharina; Weik, Patrick; Charlet, Anne; Esser, Jennifer S; Zhou, Qian; Bode, Christoph; Moser, Martin; Diehl, Philipp; Olivier, Christoph B

    2016-11-01

    High platelet reactivity (HPR) after P2Y12-inhibition in patients undergoing coronary stenting is associated with an increased risk for thromboembolic events and coronary death. So far it is not known how HPR affects the clinical outcome of different treatment strategies in patients with atrial fibrillation (AF) undergoing coronary stenting. In this single centre, observational study the antiplatelet effect of P2Y12-inhibitors in AF patients undergoing coronary stenting was investigated using impedance aggregometry. Patients received either dual antiplatelet therapy (DAPT) or triple therapy (TT). HPR was defined as the ratio of ADP-to TRAP-induced aggregation (r-ADP-agg) ≥50 %. Thromboembolic and bleeding events were assessed within the first 30 days after stenting. Out of 910 screened patients 167 patients were available for the present analysis. HPR was found in 5 of 43 (12 %) patients treated with DAPT and in 18 of 124 (15 %) patients treated with TT. In patients receiving TT, HPR was not a risk factor for thromboembolic events compared to patients with adequate response to P2Y12-inhibitors (6 vs. 8 %, p = 0.712). There was a trend for less bleeding events in patients with HPR compared to r-ADP-agg <50 % in the TT group (0 vs. 16 %, p = 0.077). Our data suggest that HPR after P2Y12-antagonism in patients receiving TT due to AF and coronary stenting might protect from bleeding without increasing thromboembolic risk. Future studies will need to investigate if patients with AF receiving coronary stenting benefit from a reduction of antithrombotic therapy.

  3. A high-resolution, absolute-dated deglacial speleothem record of Indian Ocean climate from Socotra Island, Yemen

    NASA Astrophysics Data System (ADS)

    Shakun, Jeremy D.; Burns, Stephen J.; Fleitmann, Dominik; Kramers, Jan; Matter, Albert; Al-Subary, Abdulkarim

    2007-07-01

    Stalagmite M1-5 from Socotra Island, Yemen in the northwest Indian Ocean provides a robust, high-resolution paleoclimate record from ˜ 27.4-11.1 ka based on 717 stable isotope and 28 230Th measurements. Variations in M1-5 oxygen isotope ratios ( δ18O) are interpreted to be primarily driven by an amount effect related to changes in the mean position and/or intensity of convection of the intertropical convergence zone, the island's only source of precipitation. The M1-5 δ18O time series is strongly correlated to the Greenland ice cores, similar to an older Socotra speleothem deposited from 53-40 ka [S.J. Burns, D. Fleitmann, A. Matter, J. Kramers, A. Al-Subbary, Indian Ocean climate and an absolute chronology over Dansgaard/Oeschger events 9 to 13, Science 301 (2003) 1365-1367], indicating that a North Atlantic-Indian Ocean cold-dry/warm-wet teleconnection persisted through the end of the last glacial period. Peak aridification occurred at ˜ 23 ka and a gradual increase in moisture thereafter was interrupted by an abrupt drying event at ˜ 16.4 ka, perhaps related to Heinrich event 1. Indian Ocean rainfall increased dramatically during the Bølling period and then decreased continuously and gradually through the Allerød and Younger Dryas. The Holocene began abruptly with increased precipitation at 11.4 ka and was followed by a major but short-lived drying during the Preboreal Oscillation at ˜ 11.2 ka. M1-5 is highly correlated to the Dongge Cave record from 15.5-11 ka, suggesting much of the Indian Ocean monsoon region responded similarly to the major climate changes of the last deglaciation. The transitions into the Younger Dryas and to a lesser extent the Bølling are remarkably gradual in M1-5, as they are in all other Asian speleothem records, occurring over several centuries. These gradual transitions are in striking contrast to high-resolution records from around the North Atlantic basin where the transitions are extremely abrupt and generally occur in

  4. High-quality 3-D coronary artery imaging on an interventional C-arm x-ray system

    SciTech Connect

    Hansis, Eberhard; Carroll, John D.; Schaefer, Dirk; Doessel, Olaf; Grass, Michael

    2010-04-15

    Purpose: Three-dimensional (3-D) reconstruction of the coronary arteries during a cardiac catheter-based intervention can be performed from a C-arm based rotational x-ray angiography sequence. It can support the diagnosis of coronary artery disease, treatment planning, and intervention guidance. 3-D reconstruction also enables quantitative vessel analysis, including vessel dynamics from a time-series of reconstructions. Methods: The strong angular undersampling and motion effects present in gated cardiac reconstruction necessitate the development of special reconstruction methods. This contribution presents a fully automatic method for creating high-quality coronary artery reconstructions. It employs a sparseness-prior based iterative reconstruction technique in combination with projection-based motion compensation. Results: The method is tested on a dynamic software phantom, assessing reconstruction accuracy with respect to vessel radii and attenuation coefficients. Reconstructions from clinical cases are presented, displaying high contrast, sharpness, and level of detail. Conclusions: The presented method enables high-quality 3-D coronary artery imaging on an interventional C-arm system.

  5. High-accuracy interferometer with a prism pair for measurement of the absolute refractive index of glass

    SciTech Connect

    Hori, Yasuaki; Hirai, Akiko; Minoshima, Kaoru; Matsumoto, Hirokazu

    2009-04-10

    We propose a variable-path interferometric technique for the measurement of the absolute refractive index of optical glasses. We use two interferometers to decide the ratio between changes in the optical path in a prism-shaped sample glass and in air resulting from displacement of the sample. The method allows precise measurements to be made without prior knowledge of the properties of the sample. The combined standard uncertainty of the proposed method is 1.6x10{sup -6}.

  6. Prognostic value of stress echocardiography in women with high (⩾80%) probability of coronary artery disease

    PubMed Central

    Davar, J; Roberts, E; Coghlan, J; Evans, T; Lipkin, D

    2001-01-01

    OBJECTIVE—To assess the prognostic significance of stress echocardiography in women with a high probability of coronary artery disease (CAD).
SETTING—Secondary and tertiary cardiology unit at a university teaching hospital.
PARTICIPANTS—A total of 135 women (mean (SD) age 63 (9) years) with pre-test probability of CAD ⩾80% were selected from a database of patients investigated by treadmill or dobutamine stress echocardiography between 1995 and 1998.
MAIN OUTCOME MEASURES—Patients were followed up for occurrence of subsequent cardiac events (cardiac death, myocardial infarction, admission with unstable angina, and revascularisation) using a structured telephone interview and case note review.
RESULTS—Each patient had between two and seven (mean 3.5) CAD risk factors and pre-test probability of CAD ⩾80%. Ninety three patients (68.9%) had negative stress echocardiography. Mean (SD) follow up was 20.1 (8.5) months. There were six events in the positive stress echocardiography group (two cardiac deaths, one unstable angina, three revascularisations), and one event in the negative stress echocardiography group. Cox regression analysis showed positive stress echocardiography (p=0.02) and age (p=0.03) to be the only univariate predictors and positive stress echocardiography to be the only independent predictor of future cardiac events (relative risk 8.9, confidence interval 1.0 to 76.5, p=0.04). Cumulative event free survival to 38 months was 98% in the negative stress echocardiography and 50.7% in the positive stress echocardiography groups.
CONCLUSION—In women with high pre-test likelihood of CAD: (1) negative stress echocardiography identifies a subgroup with low risk of cardiac events who do not require further invasive investigation and (2) positive stress echocardiography identifies a subgroup with increased risk of subsequent cardiac events.


Keywords: coronary artery disease; women; stress echocardiography PMID:11524515

  7. Virtual coaching for the high-intensity training of a powerlifter following coronary artery bypass grafting

    PubMed Central

    Adams, Richard; Qin, Huanying; Bilbrey, Tim; Schussler, Jeffrey M.

    2015-01-01

    A 55-year-old powerlifter in Tennessee learned about the sport-specific, high-intensity cardiac rehabilitation training available in Dallas, Texas, and contacted the staff by phone. He was recovering from quadruple coronary artery bypass grafting (CABG) and had completed several weeks of traditional cardiac rehabilitation in his hometown, but the exercise program no longer met his needs. He wanted help in returning both to his normal training regimen and to powerlifting competition but was unable to attend the Dallas program in person. An exercise physiologist with the program devised a virtual coaching model in which the patient was sent a wrist blood pressure cuff for self-monitoring and was advised about exercises that would not harm his healing sternum, even as the weight loads were gradually increased. After 17 weeks of symptom-limited, high-intensity training that was complemented by phone and e-mail support, the patient was lifting heavier loads than he had before CABG. At a powerlifting competition 10 months after CABG, he placed first in his age group. This case report exemplifies the need for alternative approaches to the delivery of cardiac rehabilitation services. PMID:25552808

  8. Virtual coaching for the high-intensity training of a powerlifter following coronary artery bypass grafting.

    PubMed

    Adams, Richard; Adams, Jenny; Qin, Huanying; Bilbrey, Tim; Schussler, Jeffrey M

    2015-01-01

    A 55-year-old powerlifter in Tennessee learned about the sport-specific, high-intensity cardiac rehabilitation training available in Dallas, Texas, and contacted the staff by phone. He was recovering from quadruple coronary artery bypass grafting (CABG) and had completed several weeks of traditional cardiac rehabilitation in his hometown, but the exercise program no longer met his needs. He wanted help in returning both to his normal training regimen and to powerlifting competition but was unable to attend the Dallas program in person. An exercise physiologist with the program devised a virtual coaching model in which the patient was sent a wrist blood pressure cuff for self-monitoring and was advised about exercises that would not harm his healing sternum, even as the weight loads were gradually increased. After 17 weeks of symptom-limited, high-intensity training that was complemented by phone and e-mail support, the patient was lifting heavier loads than he had before CABG. At a powerlifting competition 10 months after CABG, he placed first in his age group. This case report exemplifies the need for alternative approaches to the delivery of cardiac rehabilitation services.

  9. High-intensity interval training in patients with coronary heart disease: Prescription models and perspectives.

    PubMed

    Ribeiro, Paula A B; Boidin, Maxime; Juneau, Martin; Nigam, Anil; Gayda, Mathieu

    2017-01-01

    Recently, high-intensity interval training (HIIT) has emerged as an alternative and/or complementary exercise modality to continuous aerobic exercise training (CAET) in CHD patients. However, the literature contains descriptions of many HIIT protocols with different stage durations, nature of recovery and intensities. In this review, we discuss the most recent forms of validated HIIT protocols in patients with coronary heart disease (CHD) and how to prescribe and use them during short- and long-term (phase II and III) cardiac rehabilitation programs. We also compare the superior and/or equivalent short- and long-term effects of HIIT versus CAET on aerobic fitness, cardiovascular function, and quality of life; their efficiency, safety, and tolerance; and exercise adherence. Short interval HIIT was found beneficial for CHD patients with lower aerobic fitness and would ideally be used in initiation and improvement stages. Medium and/or long interval HIIT protocols may be beneficial for CHD patients with higher aerobic fitness, and would be ideally used in the improvement and maintenance stages because of their high physiological stimulus. Finally, we propose progressive individualized models of HIIT programs (phase II to III) for patients with CHD and how to ideally use them according to the clinical status of patients and phase of the cardiac rehabilitation program.

  10. [High-sensitivity troponin in patients with stable coronary artery disease].

    PubMed

    van 't Hof, Arnoud W J

    2015-01-01

    With the introduction of more sensitive markers of myocardial necrosis, it was shown that the diagnosis of (acute) myocardial infarction could be improved. However, many patients without myocardial infarction have elevated troponin levels (low sensitivity), resulting in additional diagnostic testing and longer admission times to find the cause of the troponin rise. Elevated troponin levels in these patients were found to have limited diagnostic but strong prognostic value. This led to studies assessing the value of high-sensitivity troponin in patients with stable disease, e.g. coronary artery disease, or even in patients without apparent (clinical) disease. These studies consistently showed a strong association with long-term (cardiac) mortality. What is the value for the general physician in daily practice? Although troponin levels may help in finding (healthy?) patients at higher risk, it remains unclear whether interventions (medication, lifestyle) are more (cost-)effective in this high-risk subgroup. The role of troponin levels as a prognostic marker in stable patients therefore remains to be determined.

  11. [Identification of subjects at high risk of coronary disease in a working population using a prediction model].

    PubMed

    Laurier, D; Chau, N P

    1995-11-01

    Identification of subjects at high risk of coronary morbidity is of major interest in the prevention of cardiovascular disease. This report describes the use of a multifactorial prediction model for the identification of high risk subjects in a French male population. The PCV-METRA study (Prévention Cardiovasculaire en Médecine du Travail) monitors risk factors of cardiovascular morbidity in a population of men and women employed in big companies in the Paris region. A model adapted from a prediction model conceived by K.M. Anderson et al. in the Framingham study was used. The modified model enables an estimation of individual coronary risk based on 7 factors: age, total cholesterol, HDL-cholesterol, systolic blood pressure, smoking, diabetes and presence of left ventricular hypertrophy, taking into account the relatively low prevalence of coronary heart disease in France. The population comprised 4,131 active men aged 30 to 65 years. The average risk at 5 years was estimated to be 1.6%. Subjects at high risk (over the 80th percentile of the risk distribution curve) usually had high blood pressures and cholesterol levels. However, nearly 30% of these subjects were neither hypertensive nor hypercholesteraemic. It is important to note that 3/4 of these smoked. Moreover, they also had low HDL-cholesterol levels. A risk table, derived from the Framingham model, is presented. This table allows estimation of individual risk at 5 years in men aged 30 to 65 years. In each age group, the comparison of individual risk with the percentiles of risk distribution in the PCV-METRA population allows identification of high-risk subjects. This study proposes a tool for identifying subjects at high risk of coronary morbidity in a French male population. This multifactorial model is particularly useful for detecting subjects with several borderline factors none of which overstep the usually accepted limits.

  12. Intravascular near-infrared fluorescence molecular imaging of atherosclerosis: toward coronary arterial visualization of biologically high-risk plaques

    NASA Astrophysics Data System (ADS)

    Calfon, Marcella A.; Vinegoni, Claudio; Ntziachristos, Vasilis; Jaffer, Farouc A.

    2010-01-01

    New imaging methods are urgently needed to identify high-risk atherosclerotic lesions prior to the onset of myocardial infarction, stroke, and ischemic limbs. Molecular imaging offers a new approach to visualize key biological features that characterize high-risk plaques associated with cardiovascular events. While substantial progress has been realized in clinical molecular imaging of plaques in larger arterial vessels (carotid, aorta, iliac), there remains a compelling, unmet need to develop molecular imaging strategies targeted to high-risk plaques in human coronary arteries. We present recent developments in intravascular near-IR fluorescence catheter-based strategies for in vivo detection of plaque inflammation in coronary-sized arteries. In particular, the biological, light transmission, imaging agent, and engineering principles that underlie a new intravascular near-IR fluorescence sensing method are discussed. Intravascular near-IR fluorescence catheters appear highly translatable to the cardiac catheterization laboratory, and thus may offer a new in vivo method to detect high-risk coronary plaques and to assess novel atherosclerosis biologics.

  13. Integrative physiology of coronary microcirculation.

    PubMed

    Kajiya, F; Goto, M

    1999-06-01

    Coronary microvessels play a crucial role for mechanoenergetic interaction between blood flow and myocardial function, which is not uniform transmurally. Thus, highly organized vascular regulations are required for matching local blood flow with myocardial energy requirement. Recently, new technologies to investigate in vivo coronary microcirculation with new knowledge of the signaling molecules for vascular regulation have revolutionized our abilities to understand the integrative regulation of coronary microcirculation. In this review, the mechanical aspects of the interaction between coronary blood flow and myocardium, coronary arte-rial tree and its roles in myocardial blood flow regulation, hierarchical and dynamic control of coronary flow, capillary network and function, function of venous drainage system, and molecular and cellular aspects of integrative coronary blood flow regulation are discussed, focusing on their integrational roles in maintaining coronary microvascular function and cell signaling.

  14. Hyaluronan Based Heparin Free Coated Open and Closed Extracorporeal Circuits for High Risk Coronary Revascularization

    PubMed Central

    Gunaydin, Serdar; Ucar, Halil Ibrahim; Serter, Tanzer; McCusker, Kevin; Ozcelik, Gokhan; Salman, Nevriye; Yorgancioglu, Ali Cem

    2010-01-01

    Abstract: This prospective randomized study compares the inflammatory response and fibrinolytic activation of fully coated/uncoated and open/closed extracorporeal circuits (ECC) in high risk patients. Over a 2-month period, 48 patients with EuroSCOREs 6 or greater undergoing coronary revascularization were pro spectively randomized to one of the four perfusion protocols: Group 1: Closed and totally hyaluronan based heparin free coated (Vision HFO-GBS-HF™, Gish Biomedical, Rancho Santa Margarita, CA) ECC with a soft-shell coated venous reservoir (SVR11S2-HFC™, Gish Biomedical) and a hard-shell cardiotomy (CAPVRF44, Gish Biomedical) (n = 12); Group 2: Closed and totally uncoated identical ECC with soft-shell uncoated venous reservoir and a hard-shell cardiotomy (n = 12); Group 3: Open, totally hyaluronan based heparin free coated ECC (n = 12); and Group 4: Control-open, uncoated ECC (n = 12). Blood samples were collected at T1: Baseline; T2: 15 minutes after cardiopulmonary bypass (CPB) initiation; T3: before cessation of CPB; T4: 15 minutes after protamine reversal, and T5: in the intensive care unit. Serum IL-6 levels were significantly lower at T2 in all study groups, at T3 for coated groups, and T4 for closed+coated group (p < .05 versus control). Creatine kinase M-band (MB) levels in coronary sinus blood demonstrated well preserved myocardium after CPB in both coated groups versus Control (p < .05). Neutrophil CD11b/CD18 levels were significantly lower for all study groups versus control at T2, for both coated groups at T3 and only for closed+coated group at T4 (p < .05). Postoperative hemorrhage (mL) was 510 ± 40 in closed+coated and 536 ± 40 in open+coated groups (control: 784 ± 48, p ≤ .05). No significant differences in thrombin-antithrombin complex and free plasma hemoglobin were observed. Desorbed protein amount on ECC (mg/dL) was 1.7 ± .01 in closed+coated, 2.01 ± .01 in open+coated, and 3.3 ± .015 in control groups (p ≤ .05). Use of a

  15. Hyaluronan based heparin free coated open and closed extracorporeal circuits for high risk coronary revascularization.

    PubMed

    Gunaydin, Serdar; Ucar, Halil Ibrahim; Serter, Tanzer; McCusker, Kevin; Ozcelik, Gokhan; Salman, Nevriye; Yorgancioglu, Ali Cem

    2010-12-01

    This prospective randomized study compares the inflammatory response and fibrinolytic activation of fully coated/uncoated and open/closed extracorporeal circuits (ECC) in high risk patients. Over a 2-month period, 48 patients with EuroSCOREs 6 or greater undergoing coronary revascularization were prospectively randomized to one of the four perfusion protocols: Group 1: Closed and totally hyaluronan based heparin free coated (Vision HFO-GBS-HF, Gish Biomedical, Rancho Santa Margarita, CA) ECC with a soft-shell coated venous reservoir (SVR11S2-HFC, Gish Biomedical) and a hard-shell cardiotomy (CAPVRF44, Gish Biomedical) (n = 12); Group 2: Closed and totally uncoated identical ECC with soft-shell uncoated venous reservoir and a hard-shell cardiotomy (n = 12); Group 3: Open, totally hyaluronan based heparin free coated ECC (n = 12); and Group 4: Control-open, uncoated ECC (n = 12). Blood samples were collected at T1: Baseline; T2: 15 minutes after cardiopulmonary bypass (CPB) initiation; T3: before cessation of CPB; T4: 15 minutes after protamine reversal, and T5: in the intensive care unit. Serum IL-6 levels were significantly lower at T2 in all study groups, at T3 for coated groups, and T4 for closed+coated group (p < .05 versus control). Creatine kinase M-band (MB) levels in coronary sinus blood demonstrated well preserved myocardium after CPB in both coated groups versus Control (p < .05). Neutrophil CD11b/CD18 levels were significantly lower for all study groups versus control at T2, for both coated groups at T3 and only for closed + coated group at T4 (p < .05). Postoperative hemorrhage (mL) was 510 +/- 40 in closed + coated and 536 +/- 40 in open + coated groups (control: 784 +/- 48, p < .05). No significant differences in thrombin-antithrombin complex and free plasma hemoglobin were observed. Desorbed protein amount on ECC (mg/dL) was 1.7 +/- .01 in closed+coated, 2.01 +/- .01 in open+coated, and 3.3 +/- .015 in control groups (p < or = .05). Use of a closed

  16. The Effects of Intra-Aortic Balloon Pumps on Mortality in Patients Undergoing High-Risk Coronary Revascularization: A Meta-Analysis of Randomized Controlled Trials of Coronary Artery Bypass Grafting and Stenting Era

    PubMed Central

    Wan, You-Dong; Sun, Tong-Wen; Kan, Quan-Cheng; Guan, Fang-Xia; Liu, Zi-Qi; Zhang, Shu-Guang

    2016-01-01

    Background Intra-aortic balloon pumps (IABP) have generally been used for patients undergoing high-risk mechanical coronary revascularization. However, there is still insufficient evidence to determine whether they can improve outcomes in reperfusion therapy patients, mainly by percutaneous coronary intervention (PCI) with stenting or coronary artery bypass graft (CABG). This study was designed to determine the difference between high-risk mechanical coronary revascularization with and without IABPs on mortality, by performing a meta-analysis on randomized controlled trials of the current era. Methods Pubmed and Embase databases were searched from inception to May 2015. Unpublished data were obtained from the investigators. Randomized clinical trials of IABP and non-IABP in high-risk coronary revascularization procedures (PCI or CABG) were included. In the case of PCI procedures, stents should be used in more than 80% of patients. Numbers of events at the short-term and long-term follow-up were extracted. Results A total of 12 randomized trials enrolling 2155 patients were included. IABPs did not significantly decrease short-term mortality (relative risk (RR) 0.66; 95% CI, 0.42–1.01), or long-term mortality (RR 0.79; 95% CI, 0.47–1.35), with low heterogeneity across the studies. The findings remained stable in patients with acute myocardial infarction with or without cardiogenic shock. But in high-risk CABG patients, IABP was associated with reduced mortality (71 events in 846 patients; RR 0.40; 95%CI 0.25–0.67). Conclusion In patients undergoing high-risk coronary revascularization, IABP did not significantly decrease mortality. But high-risk CABG patients may be benefit from IABP. Rigorous criteria should be applied to the use of IABPs. PMID:26784578

  17. Dysfunctional high-density lipoproteins in coronary heart disease: implications for diagnostics and therapy.

    PubMed

    Annema, Wijtske; von Eckardstein, Arnold

    2016-07-01

    Low plasma levels of high-density lipoprotein (HDL) cholesterol are associated with increased risks of coronary heart disease. HDL mediates cholesterol efflux from macrophages for reverse transport to the liver and elicits many anti-inflammatory and anti-oxidative activities which are potentially anti-atherogenic. Nevertheless, HDL has not been successfully targeted by drugs for prevention or treatment of cardiovascular diseases. One potential reason is the targeting of HDL cholesterol which does not capture the structural and functional complexity of HDL particles. Hundreds of lipid species and dozens of proteins as well as several microRNAs have been identified in HDL. This physiological heterogeneity is further increased in pathologic conditions due to additional quantitative and qualitative molecular changes of HDL components which have been associated with both loss of physiological function and gain of pathologic dysfunction. This structural and functional complexity of HDL has prevented clear assignments of molecules to the functions of normal HDL and dysfunctions of pathologic HDL. Systematic analyses of structure-function relationships of HDL-associated molecules and their modifications are needed to test the different components and functions of HDL for their relative contribution in the pathogenesis of atherosclerosis. The derived biomarkers and targets may eventually help to exploit HDL for treatment and diagnostics of cardiovascular diseases.

  18. Reversibility of High-Grade Atrioventricular Block with Revascularization in Coronary Artery Disease without Infarction: A Literature Review

    PubMed Central

    Cardoso, Rhanderson; Alfonso, Carlos E.; Coffey, James O.

    2016-01-01

    Complete atrioventricular (AV) block is known to be reversible in some cases of acute inferior wall myocardial infarction (MI). The reversibility of high-grade AV block in non-MI coronary artery disease (CAD), however, is rarely described in the literature. Herein we perform a literature review to assess what is known about the reversibility of high-grade AV block after right coronary artery revascularization in CAD patients who present without an acute MI. To illustrate this phenomenon we describe a case of 2 : 1 AV block associated with unstable angina, in which revascularization resulted in immediate and durable restoration of 1 : 1 AV conduction, thereby obviating the need for permanent pacemaker implantation. The literature review suggests two possible explanations: a vagally mediated response or a mechanism dependent on conduction system ischemia. Due to the limited understanding of AV block reversibility following revascularization in non-acute MI presentations, it remains difficult to reliably predict which patients presenting with high-grade AV block in the absence of MI may have the potential to avoid permanent pacemaker implantation via coronary revascularization. We thus offer this review as a potential starting point for the approach to such patients. PMID:26925272

  19. Absolutely classical spin states

    NASA Astrophysics Data System (ADS)

    Bohnet-Waldraff, F.; Giraud, O.; Braun, D.

    2017-01-01

    We introduce the concept of "absolutely classical" spin states, in analogy to absolutely separable states of bipartite quantum systems. Absolutely classical states are states that remain classical (i.e., a convex sum of projectors on coherent states of a spin j ) under any unitary transformation applied to them. We investigate the maximal size of the ball of absolutely classical states centered on the maximally mixed state and derive a lower bound for its radius as a function of the total spin quantum number. We also obtain a numerical estimate of this maximal radius and compare it to the case of absolutely separable states.

  20. The prognostic value of high sensitivity troponin T 7 weeks after an acute coronary syndrome

    PubMed Central

    Kao, Michelle P C; Dow, Ellie; Lang, Chim; Struthers, Allan

    2012-01-01

    Objective The role of high sensitivity troponin T (hs-TnT) in the convalescence phase after an acute coronary syndrome (ACS) is unknown. The authors aim to assess the prognostic utility of a single hs-TnT level at 7-week post-ACS. Second, the authors evaluated whether any serial changes in hs-TnT between the index admission and 7 weeks post-ACS had any link with the prognosis. Third, the authors assessed whether the prognostic utility of hs-TnT is independent of various echocardiographic abnormalities. Methods The authors measured hs-TnT levels in 326 consecutive patients at 7 weeks after an ACS event. The composite end point of death from any cause or acute myocardial infarction was evaluated over a median duration of 30 months. Results A high 7-week hs-TnT (>14 ng/l) predicted adverse clinical outcomes independent of conventional risk factors, left ventricular dysfunction and left ventricular hypertrophy on echocardiography (adjusted RR: 2.69 (95% CI 1.45 to 5.00)). Patients with persistent hs-TnT elevation at 7 weeks were also at an increased risk of cardiovascular events compared with those with an initial high hs-TnT which then normalised (unadjusted RR 3.39 (95% CI 2.02 to 5.68)). Conclusion The authors have demonstrated the prognostic utility of a single 7-week hs-TnT measurement in routine ACS patients and that it could be used to assist medium term risk stratification in this patient cohort. In addition, the authors also showed that hs-TnT predicted long-term adverse prognosis independent of various echo parameters. Future studies should evaluate whether tailoring specific treatment interventions to higher risk individuals as identified by an elevated hs-TnT during the convalescence phase of ACS would improve clinical outcomes. PMID:22689713

  1. Noninvasive Diagnosis of Coronary Artery Disease Using 12-Lead High-Frequency Electrocardiograms

    NASA Technical Reports Server (NTRS)

    Schlegel, Todd T.; Arenare, Brian

    2006-01-01

    A noninvasive, sensitive method of diagnosing certain pathological conditions of the human heart involves computational processing of digitized electrocardiographic (ECG) signals acquired from a patient at all 12 conventional ECG electrode positions. In the processing, attention is focused on low-amplitude, high-frequency components of those portions of the ECG signals known in the art as QRS complexes. The unique contribution of this method lies in the utilization of signal features and combinations of signal features from various combinations of electrode positions, not reported previously, that have been found to be helpful in diagnosing coronary artery disease and such related pathological conditions as myocardial ischemia, myocardial infarction, and congestive heart failure. The electronic hardware and software used to acquire the QRS complexes and perform some preliminary analyses of their high-frequency components were summarized in Real-Time, High-Frequency QRS Electrocardiograph (MSC- 23154), NASA Tech Briefs, Vol. 27, No. 7 (July 2003), pp. 26-28. To recapitulate, signals from standard electrocardiograph electrodes are preamplified, then digitized at a sampling rate of 1,000 Hz, then analyzed by the software that detects R waves and QRS complexes and analyzes them from several perspectives. The software includes provisions for averaging signals over multiple beats and for special-purpose nonrecursive digital filters with specific low- and high-frequency cutoffs. These filters, applied to the averaged signal, effect a band-pass operation in the frequency range from 150 to 250 Hz. The output of the bandpass filter is the desired high-frequency QRS signal. Further processing is then performed in real time to obtain the beat-to-beat root mean square (RMS) voltage amplitude of the filtered signal, certain variations of the RMS voltage, and such standard measures as the heart rate and R-R interval at any given time. A key signal feature analyzed in the present

  2. Effect of high-dose rosuvastatin loading before percutaneous coronary intervention in Chinese patients with acute coronary syndrome: A systematic review and meta-analysis

    PubMed Central

    Su, Qiang; Guo, Wenqin; Dai, Weiran; Li, Hongqing; Yang, Huafeng; Li, Lang

    2017-01-01

    Background Acute coronary syndrome (ACS) is an important disease threatening human life and health. Many studies have shown that the loading dose of atorvastatin can significantly improve the prognosis of patients with ACS, and reduce the mortality. However, this conclusion is not consistent. Thus, we aimed to evaluate the effect of high-dose rosuvastatin loading before percutaneous coronary intervention (PCI) in Chinese patients with ACS using a meta-analysis based on a systematic review of published articles. Methods We systematically reviewed published studies, evaluating the effect of high-dose rosuvastatin loading before percutaneous coronary intervention in Chinese patients with ACS. The retrieval time is limited from inception to 2 November 2016, and the retrieved databases included PubMed, Embase, the Cochrane Library, Web of Science, CBM, CNKI, the VIP database and the Wang Fang database. Two researchers independently assessed the quality of the included studies and then extracted the data. Stata 11.0 was used for data analysis. Results In total, 11 articles, which included 802 patients, were included in our meta-analysis. Among these patients, 398 patients were in the high-dose group (20 mg/day) and 404 patients were in the conventional dose group (10 mg/day). Meta-analysis results showed that compared with the conventional dose group: 1) The loading dose of rosuvastatin can significantly reduce the hs-CRP level after PCI, including at 24 hours (SMD = -0.65, 95%CI -0.84 ~ -0.47, P = 0.000), 48 hours (SMD = -0.40, 95%CI -0.68 ~ -0.11, P = 0.006), and four weeks (SMD = -1.64, 95%CI -2.01 ~ -1.26, P = 0.000). 2) The loading dose of rosuvastatin can significantly reduce the levels of LDL-C and cTnT, including the level of LDL-C at 30 d after PCI (SMD = -0.89, 95%CI -1.10 ~ -0.69, P = 0.000), and the level of cTnT at 24 h after PCI (SMD = -1.93, 95%CI -2.28 ~ -1.59, P = 0.000), and increase the level of HDL-C at 48 h after PCI (SMD = 0.61, 95%CI 0.34 ~ 0.88, P

  3. The role of absolute phase of few-cycle laser field in the generation and measurement of attosecond high-order harmonic pulses

    NASA Astrophysics Data System (ADS)

    Zeng, Zhinan; Li, Ruxin; Xu, Zhizhan

    2002-11-01

    The effect of the absolute phase of the few-cycle driving laser pulse on the generation and measurement of high-order harmonic attosecond pulses is investigated theoretically. We find that the position of the generated attosecond soft-x-ray pulse in cutoff region is locked to the oscillations of the driving laser field, but not to the envelope of the laser pulse. This property ensures the success [M. Hentschel et al. Nature vol. 414, 509 (2001)] of the width measurement of attosecond soft-x-ray pulse based on the cross-correlation between the attosecond pulse and its driving laser pulse. However, there is a timing jitter of the order of tens of attoseconds between the attosecond pulse and the driving laser field. This sets a limit for the measurement with the shorter attosecond pulses if we cannot control the absolute phase of the few-cycle laser field. Also, we propose a novel method to detect the absolute phase of the driving laser field by measuring the spatial distribution of the photoelectrons induced by the attosecond soft-x-ray pulse and its driving laser pulse.

  4. Absence of Bacteria on Coronary Angioplasty Balloons from Unselected Patients: Results with Use of a High Sensitivity Polymerase Chain Reaction Assay.

    PubMed

    Hansen, Gorm Mørk; Nilsson, Martin; Nielsen, Claus Henrik; Holmstrup, Palle; Helqvist, Steffen; Tolker-Nielsen, Tim; Givskov, Michael; Hansen, Peter Riis

    2015-01-01

    Periodontitis is a chronic, bacterially-induced inflammatory disease of the tooth-supporting tissues, which may result in transient bacteremia and a systemic inflammatory response. Periodontitis is associated with coronary artery disease independently of established cardiovascular risk factors, and translocation of bacteria from the oral cavity to the coronary arteries may play a role in the development of coronary artery disease. Very few studies have used angioplasty balloons for in vivo sampling from diseased coronary arteries, and with varying results. Therefore, the aim of this study was to assess if bacterial DNA from primarily oral bacteria could be detected on coronary angioplasty balloons by use of an optimized sampling process combined with an internally validated sensitive polymerase chain reaction (PCR) assay. Coronary angioplasty balloons and control samples from a total of 45 unselected patients with stable angina, unstable angina/non-ST elevation myocardial infarction, and ST-elevation myocardial infarction (n = 15 in each group) were collected and analyzed using a PCR assay with high sensitivity and specificity for 16S rRNA genes of the oral microbiome. Despite elimination of extraction and purification steps, and demonstration of sensitivity levels of 25-125 colony forming units (CFU), we did not detect bacterial DNA from any of the coronary angioplasty balloons. A subsequent questionnaire indicated that the prevalence of periodontitis in the study cohort was at least 39.5%. Although coronary angioplasty balloons are unlikely to be useful for detection of bacteria with current PCR techniques in unselected patients with coronary artery disease, more studies are warranted to determine the extent to which bacteria contribute to atherosclerosis and its clinical manifestations and whether the presence of bacteria in the arteries is a transient phenomenon.

  5. [Treatment of hypertension in patients with coronary arterial disease].

    PubMed

    Rosas-Peralta, Martín; Borrayo-Sánchez, Gabriela; Madrid-Miller, Alejandra; Ramírez-Arias, Erick; Pérez-Rodríguez, Gilberto

    2016-01-01

    Reports of randomized controlled trials and prospective observational studies provide the most reliable data on the association between blood pressure and coronary heart disease (CHD). The totality of the evidence indicate a strong association between blood pressure and coronary heart disease, which is continuous at levels of less than 115 mm Hg of systolic. In general, 60 to 69 years of age, 10 lower mm Hg systolic blood pressure is associated with lower risk of one-fifth of a coronary heart disease event. The size and shape of this Association are consistent in all regions, for men and women and life-threatening events such as stroke and myocardial infarction. Trials that compared active treatment with placebo or no treatment have shown that the benefits of reducing blood pressure with different classes of drugs (e.g., diuretics, beta-blockers, ACE inhibitors, calcium antagonists) are quite similar, with about a fifth of reduction in coronary heart disease. The important points in this review are: First, that the relative benefit to the decline in blood pressure for the prevention of coronary heart disease appears to be constant in a range of different populations. Second, it is likely that considerable benefit with blood pressure low below thresholds of "traditional" blood pressure (140/90 mm Hg), especially in those with high absolute risk. Third, start, reduce with caution -especially in adult- and keep the maximum tolerance of blood pressure reduction is an issue more important than the choice of the initial agent.

  6. High-accuracy absolute rotation rate measurements with a large ring laser gyro: establishing the scale factor.

    PubMed

    Hurst, Robert B; Mayerbacher, Marinus; Gebauer, Andre; Schreiber, K Ulrich; Wells, Jon-Paul R

    2017-02-01

    Large ring lasers have exceeded the performance of navigational gyroscopes by several orders of magnitude and have become useful tools for geodesy. In order to apply them to tests in fundamental physics, remaining systematic errors have to be significantly reduced. We derive a modified expression for the Sagnac frequency of a square ring laser gyro under Earth rotation. The modifications include corrections for dispersion (of both the gain medium and the mirrors), for the Goos-Hänchen effect in the mirrors, and for refractive index of the gas filling the cavity. The corrections were measured and calculated for the 16  m2 Grossring laser located at the Geodetic Observatory Wettzell. The optical frequency and the free spectral range of this laser were measured, allowing unique determination of the longitudinal mode number, and measurement of the dispersion. Ultimately we find that the absolute scale factor of the gyroscope can be estimated to an accuracy of approximately 1 part in 108.

  7. Absolute nuclear material assay

    DOEpatents

    Prasad, Manoj K [Pleasanton, CA; Snyderman, Neal J [Berkeley, CA; Rowland, Mark S [Alamo, CA

    2012-05-15

    A method of absolute nuclear material assay of an unknown source comprising counting neutrons from the unknown source and providing an absolute nuclear material assay utilizing a model to optimally compare to the measured count distributions. In one embodiment, the step of providing an absolute nuclear material assay comprises utilizing a random sampling of analytically computed fission chain distributions to generate a continuous time-evolving sequence of event-counts by spreading the fission chain distribution in time.

  8. Absolute nuclear material assay

    DOEpatents

    Prasad, Manoj K.; Snyderman, Neal J.; Rowland, Mark S.

    2010-07-13

    A method of absolute nuclear material assay of an unknown source comprising counting neutrons from the unknown source and providing an absolute nuclear material assay utilizing a model to optimally compare to the measured count distributions. In one embodiment, the step of providing an absolute nuclear material assay comprises utilizing a random sampling of analytically computed fission chain distributions to generate a continuous time-evolving sequence of event-counts by spreading the fission chain distribution in time.

  9. Pioglitazone inhibits high glucose-induced expression of receptor for advanced glycation end products in coronary artery smooth muscle cells

    PubMed Central

    DI, BEI-BING; LI, HONG-WEI; LI, WEI-PING; SHEN, XU-HUA; SUN, ZHI-JUN; WU, XING

    2015-01-01

    Receptor for advanced glycation end products (RAGE) is critical in inflammatory diseases, including diabetes and atherosclerosis. The mechanism underlying the effect of peroxisome proliferator-activated receptor γ (PPARγ) agonist pioglitazone (PIO) on RAGE expression in coronary artery smooth muscle cells (SMCs) stimulated by high glucose concentrations remains to be elucidated. In the present study, the effect and mechanism of action of PIO on RAGE expression in SMCs was investigated following treatment with high glucose concentrations. Rat coronary artery SMCs were pretreated with PIO alone, PIO and GW9662 (a PPARγ antagonist), diphenyleneiodonium (DPI; a nicotinamide adenine dinucleotide phosphate (NADPH) oxidase inhibitor) or the antioxidant pyrrolidine dithiocarbamate (PDTC; a nuclear factor-κB (NF-κB) inhibitor), followed by treatment with high glucose. RAGE mRNA and protein expression, reactive oxygen species (ROS) production and NF-κB nuclear translocation were investigated. Glucose induced RAGE expression in a dose-dependent manner, with maximal effect at a concentration of 25 mmol/l following treatment for 48 h. PIO, DPI and PDTC reduced high glucose-induced increases in RAGE protein and mRNA expression. PIO prominently downregulated RAGE expression and inhibited high glucose-induced increases in ROS production and NF-κB activation (P<0.05). Pretreatment with PIO and GW9662 did not exhibit this inhibitory effect. High glucose may stimulate RAGE expression in coronary artery SMCs through NADPH oxidase-mediated ROS generation and NF-κB activation. PIO downregulated RAGE expression and inhibited ROS production and NF-κB activation via PPARγ activation, which may prevent the inflammatory effect of AGE/RAGE system in diabetes. PMID:25523934

  10. Impact of High Risk for Obstructive Sleep Apnea on Survival after Acute Coronary Syndrome: Insights from the ERICO Registry

    PubMed Central

    Maia, Flavia C; Goulart, Alessandra C.; Drager, Luciano F.; Staniak, Henrique L.; Santos, Itamar de Souza; Lotufo, Paulo Andrade; Bensenor, Isabela M.

    2017-01-01

    Background Obstructive sleep apnea (OSA) is a very often clinical condition that can be associated with high mortality risk, particularly in coronary heart disease (CHD). The diagnosis of OSA is not always accessible via the gold-standard method polysomnography. Objective To evaluate long-term influence of the high risk for OSA on fatal and non-fatal outcomes after acute coronary syndrome (ACS) in the Acute Coronary Syndrome Registry Strategy (ERICO) Study using the Berlin questionnaire as a surrogate. Methods Berlin questionnaire, a screening questionnaire for OSA, was applied in 639 cases of ACS 30 days after the index event. Cox regression proportional-hazards model was used to calculate the hazard ratio (HR) of all-cause, cardiovascular and CHD (myocardial infarction) mortality, as well as, the combined endpoint of fatal or recurrent non-fatal CHD. Results The high-risk group for OSA had higher frequencies of previous personal/family history of CHD and diabetes, in addition to a poorer event-free survival, as compared to the low-risk group (p-log-rank=0.03). The HR for fatal or recurrent non-fatal CHD was 4.26 (95% confidence interval, 1.18 - 15.36) in patients at high risk for OSA compared to those at low risk for OSA after a 2.6-year mean follow-up. Conclusions Using Berlin questionnaire, we were able to identify high risk for OSA as an independent predictor of non-fatal reinfarction or CHD mortality in post-ACS individuals in a long-term follow-up. PMID:28146212

  11. Absolute and relative dose measurements with Gafchromic trade mark sign EBT film for high energy electron beams with different doses per pulse

    SciTech Connect

    Fiandra, Christian; Ragona, Riccardo; Ricardi, Umberto; Anglesio, Silvia; Giglioli, Francesca Romana

    2008-12-15

    The authors have evaluated the accuracy, in absolute and relative dose measurements, of the Gafchromic trade mark sign EBT film in pulsed high-energy electron beams. Typically, the electron beams used in radiotherapy have a dose-per-pulse value of less than 0.1 mGy/pulse. However, very high dose-per-pulse electron beams are employed in certain linear accelerators dedicated to intraoperatory radiation therapy (IORT). In this study, the absorbed dose measurements with Gafchromic trade mark sign EBT in both low (less than 0.3 mGy per pulse) and high (30 and 70 mGy per pulse) dose-per-pulse electron beams were compared with ferrous sulfate chemical Fricke dosimetry (operated by the Italian Primary Standard Dosimetry Laboratory), a method independent of the dose per pulse. A summary of Gafchromic trade mark sign EBT in relative and absolute beam output determination is reported. This study demonstrates the independence of Gafchromic trade mark sign EBT absorption as a function of dose per pulse at different dose levels. A good agreement (within 3%) was found with Fricke dosimeters for plane-base IORT applicators. Comparison with a diode detector is presented for relative dose measurements, showing acceptable agreement both in the steep dose falloff zone and in the homogeneous dose region. This work also provides experimental values for recombination correction factor (K{sub sat}) of a Roos (plane parallel) ionization chamber calculated on the basis of theoretical models for charge recombination.

  12. High-sensitivity C-reactive protein and exercise-induced changes in subjects suspected of coronary artery disease

    PubMed Central

    Mouridsen, Mette Rauhe; Nielsen, Olav Wendelboe; Carlsen, Christian Malchau; Mattsson, Nick; Ruwald, Martin H; Binici, Zeynep; Sajadieh, Ahmad

    2014-01-01

    Background Inflammation plays a major role in the development of atherosclerosis. We wanted to investigate the effects of exercise on high-sensitivity (hs) C-reactive protein (CRP) in subjects who were suspected of having coronary artery disease (CAD). Methods Blood samples were obtained before, 5 minutes after, and 20 hours after an exercise test in 155 subjects who were suspected of CAD. Coronary anatomy was evaluated by computed tomography coronary angiography and/or coronary angiography. Results Median baseline hs-CRP was higher in subjects with ≥50% coronary artery lumen diameter stenosis (n=41), compared with non-CAD-subjects (n=114), 2.93 mg/L (interquartile range 1.03–5.06 mg/L) and 1.30 mg/L (interquartile range 0.76–2.74 mg/L), respectively, P=0.007. In multivariate analyses testing conventional risk factors, hs-CRP proved borderline significant, odds ratio =2.32, P=0.065. Adding baseline hs-CRP to the results of the exercise test did not improve the diagnostic evaluation. Baseline natural logarithm (Ln) hs-CRP was positively associated with body mass index and baseline Ln-transformed hs troponin T levels, and negatively associated with the daily life activity level. An increase in hs-CRP of 0.13 mg/L (interquartile range 0.05–0.24 mg/L) from baseline to 5 minutes after peak exercise was found (P<0.0001), but the increase was not associated with presence of CAD. From baseline to 20 hours after exercise, no increase in hs-CRP was found. Conclusion In conclusion, hs-CRP was not independently associated with CAD. Hs-CRP increased immediately as a response to the exercise, and the increase was modest and not associated with CAD. The results indicate that exercise has potential to cause unwanted variations in hs-CRP and that exercise prior to hs-CRP measurements in subjects included in epidemiological studies, therefore, should be avoided. PMID:24715762

  13. Angiotensin converting enzyme gene polymorphism is associated with severity of coronary artery disease in men with high total cholesterol levels.

    PubMed

    Borzyszkowska, Joanna; Stanislawska-Sachadyn, Anna; Wirtwein, Marcin; Sobiczewski, Wojciech; Ciecwierz, Dariusz; Targonski, Radoslaw; Gruchala, Marcin; Rynkiewicz, Andrzej; Limon, Janusz

    2012-05-01

    This study examines whether renin-angiotensin-aldosterone system gene polymorphisms: ACE (encoding for angiotensin converting enzyme) c.2306-117_404 I/D, AGTR1 (encoding for angiotensin II type-1 receptor) c.1080*86A>C and CYP11B2 (encoding for aldosterone synthase) c.-344C>T are associated with the extension of coronary atherosclerosis in a group of 647 patients who underwent elective coronary angiography. The extension of CAD was evaluated using the Gensini score. The polymorphisms were determined by PCR and RFLP assays. The associations between genotypes and the extent of coronary atherosclerosis were tested by the Kruskal-Wallis test, followed by pairwise comparisons using Wilcoxon test. The population has been divided into groups defined by: sex, smoking habit, past myocardial infarction, BMI (>, ≤ 25), age (>, ≤ 55), diabetes mellitus, level of total cholesterol (>, ≤ 200 mg/dl), LDL cholesterol (>, ≤ 130 mg/dl), HDL cholesterol (>, ≤ 40 mg/dl), triglycerides (>, ≤ 150 mg/dl). Significant associations between the ACE c.2306-117_404 I/D polymorphism and the Gensini score in men with high total cholesterol levels (P(Kruskal-Wallis) = 0.008; P(adjusted) = 0.009), high level of LDL cholesterol (P(Kruskal-Wallis) = 0.016; P(adjusted) = 0.028) and low level of HDL cholesterol (P(Kruskal-Wallis) = 0.04; P(adjusted) = 0.055) have been found. No association between the AGTR1 c.1080*86A>C and CYP11B2 c.-344C>T and the Gensini score has been found. These results suggest that men who carry ACE c.2306-117_404 DD genotype and have high total cholesterol, high LDL cholesterol and low HDL cholesterol levels may be predisposed to the development of more severe CAD.

  14. Percutaneous Coronary Intervention of Hidden Coronary Artery-Unusual Type of Isolated Single Coronary Artery

    PubMed Central

    Patil, Shivanand; Ramalingam, Rangaraj; Manjunath, Cholenahally Nanjappa; Subramanyam, Kasamsetty

    2016-01-01

    Single coronary artery is a rare congenital coronary artery anomaly, the incidence of which is 0.024-0.066% as described in literature. Report of cases having single coronary artery along with acute myocardial infarction are scanty and reports of percutaneous intervention in such a situation are even fewer, technically challenging and potentially cataclysmic. As single coronary artery supplies the entire myocardium, occlusion of this can result in significant ischemic insult, resulting in severe biventricular dysfunction. Percutaneous Coronary Intervention (PCI) of single coronary artery is technically challenging and carries high risk which may be equated to left main intervention. We report a rare interesting case of L1 variety of single coronary artery which presented as acute inferoposterior myocardial infarction with successful rescue PCI to Left Circumflex Artery (LCx). PMID:27656488

  15. Absolute multilateration between spheres

    NASA Astrophysics Data System (ADS)

    Muelaner, Jody; Wadsworth, William; Azini, Maria; Mullineux, Glen; Hughes, Ben; Reichold, Armin

    2017-04-01

    Environmental effects typically limit the accuracy of large scale coordinate measurements in applications such as aircraft production and particle accelerator alignment. This paper presents an initial design for a novel measurement technique with analysis and simulation showing that that it could overcome the environmental limitations to provide a step change in large scale coordinate measurement accuracy. Referred to as absolute multilateration between spheres (AMS), it involves using absolute distance interferometry to directly measure the distances between pairs of plain steel spheres. A large portion of each sphere remains accessible as a reference datum, while the laser path can be shielded from environmental disturbances. As a single scale bar this can provide accurate scale information to be used for instrument verification or network measurement scaling. Since spheres can be simultaneously measured from multiple directions, it also allows highly accurate multilateration-based coordinate measurements to act as a large scale datum structure for localized measurements, or to be integrated within assembly tooling, coordinate measurement machines or robotic machinery. Analysis and simulation show that AMS can be self-aligned to achieve a theoretical combined standard uncertainty for the independent uncertainties of an individual 1 m scale bar of approximately 0.49 µm. It is also shown that combined with a 1 µm m‑1 standard uncertainty in the central reference system this could result in coordinate standard uncertainty magnitudes of 42 µm over a slender 1 m by 20 m network. This would be a sufficient step change in accuracy to enable next generation aerospace structures with natural laminar flow and part-to-part interchangeability.

  16. Coronary Calcium Scan

    MedlinePlus

    ... Scan Coronary Calcium Scan Related Topics Angina Atherosclerosis Coronary Heart Disease Electrocardiogram Heart Attack Send a link to NHLBI ... calcium, or calcifications, are a sign of atherosclerosis, coronary heart disease, or coronary microvascular disease. A coronary calcium scan ...

  17. Comparison of high energy gamma rays from absolute value of b greater than 30 deg with the galactic neutral hydrogen distribution

    NASA Technical Reports Server (NTRS)

    Ozel, M. E.; Ogelman, H.; Tumer, T.; Fichtel, C. E.; Hartman, R. C.; Kniffen, D. A.; Thompson, F. J.

    1978-01-01

    High-energy gamma-ray (energy above 35 MeV) data from the SAS 2 satellite have been used to compare the intensity distribution of gamma rays with that of neutral hydrogen (H I) density along the line of sight, at high galactic latitudes (absolute values greater than 30 deg). A model has been constructed for the case where the observed gamma-ray intensity has been assumed to be the sum of a galactic component proportional to the H I distribution plus an isotropic extragalactic emission. A chi-squared test of the model parameters indicates that about 30% of the total high-latitude emission may originate within the Galaxy.

  18. Value of Coronary Computed Tomography Angiography in Tailoring Aspirin Therapy for Primary Prevention of Atherosclerotic Events in Patients at High Risk With Diabetes Mellitus.

    PubMed

    Dimitriu-Leen, Aukelien C; Scholte, Arthur J H A; van Rosendael, Alexander R; van den Hoogen, Inge J; Kharagjitsingh, Aantje V; Wolterbeek, Ron; Knuuti, Juhani; Kroft, Lucia J M; Delgado, Victoria; Jukema, J Wouter; de Graaf, Michiel A; Bax, Jeroen J

    2016-03-15

    Aspirin use for primary prevention in patients at high risk with diabetes mellitus (DM) is often recommended under the assumption that most patients with DM have coronary artery disease (CAD). However, not all patients may have CAD. The present study evaluated, in 425 patients at high risk with DM (without chest pain syndrome or a history of cardiac disease), the prevalence of CAD on coronary computed tomography angiography (CTA). Moreover, the association between the presence and number of traditional cardiovascular (CV) risk factors and CAD (on coronary CTA) was evaluated. The median coronary artery calcium score was 29 (interquartile range 0 to 298). On coronary CTA, 116 patients (27%) had no CAD (defined as <30% stenosis). Of the 309 patients (73%) with any CAD (≥30% stenosis), 35% had obstructive CAD (≥50% stenosis). The number of traditional CV risk factors was not associated with the presence of any CAD (≥30% stenosis; p = 0.18) or obstructive CAD (≥50% stenosis; p = 0.13). Hypertension was the only traditional CV risk factor associated with a higher frequency of any CAD (≥30% stenosis; odds ratio = 2.21, 95% CI 1.43 to 3.41, p <0.001) and obstructive CAD (≥50% stenosis; odds ratio 2.03, 95% CI 1.33 to 3.11, p = 0.001). In conclusion, in patients at high risk with DM without chest pain syndrome, any CAD was ruled out by coronary CTA in 27%, whereas 65% of the patients did not have obstructive CAD. The number of CV risk factors was not associated with the presence of CAD. Hypertension was the only traditional CV risk factor that was associated with a higher frequency of CAD. These observations support potential use of coronary CTA to tailor aspirin therapy in patients at high risk with DM.

  19. Animal models of coronary heart disease.

    PubMed

    Liao, Jiawei; Huang, Wei; Liu, George

    2015-08-20

    Cardiovascular disease, predominantly coronary heart disease and stroke, leads to high morbidity and mortality not only in developed worlds but also in underdeveloped regions. The dominant pathologic foundation for cardiovascular disease is atherosclerosis and as to coronary heart disease, coronary atherosclerosis and resulting lumen stenosis, even total occlusions. In translational research, several animals, such as mice, rabbits and pigs, have been used as disease models of human atherosclerosis and related cardiovascular disorders. However, coronary lesions are either naturally rare or hard to be fast induced in these models, hence, coronary heart disease induction mostly relies on surgical or pharmaceutical interventions with no or limited primary coronary lesions, thus unrepresentative of human coronary heart disease progression and pathology. In this review, we will describe the progress of animal models of coronary heart disease following either spontaneous or diet-accelerated coronary lesions.

  20. Spontaneous Coronary Dissection Masquerading as Benign Fascicular Ventricular Tachycardia.

    PubMed

    Ho, Sara Wei-Fen; Lin, Weiqin; Chan, Koo Hui; Seow, Swee-Chong

    2016-01-01

    Spontaneous coronary artery dissection is an uncommon cause of acute coronary syndrome. Diagnosis of coronary artery dissection is made on coronary angiogram and prompt revascularisation is the key in management. We present a case of coronary artery dissection with an atypical presentation of cardiac arrhythmia mimicking benign fascicular ventricular tachycardia. A high index of suspicion and early coronary angiogram allowed us to diagnose and treat this potentially life-threatening disease.

  1. Rescue coronary stenting in acute myocardial infarction

    NASA Astrophysics Data System (ADS)

    Barbieri, Enrico; Meneghetti, Paolo; Molinari, Gionata; Zardini, Piero

    1996-01-01

    Failed rescue coronary angioplasty is a high risk situation because of high mortality. Coronary stent has given us the chance of improving and maintaining the patency of the artery. We report our preliminary experience of rescue stenting after unsuccessful coronary angioplasty.

  2. Absolute rate of the reaction of atomic hydrogen with ethylene from 198 to 320 K at high pressure

    NASA Technical Reports Server (NTRS)

    Lee, J. H.; Michael, J. V.; Payne, W. A.; Stief, L. J.

    1978-01-01

    The rate constant for the H+C2H4 reaction has been measured as a function of temperature. Experiments were performed with high pressures of Ar heat bath gas at seven temperatures from 198 to 320 K with the flash photolysis-resonance fluorescence (FP-RF) technique. Pressures were chosen so as to isolate the addition rate constant k1. The results are well represented by an Arrhenius expression. The results are compared with other studies and are theoretically discussed.

  3. A high-performance liquid chromatography-electronic circular dichroism online method for assessing the absolute enantiomeric excess and conversion ratio of asymmetric reactions.

    PubMed

    Zhang, Xiang; Wang, Mingchao; Li, Li; Yin, Dali

    2017-03-02

    Asymmetric reactions often need to be evaluated during the synthesis of chiral compounds. However, traditional evaluation methods require the isolation of the individual enantiomer, which is tedious and time-consuming. Thus, it is desirable to develop simple, practical online detection methods. We developed a method based on high-performance liquid chromatography-electronic circular dichroism (HPLC-ECD) that simultaneously analyzes the material conversion ratio and absolute optical purity of each enantiomer. In particular, only a reverse-phase C18 column instead of a chiral column is required in our method because the ECD measurement provides a g-factor that describes the ratio of each enantiomer in the mixtures. We used our method to analyze the asymmetric hydrosilylation of β-enamino esters, and we discussed the advantage, feasibility, and effectiveness of this new methodology.

  4. A high-performance liquid chromatography-electronic circular dichroism online method for assessing the absolute enantiomeric excess and conversion ratio of asymmetric reactions

    PubMed Central

    Zhang, Xiang; Wang, Mingchao; Li, Li; Yin, Dali

    2017-01-01

    Asymmetric reactions often need to be evaluated during the synthesis of chiral compounds. However, traditional evaluation methods require the isolation of the individual enantiomer, which is tedious and time-consuming. Thus, it is desirable to develop simple, practical online detection methods. We developed a method based on high-performance liquid chromatography-electronic circular dichroism (HPLC-ECD) that simultaneously analyzes the material conversion ratio and absolute optical purity of each enantiomer. In particular, only a reverse-phase C18 column instead of a chiral column is required in our method because the ECD measurement provides a g-factor that describes the ratio of each enantiomer in the mixtures. We used our method to analyze the asymmetric hydrosilylation of β-enamino esters, and we discussed the advantage, feasibility, and effectiveness of this new methodology. PMID:28252028

  5. A high-performance liquid chromatography-electronic circular dichroism online method for assessing the absolute enantiomeric excess and conversion ratio of asymmetric reactions

    NASA Astrophysics Data System (ADS)

    Zhang, Xiang; Wang, Mingchao; Li, Li; Yin, Dali

    2017-03-01

    Asymmetric reactions often need to be evaluated during the synthesis of chiral compounds. However, traditional evaluation methods require the isolation of the individual enantiomer, which is tedious and time-consuming. Thus, it is desirable to develop simple, practical online detection methods. We developed a method based on high-performance liquid chromatography-electronic circular dichroism (HPLC-ECD) that simultaneously analyzes the material conversion ratio and absolute optical purity of each enantiomer. In particular, only a reverse-phase C18 column instead of a chiral column is required in our method because the ECD measurement provides a g-factor that describes the ratio of each enantiomer in the mixtures. We used our method to analyze the asymmetric hydrosilylation of β-enamino esters, and we discussed the advantage, feasibility, and effectiveness of this new methodology.

  6. High-resolution tangential absolute extreme ultraviolet arrays for radiated power density measurements on NSTX-U

    SciTech Connect

    Delgado-Aparicio, L.; Bell, R. E.; Diallo, A.; Gerhardt, S. P.; Kozub, T. A.; LeBlanc, B. P.; Stratton, B. C.; Faust, I.; Tritz, K.

    2014-11-15

    The radiated-power-density diagnostic on the equatorial midplane for the NSTX-U tokamak will be upgraded to measure the radial structure of the photon emissivity profile with an improved radial resolution. This diagnostic will enhance the characterization and studies of power balance, impurity transport, and MHD. The layout and response expected of the new system is shown for different plasma conditions and impurity concentrations. The effect of toroidal rotation driving poloidal asymmetries in the core radiation from high-Z impurities is also addressed.

  7. High clopidogrel dose in patients with chronic kidney disease having clopidogrel resistance after percutaneous coronary intervention.

    PubMed

    Liang, Jing; Wang, Zhijian; Shi, Dongmei; Liu, Yuyang; Zhao, Yingxin; Han, Hongya; Li, Yueping; Liu, Wei; Zhang, Linlin; Yang, Lixia; Zhou, Yujie

    2015-04-01

    We evaluated the impact of clopidogrel 150 mg/d in patients with chronic kidney disease (CKD) having clopidogrel resistance (CR) after percutaneous coronary intervention (PCI); 1076 consecutive patients with coronary artery disease (CAD) having CKD were enrolled. Maximal platelet aggregation (MPA) was assessed before, 24 hours, and 30 days after a 300-mg loading dose of clopidogrel prior to PCI. After PCI, 370 patients with CR were randomized to receive clopidogrel 75 mg/d (n = 184) or 150 mg/d (n = 186) for 30 days. Stent thrombosis (ST), major adverse cardiac events (MACEs), and bleeding were analyzed after 1 month. Patients in the 150 mg group had significant lower rates of ST and MACE. There was no significant difference in major or minor bleeding. Patients in the 150 mg group had lower MPA and greater inhibition of platelet aggregation. One-month administration of 150 mg/d of clopidogrel decreases the rate of ST and MACE without increasing bleeding in patients with CKD having CR after PCI.

  8. Optically based quantification of absolute cerebral metabolic rate of oxygen (CMRO2) with high spatial resolution in rodents

    NASA Astrophysics Data System (ADS)

    Yaseen, Mohammad A.; Srinivasan, Vivek J.; Sakadžić, Sava; Vinogradov, Sergei A.; Boas, David A.

    2010-02-01

    Measuring oxygen delivery in brain tissue is important for identifying the pathophysiological changes associated with brain injury and various diseases such as cancer, stroke, and Alzheimer's disease. We have developed a multi-modal imaging system for minimally invasive measurement of cerebral oxygenation and blood flow in small animals with high spatial resolution. The system allows for simultaneous measurement of blood flow using Fourier-domain optical coherence tomography, and oxygen partial pressure (pO2) using either confocal or multiphoton phosphorescence lifetime imaging with exogenous porphyrin-based dyes sensitive to dissolved oxygen. Here we present the changes in pO2 and blood flow in superficial cortical vessels of Sprague Dawley rats in response to conditions such as hypoxia, hyperoxia, and functional stimulation. pO2 measurements display considerable heterogeneity over distances that cannot be resolved with more widely used oxygen-monitoring techniques such as BOLD-fMRI. Large increases in blood flow are observed in response to functional stimulation and hypoxia. Our system allows for quantification of cerebral metabolic rate of oxygen (CMRO2) with high spatial resolution, providing a better understanding of metabolic dynamics during functional stimulation and under various neuropathologies. Ultimately, better insight into the underlying mechanisms of neuropathologies will facilitate the development of improved therapeutic strategies to minimize damage to brain tissue.

  9. Absolute optical metrology : nanometers to kilometers

    NASA Technical Reports Server (NTRS)

    Dubovitsky, Serge; Lay, O. P.; Peters, R. D.; Liebe, C. C.

    2005-01-01

    We provide and overview of the developments in the field of high-accuracy absolute optical metrology with emphasis on space-based applications. Specific work on the Modulation Sideband Technology for Absolute Ranging (MSTAR) sensor is described along with novel applications of the sensor.

  10. Monolithically integrated absolute frequency comb laser system

    SciTech Connect

    Wanke, Michael C.

    2016-07-12

    Rather than down-convert optical frequencies, a QCL laser system directly generates a THz frequency comb in a compact monolithically integrated chip that can be locked to an absolute frequency without the need of a frequency-comb synthesizer. The monolithic, absolute frequency comb can provide a THz frequency reference and tool for high-resolution broad band spectroscopy.

  11. Absolute and relative blindsight.

    PubMed

    Balsdon, Tarryn; Azzopardi, Paul

    2015-03-01

    The concept of relative blindsight, referring to a difference in conscious awareness between conditions otherwise matched for performance, was introduced by Lau and Passingham (2006) as a way of identifying the neural correlates of consciousness (NCC) in fMRI experiments. By analogy, absolute blindsight refers to a difference between performance and awareness regardless of whether it is possible to match performance across conditions. Here, we address the question of whether relative and absolute blindsight in normal observers can be accounted for by response bias. In our replication of Lau and Passingham's experiment, the relative blindsight effect was abolished when performance was assessed by means of a bias-free 2AFC task or when the criterion for awareness was varied. Furthermore, there was no evidence of either relative or absolute blindsight when both performance and awareness were assessed with bias-free measures derived from confidence ratings using signal detection theory. This suggests that both relative and absolute blindsight in normal observers amount to no more than variations in response bias in the assessment of performance and awareness. Consideration of the properties of psychometric functions reveals a number of ways in which relative and absolute blindsight could arise trivially and elucidates a basis for the distinction between Type 1 and Type 2 blindsight.

  12. Impact of red blood cells count on the relationship between high density lipoproteins and the prevalence and extent of coronary artery disease: a single centre study [corrected].

    PubMed

    Schaffer, Alon; Verdoia, Monica; Cassetti, Ettore; Barbieri, Lucia; Perrone-Filardi, Pasquale; Marino, Paolo; De Luca, Giuseppe

    2015-07-01

    We have hypothesized that high red blood cells (RBC) count can potentially play an atheroprotective role in patients with coronary atherosclerosis. We, therefore, have investigated the relationship between high density lipoproteins cholesterol (HDL-C) and RBC levels in patients undergoing coronary angiography. Coronary artery disease (CAD) is a major cause of mortality. Impaired lipid profile represents a major risk factor for atherosclerosis. High density lipoprotein (HDL) is a key factor in atherosclerosis disease development. RBC can mimic HDL's reverse cholesterol transportation with a potential atheroprotective role. Coronary angiography has been evaluated in 3,534 patients. Fasting samples were collected for haematology and lipids levels assessment. Coronary disease was defined for at least 1 vessel stenosis >50 %. Patients were divided according to HDL-C and RBC tertiles. Lower HDL-C was significantly associated to the prevalence of CAD (84.8 vs 78.5 vs 67.3 %, p ≤ 0.001; adjusted OR [95 % CI] = 1.55 [1.3-1.8], p < 0.001) and severe CAD (30 % vs 30 % vs 24.4 %, p = 0.002; adjusted OR [95 % CI] = 1.08 [1.01-1.16], p = 0.02), this relationship was maintained even dividing our population according to RBC tertiles (p < 0.001).In conclusion, HDL-C levels are directly related to RBC count and inversely to the prevalence and extent of coronary disease. Higher RBC levels can reduce the risk of CAD in patients with lower HDL-C levels, suggesting an important atheroprotective role.

  13. The absolute path command

    SciTech Connect

    Moody, A.

    2012-05-11

    The ap command traveres all symlinks in a given file, directory, or executable name to identify the final absolute path. It can print just the final path, each intermediate link along with the symlink chan, and the permissions and ownership of each directory component in the final path. It has functionality similar to "which", except that it shows the final path instead of the first path. It is also similar to "pwd", but it can provide the absolute path to a relative directory from the current working directory.

  14. Coronary Artery Bypass Grafting

    MedlinePlus

    ... from the NHLBI on Twitter. What Is Coronary Artery Bypass Grafting? Coronary artery bypass grafting (CABG) is ... bypass multiple coronary arteries during one surgery. Coronary Artery Bypass Grafting Figure A shows the location of ...

  15. Estimating Absolute Site Effects

    SciTech Connect

    Malagnini, L; Mayeda, K M; Akinci, A; Bragato, P L

    2004-07-15

    The authors use previously determined direct-wave attenuation functions as well as stable, coda-derived source excitation spectra to isolate the absolute S-wave site effect for the horizontal and vertical components of weak ground motion. They used selected stations in the seismic network of the eastern Alps, and find the following: (1) all ''hard rock'' sites exhibited deamplification phenomena due to absorption at frequencies ranging between 0.5 and 12 Hz (the available bandwidth), on both the horizontal and vertical components; (2) ''hard rock'' site transfer functions showed large variability at high-frequency; (3) vertical-motion site transfer functions show strong frequency-dependence, and (4) H/V spectral ratios do not reproduce the characteristics of the true horizontal site transfer functions; (5) traditional, relative site terms obtained by using reference ''rock sites'' can be misleading in inferring the behaviors of true site transfer functions, since most rock sites have non-flat responses due to shallow heterogeneities resulting from varying degrees of weathering. They also use their stable source spectra to estimate total radiated seismic energy and compare against previous results. they find that the earthquakes in this region exhibit non-constant dynamic stress drop scaling which gives further support for a fundamental difference in rupture dynamics between small and large earthquakes. To correct the vertical and horizontal S-wave spectra for attenuation, they used detailed regional attenuation functions derived by Malagnini et al. (2002) who determined frequency-dependent geometrical spreading and Q for the region. These corrections account for the gross path effects (i.e., all distance-dependent effects), although the source and site effects are still present in the distance-corrected spectra. The main goal of this study is to isolate the absolute site effect (as a function of frequency) by removing the source spectrum (moment-rate spectrum) from

  16. New experimental methodology, setup and LabView program for accurate absolute thermoelectric power and electrical resistivity measurements between 25 and 1600 K: Application to pure copper, platinum, tungsten, and nickel at very high temperatures

    NASA Astrophysics Data System (ADS)

    Abadlia, L.; Gasser, F.; Khalouk, K.; Mayoufi, M.; Gasser, J. G.

    2014-09-01

    In this paper we describe an experimental setup designed to measure simultaneously and very accurately the resistivity and the absolute thermoelectric power, also called absolute thermopower or absolute Seebeck coefficient, of solid and liquid conductors/semiconductors over a wide range of temperatures (room temperature to 1600 K in present work). A careful analysis of the existing experimental data allowed us to extend the absolute thermoelectric power scale of platinum to the range 0-1800 K with two new polynomial expressions. The experimental device is controlled by a LabView program. A detailed description of the accurate dynamic measurement methodology is given in this paper. We measure the absolute thermoelectric power and the electrical resistivity and deduce with a good accuracy the thermal conductivity using the relations between the three electronic transport coefficients, going beyond the classical Wiedemann-Franz law. We use this experimental setup and methodology to give new very accurate results for pure copper, platinum, and nickel especially at very high temperatures. But resistivity and absolute thermopower measurement can be more than an objective in itself. Resistivity characterizes the bulk of a material while absolute thermoelectric power characterizes the material at the point where the electrical contact is established with a couple of metallic elements (forming a thermocouple). In a forthcoming paper we will show that the measurement of resistivity and absolute thermoelectric power characterizes advantageously the (change of) phase, probably as well as DSC (if not better), since the change of phases can be easily followed during several hours/days at constant temperature.

  17. New experimental methodology, setup and LabView program for accurate absolute thermoelectric power and electrical resistivity measurements between 25 and 1600 K: application to pure copper, platinum, tungsten, and nickel at very high temperatures.

    PubMed

    Abadlia, L; Gasser, F; Khalouk, K; Mayoufi, M; Gasser, J G

    2014-09-01

    In this paper we describe an experimental setup designed to measure simultaneously and very accurately the resistivity and the absolute thermoelectric power, also called absolute thermopower or absolute Seebeck coefficient, of solid and liquid conductors/semiconductors over a wide range of temperatures (room temperature to 1600 K in present work). A careful analysis of the existing experimental data allowed us to extend the absolute thermoelectric power scale of platinum to the range 0-1800 K with two new polynomial expressions. The experimental device is controlled by a LabView program. A detailed description of the accurate dynamic measurement methodology is given in this paper. We measure the absolute thermoelectric power and the electrical resistivity and deduce with a good accuracy the thermal conductivity using the relations between the three electronic transport coefficients, going beyond the classical Wiedemann-Franz law. We use this experimental setup and methodology to give new very accurate results for pure copper, platinum, and nickel especially at very high temperatures. But resistivity and absolute thermopower measurement can be more than an objective in itself. Resistivity characterizes the bulk of a material while absolute thermoelectric power characterizes the material at the point where the electrical contact is established with a couple of metallic elements (forming a thermocouple). In a forthcoming paper we will show that the measurement of resistivity and absolute thermoelectric power characterizes advantageously the (change of) phase, probably as well as DSC (if not better), since the change of phases can be easily followed during several hours/days at constant temperature.

  18. New experimental methodology, setup and LabView program for accurate absolute thermoelectric power and electrical resistivity measurements between 25 and 1600 K: Application to pure copper, platinum, tungsten, and nickel at very high temperatures

    SciTech Connect

    Abadlia, L.; Mayoufi, M.; Gasser, F.; Khalouk, K.; Gasser, J. G.

    2014-09-15

    In this paper we describe an experimental setup designed to measure simultaneously and very accurately the resistivity and the absolute thermoelectric power, also called absolute thermopower or absolute Seebeck coefficient, of solid and liquid conductors/semiconductors over a wide range of temperatures (room temperature to 1600 K in present work). A careful analysis of the existing experimental data allowed us to extend the absolute thermoelectric power scale of platinum to the range 0-1800 K with two new polynomial expressions. The experimental device is controlled by a LabView program. A detailed description of the accurate dynamic measurement methodology is given in this paper. We measure the absolute thermoelectric power and the electrical resistivity and deduce with a good accuracy the thermal conductivity using the relations between the three electronic transport coefficients, going beyond the classical Wiedemann-Franz law. We use this experimental setup and methodology to give new very accurate results for pure copper, platinum, and nickel especially at very high temperatures. But resistivity and absolute thermopower measurement can be more than an objective in itself. Resistivity characterizes the bulk of a material while absolute thermoelectric power characterizes the material at the point where the electrical contact is established with a couple of metallic elements (forming a thermocouple). In a forthcoming paper we will show that the measurement of resistivity and absolute thermoelectric power characterizes advantageously the (change of) phase, probably as well as DSC (if not better), since the change of phases can be easily followed during several hours/days at constant temperature.

  19. Changes in remnant and high-density lipoproteins associated with hormone therapy and progression of coronary artery disease in postmenopausal women

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The effect of hormone therapy (HT) on the plasma concentration of remnant lipoprotein cholesterol (RLP-C) and high density lipoprotein (HDL) subpopulations and the contribution of HT-related changes in these lipoproteins to the progression of coronary heart disease (CHD) were examined in 256 postmen...

  20. A Health Education Program for Parents and Children Who Exhibit High Risk Factors of Coronary Heart Disease.

    ERIC Educational Resources Information Center

    Hopp, Joyce W.; And Others

    This study demonstrated the feasibility of joint parent-child education to change the behaviors known to be associated with increased risk of coronary heart disease. Earlier studies have shown that parents who are at increased risk of coronary heart disease can be identified by studying certain factors in the children. Utilizing a combined risk…

  1. Staged High-Risk Percutaneous Coronary Intervention with Impella Support after On-Pump Transcatheter Aortic Valve Replacement

    PubMed Central

    Bahekar, Amol A.

    2016-01-01

    The management of concomitant obstructive coronary artery disease and severe aortic stenosis in poor surgical candidates is an evolving topic. Although the typical current practice is to perform percutaneous revascularization before transcatheter aortic valve replacement (TAVR), some data have emerged regarding revascularization after performing TAVR. We present the case of a 90-year-old man with multivessel coronary artery disease who was at prohibitive risk for surgical aortic valve replacement. We first performed TAVR with use of hemodynamic support, then Impella-assisted multivessel percutaneous coronary intervention on the patient's unprotected left main coronary artery. We describe this complex case and review the medical literature on percutaneous coronary intervention after TAVR PMID:27777528

  2. Unexpected patterns of Epstein-Barr virus transcription revealed by a high throughput PCR array for absolute quantification of viral mRNA.

    PubMed

    Tierney, Rosemary J; Shannon-Lowe, Claire D; Fitzsimmons, Leah; Bell, Andrew I; Rowe, Martin

    2015-01-01

    We have validated a flexible, high-throughput and relatively inexpensive RT-QPCR array platform for absolute quantification of Epstein-Barr virus transcripts in different latent and lytic infection states. Several novel observations are reported. First, during infection of normal B cells, Wp-initiated latent gene transcripts remain far more abundant following activation of the Cp promoter than was hitherto suspected. Second, EBNA1 transcript levels are remarkably low in all forms of latency, typically ranging from 1 to 10 transcripts per cell. EBNA3A, -3B and -3C transcripts are likewise very low in Latency III, typically at levels similar to or less than EBNA1 transcripts. Thirdly, a subset of lytic gene transcripts is detectable in Burkitt lymphoma lines at low levels, including: BILF1, which has oncogenic properties, and the poorly characterized LF1, LF2 and LF3 genes. Analysis of seven African BL biopsies confirmed this transcription profile but additionally revealed significant expression of LMP2 transcripts.

  3. The Incremental Diagnostic Performance of Coronary Computed Tomography Angiography Added to Myocardial Perfusion Imaging in Patients with Intermediate-to-High Cardiovascular Risk

    PubMed Central

    Hsu, Pei-Ying; Lee, Wen-Jeng; Cheng, Mei-Fang; Yen, Ruoh-Fang; Tzen, Kai-Yuan; Wu, Yen-Wen

    2016-01-01

    Purpose Several studies have suggested that a combined approach of stress myocardial perfusion imaging (MPI) and coronary computed tomography angiography (CCTA) can provide diagnostic results with excellent accuracy. We aimed to explore whether the addition of CCTA to stress MPI provides incremental diagnostic value in intermediate-to-high cardiovascular risk patients. Methods A total of 106 consecutive patients (93 male, 65 ± 10.4 years) underwent coronary artery calcium scoring (CACS), CCTA and 201Thallium stress MPI before coronary angiography was reviewed. Thirty-seven patients (34.9%) had a history of proven coronary artery disease (CAD) or revascularization procedures, and four had documented non-significant CAD (3.8%). The remaining patients consisted of 17 (16.0%) classified as intermediate, and 48 (45.3%) as the high-risk groups. Results Obstructive CAD was diagnosed by invasive coronary angiography in 88 patients with 161 vessels. The sensitivity and specificity in a patient-based analysis for obstructive CAD were 99% and 17% for CCTA, 80% and 50% for MPI and 91% and 67% for the combined method, respectively. The per-vessel diagnostic sensitivity and specificity were 95% and 54% for CCTA, 59% and 75% for MPI and 84% and 76% for the combined method. There were significant differences (p < 0.05) when comparing the combined method with MPI or CCTA by areas under the curve in a patient- or vessel-based analysis. However, CACS of 400 or more could not further stratify the patients with obstructive CAD. Conclusions CCTA, not CACS, provided additional diagnostic values to stress MPI in patients with intermediate-to-high cardiovascular risk. PMID:27122945

  4. Absolute quantitation of protein posttranslational modification isoform.

    PubMed

    Yang, Zhu; Li, Ning

    2015-01-01

    Mass spectrometry has been widely applied in characterization and quantification of proteins from complex biological samples. Because the numbers of absolute amounts of proteins are needed in construction of mathematical models for molecular systems of various biological phenotypes and phenomena, a number of quantitative proteomic methods have been adopted to measure absolute quantities of proteins using mass spectrometry. The liquid chromatography-tandem mass spectrometry (LC-MS/MS) coupled with internal peptide standards, i.e., the stable isotope-coded peptide dilution series, which was originated from the field of analytical chemistry, becomes a widely applied method in absolute quantitative proteomics research. This approach provides more and more absolute protein quantitation results of high confidence. As quantitative study of posttranslational modification (PTM) that modulates the biological activity of proteins is crucial for biological science and each isoform may contribute a unique biological function, degradation, and/or subcellular location, the absolute quantitation of protein PTM isoforms has become more relevant to its biological significance. In order to obtain the absolute cellular amount of a PTM isoform of a protein accurately, impacts of protein fractionation, protein enrichment, and proteolytic digestion yield should be taken into consideration and those effects before differentially stable isotope-coded PTM peptide standards are spiked into sample peptides have to be corrected. Assisted with stable isotope-labeled peptide standards, the absolute quantitation of isoforms of posttranslationally modified protein (AQUIP) method takes all these factors into account and determines the absolute amount of a protein PTM isoform from the absolute amount of the protein of interest and the PTM occupancy at the site of the protein. The absolute amount of the protein of interest is inferred by quantifying both the absolute amounts of a few PTM

  5. Successful management of grade III coronary perforation after percutaneous angioplasty in a high-risk patient: a case report.

    PubMed

    Coloma Araniya, Ricardo; Beas, Renato; Maticorena-Quevedo, Jesús; Anduaga-Beramendi, Alexander; Pastrana Castillo, Marco Antonio

    2016-03-03

    Coronary perforation is a rare complication in patients undergoing percutaneous coronary angioplasty. The mortality of this complication varies depending on factors related to the patient and the procedure performed, reaching 44% in patients with Ellis type III perforation. We report the case of an 81 year old male with multiple cardiovascular risk factors, who underwent percutaneous angioplasty for unstable angina management. The patient developed grade III coronary perforation in the anterior descending artery, which was successfully managed with balloon inflation to 6 atmospheres for 10 minutes twice in the affected area, with an interval of 5 minutes between each dilatation. The patient improved and was discharged.

  6. Increased carotid intima-media thickness associated with high hs-CRP levels is a predictor of unstable coronary artery disease.

    PubMed

    Abhashi, Sejran Ahmet; Kryeziu, Fadil Uke; Nazreku, Feim Durak

    2013-08-01

    Increased values of carotid intima-media thickness (CIMT) and high-sensitivity C-reactive protein (hs-CRP) are predictors of acute coronary events. We analysed the link between CIMT and hs-CRP in cases with coronary artery disease (CAD). From 1 January to 30 June 2012, we evaluated 43 patients with acute coronary syndrome (group A), 50 patients with stable coronary artery disease (group B) and 50 healthy volunteers (group C). All were analysed for CIMT and hs-CRP levels. CIMT values were higher in groups A and B (0.94 ± 0.21 mm, 0.89 ± 0.19 mm, respectively) and lower in group C (0.64 ± 0.09 mm), and this was statistically significant (p < 0.0001). However the values of hs-CRP were higher in group A (1.87 ± 0.36 mg/l) and lower in groups B and C (1.07 ± 0.28 mg/l, 0.97 ± 0.45 mg/l, respectively) and this was also statistically significant (p < 0.0001).

  7. Impact of high-sensitivity cardiac troponin on use of coronary angiography, cardiac stress testing, and time to discharge in suspected acute myocardial infarction

    PubMed Central

    Twerenbold, Raphael; Jaeger, Cedric; Rubini Gimenez, Maria; Wildi, Karin; Reichlin, Tobias; Nestelberger, Thomas; Boeddinghaus, Jasper; Grimm, Karin; Puelacher, Christian; Moehring, Berit; Pretre, Gil; Schaerli, Nicolas; Campodarve, Isabel; Rentsch, Katharina; Steuer, Stephan; Osswald, Stefan; Mueller, Christian

    2016-01-01

    Aims High-sensitivity cardiac troponin (hs-cTn) assays provide higher diagnostic accuracy for acute myocardial infarction (AMI) when compared with conventional assays, but may result in increased use of unnecessary coronary angiographies due to their increased detection of cardiomyocyte injury in conditions other than AMI. Methods and results We evaluated the impact of the clinical introduction of high-sensitivity cardiac troponin T (hs-cTnT) on the use of coronary angiography, stress testing, and time to discharge in 2544 patients presenting with symptoms suggestive of AMI to the emergency department (ED) within a multicentre study either before (1455 patients) or after (1089 patients) hs-cTnT introduction. Acute myocardial infarction was more often the clinical discharge diagnosis after hs-cTnT introduction (10 vs. 14%, P < 0.001), while unstable angina less often the clinical discharge diagnosis (14 vs. 9%, P = 0.007). The rate of coronary angiography was similar before and after the introduction of hs-cTnT (23 vs. 23%, P = 0.092), as was the percentage of coronary angiographies showing no stenosis (11 vs. 7%, P = 0.361). In contrast, the use of stress testing was substantially reduced from 29 to 19% (P < 0.001). In outpatients, median time to discharge from the ED decreased by 79 min (P < 0.001). Mean total costs decreased by 20% in outpatients after the introduction of hs-cTnT (P = 0.002). Conclusion The clinical introduction of hs-cTn does not lead to an increased or inappropriate use of coronary angiography. Introduction of hs-cTn is associated with an improved rule-out process and thereby reduces the need for stress testing and time to discharge. Clinical Trial Registration Information www.clinicaltrials.gov. Identifier, NCT00470587. PMID:27357358

  8. Goal-directed Therapy Improves the Outcome of High-risk Cardiac Patients Undergoing Off-pump Coronary Artery Bypass

    PubMed Central

    Kapoor, Poonam Malhotra; Magoon, Rohan; Rawat, Rajinder Singh; Mehta, Yatin; Taneja, Sameer; Ravi, R; Hote, Milind P

    2017-01-01

    Background: There has been a constant emphasis on developing management strategies to improve the outcome of high-risk cardiac patients undergoing surgical revascularization. The performance of coronary artery bypass surgery on an off-pump coronary artery bypass (OPCAB) avoids the risks associated with extra-corporeal circulation. The preliminary results of goal-directed therapy (GDT) for hemodynamic management of high-risk cardiac surgical patients are encouraging. The present study was conducted to study the outcome benefits with the combined use of GDT with OPCAB as compared to the conventional hemodynamic management. Material and Method: Patients with the European System for Cardiac Operative Risk Evaluation ≥3 scheduled for OPCAB were randomly divided into two groups; the control and GDT groups. The GDT group included the monitoring and optimization of advanced parameters, including cardiac index (CI), systemic vascular resistance index, oxygen delivery index, stroke volume variation; continuous central venous oxygen saturation (ScVO2), global end-diastolic volume, and extravascular lung water (EVLW), using FloTrac™, PreSep™, and EV-1000® monitoring panels, in addition to the conventional hemodynamic management in the control group. The hemodynamic parameters were continuously monitored for 48 h in Intensive Care Unit (ICU) and corrected according to GDT protocol. A total of 163 patients consented for the study. Result: Seventy-five patients were assigned to the GDT group and 88 patients were in the control group. In view of 9 exclusions from the GDT group and 12 exclusions from control group, 66 patients in the GDT group and 76 patients in control group completed the study. Conclusion: The length of stay in hospital (LOS-H) (7.42 ± 1.48 vs. 5.61 ± 1.11 days, P < 0.001) and ICU stay (4.2 ± 0.82 vs. 2.53 ± 0.56 days, P < 0.001) were significantly lower in the GDT group as compared to control group. The duration of inotropes (3.24 ± 0.73 vs. 2.89

  9. Absolute High-Precision Localisation of an Unmanned Ground Vehicle by Using Real-Time Aerial Video Imagery for Geo-referenced Orthophoto Registration

    NASA Astrophysics Data System (ADS)

    Kuhnert, Lars; Ax, Markus; Langer, Matthias; Nguyen van, Duong; Kuhnert, Klaus-Dieter

    This paper describes an absolute localisation method for an unmanned ground vehicle (UGV) if GPS is unavailable for the vehicle. The basic idea is to combine an unmanned aerial vehicle (UAV) to the ground vehicle and use it as an external sensor platform to achieve an absolute localisation of the robotic team. Beside the discussion of the rather naive method directly using the GPS position of the aerial robot to deduce the ground robot's position the main focus of this paper lies on the indirect usage of the telemetry data of the aerial robot combined with live video images of an onboard camera to realise a registration of local video images with apriori registered orthophotos. This yields to a precise driftless absolute localisation of the unmanned ground vehicle. Experiments with our robotic team (AMOR and PSYCHE) successfully verify this approach.

  10. Electronic Absolute Cartesian Autocollimator

    NASA Technical Reports Server (NTRS)

    Leviton, Douglas B.

    2006-01-01

    An electronic absolute Cartesian autocollimator performs the same basic optical function as does a conventional all-optical or a conventional electronic autocollimator but differs in the nature of its optical target and the manner in which the position of the image of the target is measured. The term absolute in the name of this apparatus reflects the nature of the position measurement, which, unlike in a conventional electronic autocollimator, is based absolutely on the position of the image rather than on an assumed proportionality between the position and the levels of processed analog electronic signals. The term Cartesian in the name of this apparatus reflects the nature of its optical target. Figure 1 depicts the electronic functional blocks of an electronic absolute Cartesian autocollimator along with its basic optical layout, which is the same as that of a conventional autocollimator. Referring first to the optical layout and functions only, this or any autocollimator is used to measure the compound angular deviation of a flat datum mirror with respect to the optical axis of the autocollimator itself. The optical components include an illuminated target, a beam splitter, an objective or collimating lens, and a viewer or detector (described in more detail below) at a viewing plane. The target and the viewing planes are focal planes of the lens. Target light reflected by the datum mirror is imaged on the viewing plane at unit magnification by the collimating lens. If the normal to the datum mirror is parallel to the optical axis of the autocollimator, then the target image is centered on the viewing plane. Any angular deviation of the normal from the optical axis manifests itself as a lateral displacement of the target image from the center. The magnitude of the displacement is proportional to the focal length and to the magnitude (assumed to be small) of the angular deviation. The direction of the displacement is perpendicular to the axis about which the

  11. Absolute airborne gravimetry

    NASA Astrophysics Data System (ADS)

    Baumann, Henri

    This work consists of a feasibility study of a first stage prototype airborne absolute gravimeter system. In contrast to relative systems, which are using spring gravimeters, the measurements acquired by absolute systems are uncorrelated and the instrument is not suffering from problems like instrumental drift, frequency response of the spring and possible variation of the calibration factor. The major problem we had to resolve were to reduce the influence of the non-gravitational accelerations included in the measurements. We studied two different approaches to resolve it: direct mechanical filtering, and post-processing digital compensation. The first part of the work describes in detail the different mechanical passive filters of vibrations, which were studied and tested in the laboratory and later in a small truck in movement. For these tests as well as for the airborne measurements an absolute gravimeter FG5-L from Micro-G Ltd was used together with an Inertial navigation system Litton-200, a vertical accelerometer EpiSensor, and GPS receivers for positioning. These tests showed that only the use of an optical table gives acceptable results. However, it is unable to compensate for the effects of the accelerations of the drag free chamber. The second part describes the strategy of the data processing. It is based on modeling the perturbing accelerations by means of GPS, EpiSensor and INS data. In the third part the airborne experiment is described in detail, from the mounting in the aircraft and data processing to the different problems encountered during the evaluation of the quality and accuracy of the results. In the part of data processing the different steps conducted from the raw apparent gravity data and the trajectories to the estimation of the true gravity are explained. A comparison between the estimated airborne data and those obtained by ground upward continuation at flight altitude allows to state that airborne absolute gravimetry is feasible and

  12. A Conceptual Approach to Absolute Value Equations and Inequalities

    ERIC Educational Resources Information Center

    Ellis, Mark W.; Bryson, Janet L.

    2011-01-01

    The absolute value learning objective in high school mathematics requires students to solve far more complex absolute value equations and inequalities. When absolute value problems become more complex, students often do not have sufficient conceptual understanding to make any sense of what is happening mathematically. The authors suggest that the…

  13. Coronary arteriography and angioplasty

    SciTech Connect

    King, S.B.; Douglas, J.S.

    1985-01-01

    This book explores biomedical radiography of the heart. Topics considered include six bench marks in the history of cardiac catheterization; normal coronary anatomy; anomalies of the coronary arteries; pathoanotomy of the coronary arteries and complications; indications, limitations, and risks of coronary arteriography and left ventriculography; catheterization techniques in coronary arteriography and left ventriculography: the Sones technique; catheterization techniques in coronary arteriography and left ventriculography: the Judkins technique; modification of Judkins catheters; catheterization techniques in coronary arteriography and left ventriculography multipurpose technique; new views in coronary arteriography; quantitative evaluation of left ventricular function; complications of coronary arteriography: management during and following the procedure; interpretation of coronary arteriograms and left ventriculograms; prevalence and distribution of disease in patients catheterized for suspected coronary disease at Emory University Hospital; the Cardiac Catheterization Laboratory; selection for surgery or percutaneous transluminal coronary angioplasty; intracoronary thrombolysis; and percutaneous transluminal coronary angioplasty.

  14. Absolute-structure reports.

    PubMed

    Flack, Howard D

    2013-08-01

    All the 139 noncentrosymmetric crystal structures published in Acta Crystallographica Section C between January 2011 and November 2012 inclusive have been used as the basis of a detailed study of the reporting of absolute structure. These structure determinations cover a wide range of space groups, chemical composition and resonant-scattering contribution. Defining A and D as the average and difference of the intensities of Friedel opposites, their level of fit has been examined using 2AD and selected-D plots. It was found, regardless of the expected resonant-scattering contribution to Friedel opposites, that the Friedel-difference intensities are often dominated by random uncertainty and systematic error. An analysis of data collection strategy is provided. It is found that crystal-structure determinations resulting in a Flack parameter close to 0.5 may not necessarily be from crystals twinned by inversion. Friedifstat is shown to be a robust estimator of the resonant-scattering contribution to Friedel opposites, very little affected by the particular space group of a structure nor by the occupation of special positions. There is considerable confusion in the text of papers presenting achiral noncentrosymmetric crystal structures. Recommendations are provided for the optimal way of treating noncentrosymmetric crystal structures for which the experimenter has no interest in determining the absolute structure.

  15. Enhanced diagnostic value for coronary CT angiography of calcified coronary arteries using dual energy and a novel high-Z contrast material: a phantom study

    NASA Astrophysics Data System (ADS)

    Lambert, Jack W.; Ordovas, Karen G.; Sun, Yuxin; Yeh, Benjamin M.

    2016-03-01

    Dual-energy CT is emerging as a dose-saving tool for coronary CT angiography that allows calcium-scoring without the need for a separate unenhanced scan acquisition. Unfortunately the similar attenuation coefficient profiles of iodine and calcium limits the accuracy of their decomposition in the material basis images. We evaluate a tungsten-based contrast material with a more distinct attenuation profile from calcium, and compare its performance to a conventional iodinated agent. We constructed a custom thorax phantom containing simulated sets of vessels 3, 6 and 9 mm in diameter. The vessel sets were walled with concentric and eccentric calcifications ("plaque") with concentrations of 0, 20, 30 and 40% weight calcium hydroxyapatite (HAP). The phantom was filled sequentially with iodine and tungsten contrast material, and scanned helically using a fast-kV-switching DECT scanner. At material decomposition, both iodine and tungsten vessel lumens were separable from the HAP vessel walls, but separation was superior with tungsten which showed minimal false positive signal in the HAP image. Assessing their relative performance using line profiles, the HAP signal was greater in the tungsten separation in 6/9 of the vessel sets, and within 15% of the iodine separation for the remaining 3/9 sets. The robust phantom design enabled systematic evaluation of dual-energy material separation for calcium and a candidate non-iodinated vascular contrast element. This approach can be used to screen further agents and also refine dual energy CT material decomposition approaches.

  16. Negative Association of Circulating MicroRNA-126 with High-sensitive C-reactive Protein and Vascular Cell Adhesion Molecule-1 in Patients with Coronary Artery Disease Following Percutaneous Coronary Intervention

    PubMed Central

    Wang, Jun-Nan; Yan, You-You; Guo, Zi-Yuan; Jiang, Ya-Juan; Liu, Lu-Lu; Liu, Bin

    2016-01-01

    Background: Percutaneous coronary intervention (PCI) causes endothelial damage, resulting in an inflammatory response with elevation of markers such as high-sensitive C-reactive protein (hs-CRP) and vascular cell adhesion molecule-1 (VCAM-1), which are associated with restenosis after PCI. Evidence suggests that microRNA-126 (miR-126) plays an important role in vascular inflammation, but its correlation with PCI-mediated inflammation has not been investigated. In this study, we investigated the effect of PCI on circulating miR-126 and inflammation markers such as hs-CRP and VCAM-1. Methods: We enrolled 130 patients with coronary artery disease (CAD) in the Second Hospital of Jilin University from October 2015 to December 2015. Among them, 82 patients with CAD, defined as at least one major epicardial vessel with >70% stenosis who planned to undergo PCI, were divided into acute coronary syndrome (ACS) group (46 patients) and stable angina (SA) group (36 patients). Forty-eight patients confirmed by coronary angiography without PCI were used as controls. The plasmas of all patients were collected prior to PCI and at 30 min, 24 h, and 72 h after PCI. The plasma VCAM-1 and hs-CRP were detected by enzyme-linked immunosorbent assay, and the miR-126 was evaluated by quantitative reverse transcription-polymerase chain reaction. Results: Plasma concentrations of hs-CRP and VCAM-1 in patients with either ACS (n = 46) or SA (n = 36) were significantly higher than in controls (n = 48) (P < 0.01) prior to PCI, and increased further at 24 h and 72 h after PCI, compared with prior PCI. Moreover, VCAM-1 was positively correlated with balloon time and pressure. In contrast, the plasma concentration of miR-126 was significantly lower in patients with CAD than in controls, and further decreased with time post-PCI. A negative correlation was observed between miR-126 and hs-CRP and VCAM-1 at 72 h after PCI. Conclusion: There was a negative correlation of miR-126 with the PCI

  17. Real-Time 12-Lead High-Frequency QRS Electrocardiography for Enhanced Detection of Myocardial Ischemia and Coronary Artery Disease

    NASA Technical Reports Server (NTRS)

    Schlegel, Todd T.; Kulecz, Walter B.; DePalma, Jude L.; Feiveson, Alan H.; Wilson, John S.; Rahman, M. Atiar; Bungo, Michael W.

    2004-01-01

    Several studies have shown that diminution of the high-frequency (HF; 150-250 Hz) components present within the central portion of the QRS complex of an electrocardiogram (ECG) is a more sensitive indicator for the presence of myocardial ischemia than are changes in the ST segments of the conventional low-frequency ECG. However, until now, no device has been capable of displaying, in real time on a beat-to-beat basis, changes in these HF QRS ECG components in a continuously monitored patient. Although several software programs have been designed to acquire the HF components over the entire QRS interval, such programs have involved laborious off-line calculations and postprocessing, limiting their clinical utility. We describe a personal computer-based ECG software program developed recently at the National Aeronautics and Space Administration (NASA) that acquires, analyzes, and displays HF QRS components in each of the 12 conventional ECG leads in real time. The system also updates these signals and their related derived parameters in real time on a beat-to-beat basis for any chosen monitoring period and simultaneously displays the diagnostic information from the conventional (low-frequency) 12-lead ECG. The real-time NASA HF QRS ECG software is being evaluated currently in multiple clinical settings in North America. We describe its potential usefulness in the diagnosis of myocardial ischemia and coronary artery disease.

  18. Anomalous Origination of Right Coronary Artery from Left Sinus in Asymptomatic Young Male Presenting with Positive Ischemic Response on Treadmill Test

    PubMed Central

    Setianto, Budi Yuli; Hartopo, Anggoro Budi; Gharini, Putrika Prastuti Ratna; Taufiq, Nahar

    2016-01-01

    Anomalous origination of coronary artery from the opposite sinus (ACAOS) is a rare coronary artery anomaly. Right ACAOS with interarterial course is a type of ACAOS, which conveys a high risk for myocardial ischemia or sudden death. We reported a case of right ACAOS with interarterial course in otherwise healthy young male. He was asymptomatic, until an obligatory medical check-up with treadmill test showed a sign of positive ischemic response. Further work-up revealed that he had right ACAOS with interarterial course. Watchful observation was applied to him, while strenuous physical activity and competitive sport were absolutely prohibited. PMID:26885410

  19. Absolute Equilibrium Entropy

    NASA Technical Reports Server (NTRS)

    Shebalin, John V.

    1997-01-01

    The entropy associated with absolute equilibrium ensemble theories of ideal, homogeneous, fluid and magneto-fluid turbulence is discussed and the three-dimensional fluid case is examined in detail. A sigma-function is defined, whose minimum value with respect to global parameters is the entropy. A comparison is made between the use of global functions sigma and phase functions H (associated with the development of various H-theorems of ideal turbulence). It is shown that the two approaches are complimentary though conceptually different: H-theorems show that an isolated system tends to equilibrium while sigma-functions allow the demonstration that entropy never decreases when two previously isolated systems are combined. This provides a more complete picture of entropy in the statistical mechanics of ideal fluids.

  20. Implications of Public Reporting of Risk-Adjusted Mortality Following Percutaneous Coronary Intervention: Misperceptions and Potential Consequences for High-Risk Patients Including Nonsurgical Patients.

    PubMed

    Gupta, Anuj; Yeh, Robert W; Tamis-Holland, Jacqueline E; Patel, Shalin H; Guyton, Robert A; Klein, Lloyd W; Rab, Tanveer; Kirtane, Ajay J

    2016-10-24

    Assessment of clinical outcomes such as 30-day mortality following coronary revascularization procedures has historically been used to spur quality improvement programs. Public reporting of risk-adjusted outcomes is already mandated in several states, and proposals to further expand public reporting have been put forward as a means of increasing transparency and potentially incentivizing high quality care. However, for public reporting of outcomes to be considered a useful surrogate of procedural quality of care, several prerequisites must be met. First, the reporting measure must be truly representative of the quality of the procedure itself, rather than be dominated by other underlying factors, such as the overall level of illness of a patient. Second, to foster comparisons among physicians and institutions, the metric requires accurate ascertainment of and adjustment for differences in patient risk profiles. This is particularly relevant for high-risk clinical patient scenarios. Finally, the potential deleterious consequences of public reporting of a quality metric should be considered prior to expanding the use of public reporting more broadly. In this viewpoint, the authors review in particular the characterization of high-risk patients currently treated by percutaneous coronary interventional procedures, assessing the adequacy of clinical risk models used in this population. They then expand upon the limitations of 30-day mortality as a quality metric for percutaneous coronary intervention, addressing the strengths and limitations of this metric, as well as offering suggestions to enhance its future use in public reporting.

  1. Spontaneous Coronary Artery Dissection

    MedlinePlus

    Spontaneous coronary artery dissection (SCAD) Overview By Mayo Clinic Staff Spontaneous coronary artery dissection — sometimes referred to as SCAD — is an ... the blood vessels in the heart. Spontaneous coronary artery dissection (SCAD) can slow or block blood flow ...

  2. Coronary artery fistula

    MedlinePlus

    Congenital heart defect - coronary artery fistula; Birth defect heart - coronary artery fistula ... A coronary artery fistula is often congenital, meaning that it is present at birth. It generally occurs when one of the ...

  3. [Acute coronary syndrome -- 2012].

    PubMed

    Becker, Dávid; Merkely, Béla

    2012-12-23

    The acute coronary syndrome is the most severe form of coronary artery disease. It is an immediate threat of life and the mortality rate can be high without proper therapy and patient management. Based on the first ECG, two different forms can be distinguished: acute coronary syndrome with and without ST elevation. Besides adequate medication, management of these patients is an essential part of treatment. In case of ST elevation, coronarography and percutaneous coronary intervention is needed in general, within 24 hours from the onset of symptoms. When ST elevation is not detected on the ECG, individual ischemic risk factors and predictable mortality of the patient may define the necessity and the date of the invasive examination. The Hungarian hemodynamic laboratory network covers almost the whole country and, therefore, practically each patient may receive a state-of-the-art therapy. Although indicators of cardiovascular diseases are still prominent, the mortality rate of myocardial Infarction is decreasing in Hungary due to the well-organized invasive care.

  4. Quantitative severity of stress thallium-201 myocardial perfusion single-photon emission computed tomography defects in one-vessel coronary artery disease.

    PubMed

    Matzer, L; Kiat, H; Van Train, K; Germano, G; Papanicolaou, M; Silagan, G; Eigler, N; Maddahi, J; Berman, D S

    1993-08-01

    The relation between the quantitative myocardial perfusion defect severity of exercise thallium-201 single-photon emission computed tomography (SPECT) and the quantitative degree of coronary stenosis was examined in 18 patients with 1-vessel disease (> or = 50% diameter stenosis), and abnormal thallium-201 SPECT. A total of 26 vessels were analyzed. Thallium-201 SPECT quantitative defect severity score was derived by summing the number of pixels in a coronary territory in which counts fell below the normal mean and multiplied by the number of SDs by which they fell below the normal mean. The thallium-201 defect severity score was significantly (p < 0.001) related to the maximal percent luminal diameter narrowing (r = 0.93), percent area narrowing (r = 0.89), absolute stenotic area (r = 0.79), and absolute stenotic diameter (r = 0.81). As expected, the strongest relation between thallium-201 defect severity and quantitative angiographic indexes was in the low and high ranges of coronary stenosis, with more variability and lower correlation coefficients (percent diameter: r = 0.75, p < 0.02, percent area stenosis: r = 0.63, p < 0.05) in the middle ranges (50 to 80% diameter stenosis). This observation is likely to be due to the complex flow characteristics across stenotic lesions. The findings suggest that in a select population, thallium-201 defect severity is potentially useful for noninvasive characterization of the functional severity of coronary artery stenosis and may complement coronary angiography in predicting functionally significant stenosis.

  5. The Duration of Impella 2.5 Circulatory Support and Length of Hospital Stay of Patients Undergoing High-risk Percutaneous Coronary Interventions

    PubMed Central

    Anusionwu, Obiora; Fischman, Daniel; Cheriyath, Pramil

    2012-01-01

    Background To evaluate the impact of duration of Impella 2.5 support (Abiomed, Danvers, MA) on hospitalization of patients after high-risk percutaneous coronary intervention (PCI). There has been a continuous increase in prevalence of coronary artery disease with more patients needing PCI during acute myocardial infarction. Some of these patients have to undergo high-risk revascularization with circulatory support like the Impella 2.5 device. Methods This study was a single center retrospective study of patients admitted to our hospital who required Impella circulatory support during percutaneous coronary intervention. Patients’ medical records, cardiac catheterization laboratory and 2-D echocardiography reports were reviewed to ascertain left ventricular ejection fraction, duration of Impella support, Coronary Care Unit (CCU) days and the length of stay in the hospital. A P-value of ≤ 0.05 was considered statistically significant. Results Over a 15-month period, we had 25 patients with 19 males and 6 females. Mean age of the patient cohort was 68 ± 10 years. Mean LVEF of the group was 32 ± 16%. Mean length of hospital stay was 8 ± 8 days and mean CCU stay was 4 ± 4 days. The Impella was successfully inserted in all cases with a median duration of support of 70 minutes (range, 4 - 5760 minutes). Bleeding complication occurred in 8%. Spearman's rank correlation coefficient between the duration of Impella support and hospital stay was 0.49 (P = 0.023) while it was 0.71 (P = 0.001) between Impella support duration and CCU days. Conclusions Our study suggests that there is a positive correlation between the duration of Impella 2.5 circulatory support and hospital stay and/or CCU days. The correlation seems to be stronger with CCU days.

  6. Effect of serial infusions of reconstituted high-density lipoprotein (CER-001) on coronary atherosclerosis: rationale and design of the CARAT study

    PubMed Central

    Andrews, Jordan; Janssan, Alex; Nguyen, Tracy; Pisaniello, Anthony D.; Scherer, Daniel J.; Kastelein, John J. P.; Merkely, Bela; Nissen, Steven E.; Ray, Kausik; Schwartz, Gregory G.; Worthley, Stephen G.; Keyserling, Connie; Dasseux, Jean-Louis; Butters, Julie; Girardi, Jacinta; Miller, Rosemary

    2017-01-01

    Background High-density lipoprotein (HDL) is believed to have atheroprotective properties, but an effective HDL-based therapy remains elusive. Early studies have suggested that infusion of reconstituted HDL promotes reverse cholesterol transport and vascular reactivity. The CER-001 Atherosclerosis Regression Acute Coronary Syndrome Trial (CARAT) is investigating the impact of infusing an engineered pre-beta HDL mimetic containing sphingomyelin (SM) and dipalmitoyl phosphatidlyglycerol (CER-001) on coronary atheroma volume in patients with a recent acute coronary syndrome (ACS). Methods The CARAT is a phase 2, multicenter trial in which 292 patients with an ACS undergoing intracoronary ultrasonography and showing percent atheroma volume (PAV) greater than 30% are randomly assigned to treatment with ten infusions of CER-001 3 mg/kg or matching placebo, administered at weekly intervals. Intracoronary ultrasonography is repeated at the end of the treatment period. Results The primary endpoint is the nominal change in PAV. Safety and tolerability will also be evaluated. Conclusions CARAT will establish whether serial 3 mg/kg infusions of an engineered pre-beta HDL mimetic containing SM and dipalmitoyl phosphatidlyglycerol (CER-001) will regress atherosclerotic plaque in patients with a recent ACS. PMID:28164012

  7. Study to Improve Cardiovascular Outcomes in high-risk older patieNts (ICON1) with acute coronary syndrome: study design and protocol of a prospective observational study

    PubMed Central

    Kunadian, Vijay; Neely, R Dermot G; Sinclair, Hannah; Batty, Jonathan A; Veerasamy, Murugapathy; Ford, Gary A; Qiu, Weiliang

    2016-01-01

    Introduction The ICON1 study (a study to Improve Cardiovascular Outcomes in high-risk older patieNts with acute coronary syndrome) is a prospective observational study of older patients (≥75 years old) with non-ST-elevation acute coronary syndrome managed by contemporary treatment (pharmacological and invasive). The aim of the study was to determine the predictors of poor cardiovascular outcomes in this age group and to generate a risk prediction tool. Methods and analysis Participants are recruited from 2 tertiary hospitals in the UK. Baseline evaluation includes frailty, comorbidity, cognition and quality-of-life measures, inflammatory status assessed by a biomarker panel, including microRNAs, senescence assessed by telomere length and telomerase activity, cardiovascular status assessed by arterial stiffness, endothelial function, carotid intima media thickness and left ventricular systolic and diastolic function, and coronary plaque assessed by virtual histology intravascular ultrasound and optical coherence tomography. The patients are followed-up at 30 days and at 1 year for primary outcome measures of death, myocardial infarction, stroke, unplanned revascularisation, bleeding and rehospitalisation. Ethics and dissemination The study has been approved by the regional ethics committee (REC 12/NE/016). Findings of the study will be presented in scientific sessions and will be published in peer-reviewed journals. Trial registration number NCT01933581: Pre-results. PMID:27554105

  8. Effects of cocaine on epicardial coronary artery reactivity in miniature swine after endothelial injury and high cholesterol feeding. In vivo and in vitro analysis.

    PubMed Central

    Egashira, K; Pipers, F S; Morgan, J P

    1991-01-01

    The purpose of this study was to determine the effects of cocaine on vasoreactivity in the swine model. Eight miniature pigs underwent regional endothelial denudation of the left anterior descending coronary artery and were then fed a high cholesterol diet. Cross-sectional area (CSA) of coronary arteries was measured by quantitative angiography. Before denudation, intravenous cocaine (1, 3, and 10 mg/kg) decreased CSA of epicardial vessels by 19-44%. At 3 mo after the denudation, the percent reduction in CSA of the denuded vessels induced by the 10 mg/kg dose was significantly augmented compared to nondenuded vessels (59 +/- 5% vs. 48 +/- 4%, P less than 0.05). Under in vitro conditions where isometric force of isolated ring segments was measured, methoxamine (an alpha 1 agonist) or BHT-920 (an alpha 2 agonist) produced similar degrees of contraction of denuded and control vessels; however, cocaine in concentrations up to 3 x 10(-3) M did not produce contraction. These responses were unaffected by removal of the endothelium. Histologically, myointimal thickening was noted at the denuded site. The present study demonstrates an enhanced vasoreactivity of atherosclerotic coronary arteries to cocaine in vivo, the mechanism of which appears to be mediated by endogenous vasoactive substances rather than by a direct action of cocaine on vascular smooth muscle. Images PMID:1918381

  9. Sudden cardiac death rate in an area characterized by high incidence of coronary artery disease and low hardness of drinking water.

    PubMed

    Bernardi, D; Dini, F L; Azzarelli, A; Giaconi, A; Volterrani, C; Lunardi, M

    1995-02-01

    From January 1992 to January 1993 the incidence of sudden cardiac death among the population of the Media Valle del Serchio area (Tuscany, Italy), composed of a population of 35,000, was found to be twice that of the European average; 32 cases have been reported over this period in that area (9 per 10,000 in the examined year), with a male/female (M/F) ratio of 2.5:1 (23 M, 9 F). In Italy the mean incidence of sudden death was calculated as 6/10,000 and in Europe 5/10,000. In the examined population hypertension was the coronary risk factor present most frequently (87%). A previous diagnosis of coronary artery disease was documented in 21 cases (66%); 5 of these exhibited previous myocardial infarction and 3 previous myocardial infarction associated with left ventricular heart failure. In 7 subjects no previous cardiovascular disorders were discovered. Prodromal symptoms had been reported in 20 cases (62%), which included chest pain in 8 and dyspnea in 8. In the examined geographic area a high prevalence of coronary artery disease was verified through the records of the Public Health Service, which documents the main causes of mortality in Tuscany, and through the hospitalization data and the services provided for ischemic heart disease at the local coronary care unit compared with the national average. Moreover, research was accomplished on physical and chemical properties of drinking water in the same area, and this revealed a very low total hardness due to the paucity of calcium and magnesium salts.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Absolute cross section for loss of supercoiled topology induced by 10 eV electrons in highly uniform /DNA/1,3-diaminopropane films deposited on highly ordered pyrolitic graphite

    NASA Astrophysics Data System (ADS)

    Boulanouar, Omar; Fromm, Michel; Bass, Andrew D.; Cloutier, Pierre; Sanche, Léon

    2013-08-01

    It was recently shown that the affinity of doubly charged, 1-3 diaminopropane (Dap2+) for DNA permits the growth on highly ordered pyrolitic graphite (HOPG) substrates, of plasmid DNA films, of known uniform thickness [O. Boulanouar, A. Khatyr, G. Herlem, F. Palmino, L. Sanche, and M. Fromm, J. Phys. Chem. C 115, 21291-21298 (2011)]. Post-irradiation analysis by electrophoresis of such targets confirms that electron impact at 10 eV produces a maximum in the yield of single strand breaks that can be associated with the formation of a DNA- transient anion. Using a well-adapted deterministic survival model for the variation of electron damage with fluence and film thickness, we have determined an absolute cross section for strand-break damage by 10 eV electrons and inelastic scattering attenuation length in DNA-Dap complex films.

  11. Absolute cross section for loss of supercoiled topology induced by 10 eV electrons in highly uniform /DNA/1,3-diaminopropane films deposited on highly ordered pyrolitic graphite.

    PubMed

    Boulanouar, Omar; Fromm, Michel; Bass, Andrew D; Cloutier, Pierre; Sanche, Léon

    2013-08-07

    It was recently shown that the affinity of doubly charged, 1-3 diaminopropane (Dap(2+)) for DNA permits the growth on highly ordered pyrolitic graphite (HOPG) substrates, of plasmid DNA films, of known uniform thickness [O. Boulanouar, A. Khatyr, G. Herlem, F. Palmino, L. Sanche, and M. Fromm, J. Phys. Chem. C 115, 21291-21298 (2011)]. Post-irradiation analysis by electrophoresis of such targets confirms that electron impact at 10 eV produces a maximum in the yield of single strand breaks that can be associated with the formation of a DNA(-) transient anion. Using a well-adapted deterministic survival model for the variation of electron damage with fluence and film thickness, we have determined an absolute cross section for strand-break damage by 10 eV electrons and inelastic scattering attenuation length in DNA-Dap complex films.

  12. Absolute cross section for loss of supercoiled topology induced by 10 eV electrons in highly uniform /DNA/1,3-diaminopropane films deposited on highly ordered pyrolitic graphite

    SciTech Connect

    Boulanouar, Omar; Fromm, Michel; Bass, Andrew D.; Cloutier, Pierre; Sanche, Léon

    2013-08-07

    It was recently shown that the affinity of doubly charged, 1-3 diaminopropane (Dap{sup 2+}) for DNA permits the growth on highly ordered pyrolitic graphite (HOPG) substrates, of plasmid DNA films, of known uniform thickness [O. Boulanouar, A. Khatyr, G. Herlem, F. Palmino, L. Sanche, and M. Fromm, J. Phys. Chem. C 115, 21291–21298 (2011)]. Post-irradiation analysis by electrophoresis of such targets confirms that electron impact at 10 eV produces a maximum in the yield of single strand breaks that can be associated with the formation of a DNA{sup −} transient anion. Using a well-adapted deterministic survival model for the variation of electron damage with fluence and film thickness, we have determined an absolute cross section for strand-break damage by 10 eV electrons and inelastic scattering attenuation length in DNA-Dap complex films.

  13. Radiation dose measurements in coronary CT angiography

    PubMed Central

    Sabarudin, Akmal; Sun, Zhonghua

    2013-01-01

    Coronary computed tomography (CT) angiography is associated with high radiation dose and this has raised serious concerns in the literature. Awareness of various parameters for dose estimates and measurements of coronary CT angiography plays an important role in increasing our understanding of the radiation exposure to patients, thus, contributing to the implementation of dose-saving strategies. This article provides an overview of the radiation dose quantity and its measurement during coronary CT angiography procedures. PMID:24392190

  14. Impact of insulin like growth factor-1 in development of coronary artery ectasia.

    PubMed

    Akturk, Ibrahim Faruk; Biyik, Ismail; Yalcin, Ahmet Arif; Isiksacan, Nilgun; Celik, Omer; Ozturk, Derya; Erturk, Mehmet

    2014-09-12

    Coronary artery ectasia (CAE) is characterized by inappropriate dilatation of the coronary vasculature. The mechanisms of CAE are not well known. Insulin-like growth factor-1 (IGF-1) may make endothelial cells and smooth muscle cells more sensitive to the effects of growth hormone. In the present study, we hypothesized that IGF-1 may have an impact on the formation of ectasia and aneurysm in arterial system, and aimed to investigate the associations between the presence of CAE and serum IGF-1 levels in patients undergoing coronary angiography. The study included 2.980 subjects undergoing elective diagnostic coronary angiography. We selected 40 patients diagnosed with CAE as CAE group and 44 subjects with absolutely normal coronary arteries were assigned as normal control group. IGF-1 levels were measured in both groups of patients. Groups were similar in terms of age, sex and coronary artery disease risk factors. The serum IGF-1 levels were significantly higher in CAE patients with 109.64 ± 54.64 ng/mL than in controls with 84.76 ± 34.01 ng/mL (p=0.016). HDL levels were lower in ectasia group with 41.5 ± 10.7 mg/dL than controls with 47.7 ± 10.4 mg/dL (p=0.018). By means of logistic regression analysis, high IGF-1 and low HDL levels were found to be independent risk factors for the presence of CAE (p<0.02, p<0.016, respectively). The study revealed that there was a positive correlation between serum IGF-1 levels and presence of CAE, and high IGF-1 levels and low HDL levels were independent risk factors for the presence of CAE. Future studies are needed to confirm these results.

  15. High-grade, nonmyogenic pulmonary artery sarcoma: rare findings on coronary angiography.

    PubMed

    Ramjee, Vimal; Lewis, Melinda M; Clements, Stephen D

    2011-01-01

    Pulmonary artery sarcomas are exceptionally rare, and they are often misdiagnosed as chronic pulmonary thromboemboli. Early and accurate diagnosis is crucial to the prognosis of patients who have pulmonary artery sarcomas.Herein, we describe the case of a 74-year-old man who presented with dyspnea and was initially thought to have a pulmonary embolus. Anticoagulation with unfractionated heparin was ineffective. Rare angiographic findings during routine cardiac catheterization led to the diagnosis of a high-grade, nonmyogenic, primary pulmonary artery sarcoma. This case illustrates the usefulness of angiographic findings as an adjunct to conventional diagnostic methods in correctly identifying this rare, aggressive malignancy.

  16. Dispersive white light combined with a frequency-modulated continuous-wave interferometer for high-resolution absolute measurements of distance.

    PubMed

    Rovati, L; Minoni, U; Docchio, F

    1997-06-15

    A nonincremental interferometer for the absolute measurement of distances is presented. The measuring technique is based on both dispersive white-light (DWL) interferometry and frequency-modulated continuous-wave (FMCW) interferometry. The proposed configuration integrates both techniques in the same interferometer by use of a single laser diode. This solution enables the results from the coarse measurements from the FMCW interferometer to be combined with the fine readouts from the DWL interferometer. Preliminary experimental results confirm the capability of the system to combine the advantages of the two techniques.

  17. Interethnic differences in the accuracy of anthropometric indicators of obesity in screening for high risk of coronary heart disease

    PubMed Central

    Herrera, VM; Casas, JP; Miranda, JJ; Perel, P; Pichardo, R; González, A; Sanchez, JR; Ferreccio, C; Aguilera, X; Silva, E; Oróstegui, M; Gómez, LF; Chirinos, JA; Medina-Lezama, J; Pérez, CM; Suárez, E; Ortiz, AP; Rosero, L; Schapochnik, N; Ortiz, Z; Ferrante, D; Diaz, M; Bautista, LE

    2009-01-01

    Background Cut points for defining obesity have been derived from mortality data among Whites from Europe and the United States and their accuracy to screen for high risk of coronary heart disease (CHD) in other ethnic groups has been questioned. Objective To compare the accuracy and to define ethnic and gender-specific optimal cut points for body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) when they are used in screening for high risk of CHD in the Latin-American and the US populations. Methods We estimated the accuracy and optimal cut points for BMI, WC and WHR to screen for CHD risk in Latin Americans (n=18 976), non-Hispanic Whites (Whites; n=8956), non-Hispanic Blacks (Blacks; n=5205) and Hispanics (n=5803). High risk of CHD was defined as a 10-year risk ≥20% (Framingham equation). The area under the receiver operator characteristic curve (AUC) and the misclassification-cost term were used to assess accuracy and to identify optimal cut points. Results WHR had the highest AUC in all ethnic groups (from 0.75 to 0.82) and BMI had the lowest (from 0.50 to 0.59). Optimal cut point for BMI was similar across ethnic/gender groups (27 kg/m2). In women, cut points for WC (94 cm) and WHR (0.91) were consistent by ethnicity. In men, cut points for WC and WHR varied significantly with ethnicity: from 91 cm in Latin Americans to 102 cm in Whites, and from 0.94 in Latin Americans to 0.99 in Hispanics, respectively. Conclusion WHR is the most accurate anthropometric indicator to screen for high risk of CHD, whereas BMI is almost uninformative. The same BMI cut point should be used in all men and women. Unique cut points for WC and WHR should be used in all women, but ethnic-specific cut points seem warranted among men. PMID:19238159

  18. Collateral circulation from the conus coronary artery to the anterior descending coronary artery: assessment using multislice coronary computed tomography.

    PubMed

    de Agustín, José A; Marcos-Alberca, Pedro; Hernández-Antolín, Rosana; Vilacosta, Isidre; Pérez de Isla, Leopoldo; Rodríguez, Enrique; Macaya, Carlos; Zamorano, José

    2010-03-01

    The prognosis of patients with coronary artery disease largely depends on the presence of a collateral circulation. The location and extent of the collateral circulation is highly variable and these parameters determine whether or not ischemic symptoms occur and whether left ventricular contractility is abnormal. The collateral circulation is generally established through small-caliber distal vessels, although many different forms have been described. We report on three patients with severe left coronary artery disease and collateral circulation through a large conus coronary artery that joined a proximal or medial segment of the left anterior descending coronary artery. In all three cases, left ventricular function was preserved.

  19. [Pediatric case of congenital coronary artery fistula; surgical result and late changes in coronary artery aneurysm].

    PubMed

    Sugawara, Masaaki; Oguma, Fumiaki; Hirahara, Hiroyuki

    2014-07-01

    Congenital coronary artery fistula is an uncommon heart anomaly involving the coronary arteries. We report here a case of a 4-year-old boy who had a coronary fistula from the right coronary artery to the right ventricle, with a coronary aneurysm. He was asymptomatic, but the calculated ratio of pulmonary blood flow to systemic blood flow was shown to be high [pulmonary flow (Qp)/systemic flow(Qs)=1.78]. The coronary angiography showed that the right coronary artery was dilated beginning at the ostium and had an aneurysm at the acute marginal portion. A large spherical aneurysm approximately 20 mm in diameter was found to have been connected with coronary fistula opening into the right ventricle. Surgical repair by closure of the fistula under direct vision, partial resection and suture closure of the aneurysm was performed. Plication of the proximal portion of the right coronary artery was not performed, and the diffusely dilated artery was left untouched. After this operation, he recovered well under anticoagulant treatment with warfarin and aspirin. Postoperative angiography was performed 17 months after the surgery to evaluate morphological changes in the coronary artery. The angiography confirmed the closure of the fistula and the regression of coronary artery dilatation.

  20. Coronary magnetic resonance imaging.

    PubMed

    Manning, Warren J; Nezafat, Reza; Appelbaum, Evan; Danias, Peter G; Hauser, Thomas H; Yeon, Susan B

    2007-02-01

    This article highlights the technical challenges and general imaging strategies for coronary MRI. This is followed by a review of the clinical results for the assessment of anomalous CAD, coronary artery aneurysms, native vessel integrity, and coronary artery bypass graft disease using the more commonly applied MRI methods. It concludes with a brief discussion of the advantages/disadvantages and clinical results comparing coronary MRI with multidetector CT (MDCT) coronary angiography.

  1. Absolute atomic oxygen and nitrogen densities in radio-frequency driven atmospheric pressure cold plasmas: Synchrotron vacuum ultra-violet high-resolution Fourier-transform absorption measurements

    SciTech Connect

    Niemi, K.; O'Connell, D.; Gans, T.; Oliveira, N. de; Joyeux, D.; Nahon, L.; Booth, J. P.

    2013-07-15

    Reactive atomic species play a key role in emerging cold atmospheric pressure plasma applications, in particular, in plasma medicine. Absolute densities of atomic oxygen and atomic nitrogen were measured in a radio-frequency driven non-equilibrium plasma operated at atmospheric pressure using vacuum ultra-violet (VUV) absorption spectroscopy. The experiment was conducted on the DESIRS synchrotron beamline using a unique VUV Fourier-transform spectrometer. Measurements were carried out in plasmas operated in helium with air-like N{sub 2}/O{sub 2} (4:1) admixtures. A maximum in the O-atom concentration of (9.1 {+-} 0.7) Multiplication-Sign 10{sup 20} m{sup -3} was found at admixtures of 0.35 vol. %, while the N-atom concentration exhibits a maximum of (5.7 {+-} 0.4) Multiplication-Sign 10{sup 19} m{sup -3} at 0.1 vol. %.

  2. A Concise and Highly Enantioselective Total Synthesis of (+)-anti- and (-)-syn-Mefloquine Hydrochloride: Definitive Absolute Stereochemical Assignment of the Mefloquines.

    PubMed

    Rastelli, Ettore J; Coltart, Don M

    2015-11-16

    A concise asymmetric (>99:1 e.r.) total synthesis of (+)-anti- and (-)-syn-mefloquine hydrochloride from a common intermediate is described. The key asymmetric transformation is a Sharpless dihydroxylation of an olefin that is accessed in three steps from commercially available materials. The Sharpless-derived diol is converted into either a trans or cis epoxide, and these are subsequently converted into (+)-anti- and (-)-syn-mefloquine, respectively. The synthetic (+)-anti- and (-)-syn-mefloquine samples were derivatized with (S)-(+)-mandelic acid tert-butyldimethylsilyl ether, and a crystal structure of each derivative was obtained. These are the first X-ray structures for mefloquine derivatives that were obtained by coupling to a known chiral, nonracemic compound, and provide definitive confirmation of the absolute stereochemistry of (+)-anti- as well as (-)-syn-mefloquine.

  3. Failure of dipyridamole-thallium myocardial imaging to detect severe coronary disease

    SciTech Connect

    Chin, W.; Go, R.; Lenehan, S.; Underwood, D.A.

    1989-09-01

    Three patients referred for peripheral vascular surgery who died of coronary artery disease complications despite normal dipyridamole-thallium scans are discussed. Although recent literature has shown enthusiasm for this test in this clinical setting, the dipyridamole-thallium scans are not absolute and patients remain at risk for major coronary artery events. Careful clinical screening and awareness of the signs of left main coronary disease on thallium images are important in the evaluation of these patients.

  4. High Calcium-Magnesium Ratio in Hair Is Associated with Coronary Artery Calcification in Middle-Aged and Elderly Individuals.

    PubMed

    Park, Byoungjin; Kim, Mi-Hyun; Cha, Choong Keun; Lee, Yong-Jae; Kim, Kyong-Chol

    2017-02-06

    The interaction between calcium and magnesium as a risk modifier for cardiovascular disease (CVD) has been largely overlooked in previous studies, for the strict regulatory system in blood has been thought to keep such homeostatic interactions under tight control. This study aimed to investigate the association between calcium-magnesium ratio in hair and subclinical coronary artery calcification. Using multiple linear regression analysis, we examined the associations between calcium-magnesium ratio in hair and the coronary calcium score (CCS) in 216 Koreans aged 40 years and above (122 men and 94 women). We found that the calcium-to-magnesium ratio in hair was independently and positively associated with CCS after adjusting for age and sex (regression coefficient 6.051 ± 2.329, P = 0.010). When we assessed the association between the calcium-magnesium ratio and CCS after adjusting for potential cardiovascular risk factors and vascular function modifying drugs, we found that the strength of association with CCS was comparable to before (regression coefficient 5.434 ± 2.523, P = 0.032). Our findings suggest that among middle-aged and elderly Koreans without clinical CVD, the association between coronary artery calcification and hair calcium-magnesium ratio is stronger in those with a higher calcium-magnesium ratio in hair than in those with a lower ratio.

  5. An evaluation of coronary atherosclerosis using coronary CT in subjects with asymptomatic carotid lesions

    PubMed Central

    Bonomo, Vito; Piraino, Davide; Bracale, Umberto Marcello; Evola, Salvatore; Di Piazza, Mariaconcetta; Vicari, Claudia; Lupo, Ambra; Inga, Giuseppe; Andolina, Giuseppe; Assennato, Pasquale; Novo, Salvatore

    2014-01-01

    The evaluation of coronary lesions in patients with asymptomatic carotid plaque represents a very promising line of research to assess cardiovascular risk and the possible implementation of a more aggressive prevention therapy. Methods: In this study we enrolled 102 patients with intermediate to high cardiovascular risk but no history of coronary artery disease. The first group, consisting of 51 patients, underwent a Coronary CT scan (CCT-group) as well as carotid ultrasonography. The second group, also consisting of 51 patients, underwent coronary angiography (CA) and carotid ultrasonography. Results: The absence of a statistically significant difference between the involvement of both coronary and carotid sites, assessed by CCT and CA, confirms the role of coronary CT as a useful method in the preclinical evaluation of cardiovascular risk. In the CCT group, the correlation between atherosclerosis of carotid artery and coronary disease, as well as between the mean carotid intimal medial thickness and the number of involved coronary vessels, and between the maximum values of carotid plaque and the presence of coronary artery stenosis > 50%, were statistically significant. The Agatson calcium score was also statistically associated with carotid plaque size. Conclusion: The imaging biomarkers have a key role in the evaluation of subclinical atherosclerotic disease. Moreover, carotid ultrasound examination and a CT-scan of coronary arteries, in a particular sub-group of patients with intermediate to high cardiovascular risk, can play a crucial role to assess the preventive therapeutic strategies. PMID:25147763

  6. High resolution absolute absorption cross sections of the B ̃(1)A'-X ̃(1)A' transition of the CH2OO biradical.

    PubMed

    Foreman, Elizabeth S; Kapnas, Kara M; Jou, YiTien; Kalinowski, Jarosław; Feng, David; Gerber, R Benny; Murray, Craig

    2015-12-28

    Carbonyl oxides, or Criegee intermediates, are formed from the gas phase ozonolysis of alkenes and play a pivotal role in night-time and urban area atmospheric chemistry. Significant discrepancies exist among measurements of the strong B ̃(1)A'-X ̃(1)A' electronic transition of the simplest Criegee intermediate, CH2OO in the visible/near-UV. We report room temperature spectra of the B ̃(1)A'-X ̃(1)A' electronic absorption band of CH2OO acquired at higher resolution using both single-pass broadband absorption and cavity ring-down spectroscopy. The new absorption spectra confirm the vibrational structure on the red edge of the band that is absent from ionization depletion measurements. The absolute absorption cross sections over the 362-470 nm range are in good agreement with those reported by Ting et al. Broadband absorption spectra recorded over the temperature range of 276-357 K were identical within their mutual uncertainties, confirming that the vibrational structure is not due to hot bands.

  7. Transradial approach for coronary angiography and interventions in patients with coronary bypass grafts: tips and tricks.

    PubMed

    Burzotta, Francesco; Trani, Carlo; Hamon, Martial; Amoroso, Giovanni; Kiemeneij, Ferdinand

    2008-08-01

    Among patients undergoing coronary procedures, patients with coronary artery bypass grafts represent an important, high risk subgroup. Routine transradial approach may be successfully adopted in these patients to reduce access-site complications. However, transradial cannulation of the grafts may result technically demanding. In this article we discuss the specific technical issues and we present a series of tips and tricks which may facilitate angiography and interventions on both internal mammary and aorto-coronary grafts.

  8. Dietary patterns and the risk of major adverse cardiovascular events in a global study of high-risk patients with stable coronary heart disease

    PubMed Central

    Stewart, Ralph A. H.; Wallentin, Lars; Benatar, Jocelyne; Danchin, Nicolas; Hagström, Emil; Held, Claes; Husted, Steen; Lonn, Eva; Stebbins, Amanda; Chiswell, Karen; Vedin, Ola; Watson, David; White, Harvey D.

    2016-01-01

    Objectives To determine whether dietary pattern assessed by a simple self-administered food frequency questionnaire is associated with major adverse cardiovascular events (MACE) in high-risk patients with stable coronary artery disease. Background A Mediterranean dietary pattern has been associated with lower cardiovascular (CV) mortality. It is less certain whether foods common in western diets are associated with CV risk. Methods At baseline, 15 482 (97.8%) patients (mean age 67 ± 9 years) with stable coronary heart disease from 39 countries who participated in the Stabilisation of atherosclerotic plaque by initiation of darapladib therapy (STABILITY) trial completed a life style questionnaire which included questions on common foods. A Mediterranean diet score (MDS) was calculated for increasing consumption of whole grains, fruits, vegetables, legumes, fish, and alcohol, and for less meat, and a ‘Western diet score’ (WDS) for increasing consumption of refined grains, sweets and deserts, sugared drinks, and deep fried foods. A multi-variable Cox proportional hazards models assessed associations between MDS or WDS and MACE, defined as CV death, non-fatal myocardial infarction, or non-fatal stroke. Results After a median follow-up of 3.7 years MACE occurred in 7.3% of 2885 subjects with an MDS ≥15, 10.5% of 4018 subjects with an MDS of 13–14, and 10.8% of 8579 subjects with an MDS ≤12. A one unit increase in MDS >12 was associated with lower MACE after adjusting for all covariates (+1 category HR 0.95, 95% CI 0.91, 0.98, P = 0.002). There was no association between WDS (adjusted model +1 category HR 0.99, 95% CI 0.97, 1.01) and MACE. Conclusion Greater consumption of healthy foods may be more important for secondary prevention of coronary artery disease than avoidance of less healthy foods typical of Western diets. PMID:27109584

  9. Long-Term Prospective Study of the Influence of Estrone Levels on Events in Postmenopausal Women with or at High Risk for Coronary Artery Disease

    PubMed Central

    Mansur, Antonio de Padua; Silva, Tereza Cristina B. F.; Takada, Julio Yoshio; Avakian, Solange Desirée; Strunz, Célia Maria C.; César, Luiz Antonio Machado; Aldrighi, José Mendes; Ramires, José Antonio F.

    2012-01-01

    Background. The link between endogenous estrogen, coronary artery disease (CAD), and death in postmenopausal women is uncertain. We analyzed the association between death and blood levels of estrone in postmenopausal women with known coronary artery disease (CAD) or with a high-risk factor score for CAD. Methods. 251 postmenopausal women age 50–90 years not on estrogen therapy. Fasting blood for estrone and heart disease risk factors were collected at baseline. Women were grouped according to their estrone levels (<15 and ≥15 pg/mL). Fatal events were recorded after 5.8 ± 1.4 years of followup. Results. The Kaplan-Meier survival curve showed a significant trend (P = 0.039) of greater all-cause mortality in women with low estrone levels (<15 pg/mL). Cox multivariate regression analysis model adjusted for body mass index, diabetes, dyslipidemia, family history, and estrone showed estrone (OR = 0.45; P = 0.038) as the only independent variable for all-cause mortality. Multivariate regression model adjusted for age, body mass index, hypertension, diabetes, dyslipidemia, family history, and estrone showed that only age (OR = 1.06; P = 0.017) was an independent predictor of all-cause mortality. Conclusions. Postmenopausal women with known CAD or with a high-risk factor score for CAD and low estrone levels (<15 pg/mL) had increased all-cause mortality. PMID:22701354

  10. Prevalence of coronary atherosclerosis in patients with aortic valve replacement

    PubMed Central

    Ottervanger, J.P.; Thomas, K.; Sie, T.H.; Haalebos, M.M.P.; Zijlstra, F.

    2002-01-01

    Background Because of a high prevalence of coronary artery disease in patients with aortic valve disease, coronary angiography is recommended before aortic valve replacement. However, during the last three decades, a decline in mortality due to coronary heart disease has been observed in the general population in both Western Europe and the United States. It is unknown whether preoperative angiography is still mandatory in all patients. Aim To assess the prevalence of angiographically defined coronary artery disease in patients with aortic valve replacement and trends during a ten-year period. Methods We performed a retrospective cross-sectional study of patients undergoing aortic valve replacement between 1988 and 1998 in our institution. Patients with a history of coronary artery disease and patients younger than 25 years were excluded. Coronary atherosclerosis was defined as one or more coronary artery luminal stenosis of 50% or more on preoperative coronary angiography. Results During the study period 1339 patients had aortic valve replacement in our institution, data on 1322 (98%) were available for analysis. Previous coronary artery disease was documented in 124 patients (10%). After exclusion of 17 patients (no angiography), data on a total of 1181 patients were analysed. Coronary atherosclerosis was present in 472 patients (40%) on preoperative coronary angiography. Several well-known risk factors of ischaemic heart disease were associated with coronary atherosclerosis. The prevalence of angiographically defined coronary atherosclerosis varied between 30% and 50% per year. There was, however, no significant trend during the study period. Multivariate analyses, to adjust for potential differences in risk factors during the observation period, did not change this conclusion. Conclusions The prevalence of angiographically defined coronary artery disease in patients scheduled for aortic valve replacement is still high. From 1988 to 1998, no significant change

  11. Coexistence of Low Vitamin D and High Fibroblast Growth Factor-23 Plasma Levels Predicts an Adverse Outcome in Patients with Coronary Artery Disease

    PubMed Central

    Tuñón, José; Cristóbal, Carmen; Tarín, Nieves; Aceña, Álvaro; González-Casaus, María Luisa; Huelmos, Ana; Alonso, Joaquín; Lorenzo, Óscar; González-Parra, Emilio; Mahíllo-Fernández, Ignacio; Pello, Ana María; Carda, Rocío; Farré, Jerónimo; Rodríguez-Artalejo, Fernando

    2014-01-01

    Objective Vitamin D and fibroblast growth factor-23 (FGF-23) are related with cardiovascular disorders. We have investigated the relationship of calcidiol (vitamin D metabolite) and FGF-23 plasma levels with the incidence of adverse outcomes in patients with coronary artery disease. Methods Prospective follow-up study of 704 outpatients, attending the departments of Cardiology of four hospitals in Spain, 6–12 months after an acute coronary event. Baseline calcidiol, FGF-23, parathormone, and phosphate plasma levels were assessed. The outcome was the development of acute ischemic events (any acute coronary syndrome, stroke, or transient ischemic attack), heart failure, or death. Cox regression adjusted for the main confounders was performed. Results Calcidiol levels showed a moderate-severe decrease in 57.3% of cases. Parathormone, FGF-23, and phosphate levels were increased in 30.0%, 11.5% and 0.9% of patients, respectively. Only 22.4% of patients had glomerular filtration rate<60 ml/min1.73 m2. After a mean follow-up was 2.15±0.99 years, 77 patients developed the outcome. Calcidiol (hazard ratio [HR] = 0.67; 95% confidence interval [CI] = 0.48–0.94; p = 0.021) and FGF-23 (HR = 1.13; 95% CI = 1.04–1.23; p = 0.005) plasma levels predicted independently the outcome. There was a significant interaction between calcidiol and FGF-23 levels (p = 0.025). When the population was divided according to FGF-23 levels, calcidiol still predicted the outcome independently in patients with FGF-23 levels higher than the median (HR = 0.50; 95% CI = 0.31–0.80; p = 0.003) but not in those with FGF-23 levels below this value (HR = 1.03; 95% CI = 0.62–1.71; p = 0.904). Conclusions Abnormalities in mineral metabolism are frequent in patients with stable coronary artery disease. In this population, low calcidiol plasma levels predict an adverse prognosis in the presence of high FGF-23 levels. PMID:24748388

  12. Mass variation in outcome to high production activity in Kamojang Geothermal Field, Indonesia: A reservoir monitoring with relative and absolute gravimetry

    NASA Astrophysics Data System (ADS)

    Sofyan, Y.; Kamah, Y.; Nishijima, J.; Fujimitsu, Y.; Ehara, S.; Fukuda, Y.; Taniguchi, M.

    2011-11-01

    The Kamojang Geothermal Field (KGF) is a typical vapor dominated hydrothermal system in west Java, Indonesia. This geothermal field is the oldest exploited geothermal field in Indonesia. From 1983 to 2005, more than 160 million tons of steam has been exploited from the KGF and more than 30 million tons of condensed water and river water were injected to the reservoir system. Regarding to the electricity demand, installed capacity of KGF increased from 30 MWe to 140 MWe in 1987 and 200 MWe in 2007. Mass variation in the geothermal reservoir can be measured by using the map of the gravity changes. Gravity changes observed in the KGF between 1999 and 2005 at 51 benchmarks are interpreted in terms of a change of mass. Concerning to the production mass increase, gravity changes also observed between 1999 and 2008 at 30 benchmarks. The recent gravity measurement was conducted using absolute gravimeter in 2009 and 2010 at 12 gravity benchmarks. Mass variation in the reservoir was caused by production and injection activities. Mass variation in KGF from 1999 to 2005 is about -3.34 Mt/year while is about -3.78 Mt/year from 1999 to 2008. Another period between 2009 and 2010, mass variation decreased about -8.24 Mt. According to the history of production and injection, natural recharge to the KGF's reservoir is estimated at about 2.77 Mt/year from 1999 to 2005 and 2.75 Mt/year from 1999 to 2008. Between 2009 and 2010, KGF has a bigger mass deficiency rate throughout 200 MWe maintain production.

  13. Coronary artery disease

    MedlinePlus Videos and Cool Tools

    ... heart muscle itself. Damage to or blockage of a coronary artery can result in injury to the heart. Normally, blood flows through a coronary artery unimpeded. However, a process called atherosclerosis ...

  14. Coronary heart disease

    MedlinePlus

    Heart disease, Coronary heart disease, Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD ... buildup of plaque in the arteries to your heart. This may also be called hardening of the ...

  15. Counseling the Coronary Patient

    ERIC Educational Resources Information Center

    Semmler, Caryl; Semmler, Maynard

    1974-01-01

    The article discusses counseling sessions designed to a) help the coronary patient adjust to cardiovascular disease, b) diminish patient anxieties and fears, and c) educate the patient and family members on controlling risk factors to deter another coronary attack. (JS)

  16. Intracoronary versus intravenous high-dose bolus plus maintenance administration of tirofiban in patients undergoing primary percutaneous coronary intervention for acute ST elevation myocardial infarction.

    PubMed

    Candemir, Basar; Kilickap, Mustafa; Ozcan, Ozgur Ulas; Kaya, Cansin Tulunay; Gerede, Menekse; Ozdemir, Aydan Ongun; Ozdol, Cagdas; Kumbasar, Deniz; Erol, Cetin

    2012-07-01

    We aimed to examine whether intracoronary high-dose bolus of tirofiban plus maintenance would result in improved clinical outcome in STEMI patients undergoing primary PCI in this pilot trial. A total of 56 patients were enrolled to receive either intracoronary high-dose bolus plus maintenance (n = 34) or intravenous high-dose bolus plus maintenance (n = 22) of tirofiban. Pre and post intervention TIMI flow grades, myocardial blush grades, peak CKMB and troponin levels, time to peak CKMB and troponin, time to 50% ST resolution and major composite adverse cardiac event rates at 30 days were recorded. Although incidence of major adverse cardiac events was not different, post intervention TIMI flow and TIMI blush grades, peak CKMB and troponin levels, and time to peak CKMB and time to peak troponin were significantly different, favoring intracoronary strategy. In conclusion, this regimen improved myocardial reperfusion and coronary flow, and reduced myocardial necrosis, but failed to improve clinical outcomes at 30 days.

  17. Single Coronary Artery with Aortic Regurgitation

    SciTech Connect

    Katsetos, Manny C. Toce, Dale T.

    2003-11-15

    An isolated single coronary artery can be associated with normal life expectancy; however, patients are at an increased risk of sudden death. A case is reported of a 54-year-old man with several months of chest pressure with activity. On exercise Sestamibi stress testing, the patient developed a hypotensive response with no symptoms and minimal electrocardiographic changes. Nuclear scanning demonstrated reversible septal and lateral perfusion defects consistent with severe ischemia. Coronary angiography revealed a single coronary artery with the right coronary artery arising from the left main. There were high-grade stenotic lesions in the left anterior descending and circumflex arteries with only moderate atherosclerotic disease in the right coronary artery. An aortogram showed 2-3+ aortic regurgitation, with an ejection fraction of 45% on ventriculography. The patient underwent four-vessel revascularization and aortic valve replacement and did well postoperatively.

  18. Coronary CT angiography: Beyond morphological stenosis analysis.

    PubMed

    Sun, Zhonghua

    2013-12-26

    Rapid technological developments in computed tomography (CT) imaging technique have made coronary CT angiography an attractive imaging tool in the detection of coronary artery disease. Despite visualization of excellent anatomical details of the coronary lumen changes, coronary CT angiography does not provide hemodynamic changes caused by presence of plaques. Computational fluid dynamics (CFD) is a widely used method in the mechanical engineering field to solve complex problems through analysing fluid flow, heat transfer and associated phenomena by using computer simulations. In recent years, CFD is increasingly used in biomedical research due to high performance hardware and software. CFD techniques have been used to study cardiovascular hemodynamics through simulation tools to assist in predicting the behaviour of circulatory blood flow inside the human body. Blood flow plays a key role in the localization and progression of coronary artery disease. CFD simulation based on 3D luminal reconstructions can be used to analyse the local flow fields and flow profiling due to changes of vascular geometry, thus, identifying risk factors for development of coronary artery disease. The purpose of this article is to provide an overview of the coronary CT-derived CFD applications in coronary artery disease.

  19. Transient cortical blindness after coronary artery angiography.

    PubMed

    Terlecki, Michał; Wojciechowska, Wiktoria; Rajzer, Marek; Jurczyszyn, Artur; Bazan-Socha, Stanisława; Bryniarski, Leszek; Czarnecka, Danuta

    2013-01-01

    Coronary angiography is the current gold standard for the diagnosis of ischemic heart disease and therefore the prevalence of percutaneous coronary procedures such as angiography and angioplasty is high. The occurrence of cerebral complications after coronary angiography and coronary angioplasty is low and it mainly includes transient ischemic attack and stroke. The prevalence of transient cortical blindness after X-ray contrast media is low and it is usually seen after cerebral angiography. Until now only a few cases of transient cortical blindness have been described after coronary artery angiography. Regarding the spread of coronary angiography worldwide and in Poland this complication is uniquely rare. A 32-year-old man with multiple extrasystolic ventricular arrhythmia suggesting Brugada syndrome diagnosis according to morphology of the left bundle branch block and with decreased left ventricular ejection fraction was admitted to the First Department of Cardiology and Hypertension, Medical College of the Jagiellonian University in Krakow. Coronary angiography was performed in order to exclude ischemic etiology of the observed abnormalities. No arteriosclerotic lesions were found in coronary arteries. Transient cortical blindness was observed directly after angiography which may have been caused by the neurotoxic effect of the used X-ray contrast medium. In ophthalmologic and neurologic examination as well as in the cerebral computed tomography scan no pathologies were found. Visual impairment disappeared totally within several hours.

  20. Database applicaton for absolute spectrophotometry

    NASA Astrophysics Data System (ADS)

    Bochkov, Valery V.; Shumko, Sergiy

    2002-12-01

    32-bit database application with multidocument interface for Windows has been developed to calculate absolute energy distributions of observed spectra. The original database contains wavelength calibrated observed spectra which had been already passed through apparatus reductions such as flatfielding, background and apparatus noise subtracting. Absolute energy distributions of observed spectra are defined in unique scale by means of registering them simultaneously with artificial intensity standard. Observations of sequence of spectrophotometric standards are used to define absolute energy of the artificial standard. Observations of spectrophotometric standards are used to define optical extinction in selected moments. FFT algorithm implemented in the application allows performing convolution (deconvolution) spectra with user-defined PSF. The object-oriented interface has been created using facilities of C++ libraries. Client/server model with Windows Socket functionality based on TCP/IP protocol is used to develop the application. It supports Dynamic Data Exchange conversation in server mode and uses Microsoft Exchange communication facilities.

  1. Absolute classification with unsupervised clustering

    NASA Technical Reports Server (NTRS)

    Jeon, Byeungwoo; Landgrebe, D. A.

    1992-01-01

    An absolute classification algorithm is proposed in which the class definition through training samples or otherwise is required only for a particular class of interest. The absolute classification is considered as a problem of unsupervised clustering when one cluster is known initially. The definitions and statistics of the other classes are automatically developed through the weighted unsupervised clustering procedure, which is developed to keep the cluster corresponding to the class of interest from losing its identity as the class of interest. Once all the classes are developed, a conventional relative classifier such as the maximum-likelihood classifier is used in the classification.

  2. Typical coronary appearance of dilated cardiomyopathy versus left ventricular concentric hypertrophy: coronary volumes measured by multislice computed tomography.

    PubMed

    Ehara, Shoichi; Matsumoto, Kenji; Shirai, Nobuyuki; Nakanishi, Koki; Otsuka, Kenichiro; Iguchi, Tomokazu; Hasegawa, Takao; Nakata, Shinji; Yoshikawa, Junichi; Yoshiyama, Minoru

    2013-03-01

    Several coronary angiographic studies have reported that enlarged and tortuous epicardial coronary arteries are characteristic of patients with left ventricular concentric hypertrophy (LVCH). Recently, we showed that small volumes opacified by contrast medium can be accurately measured by 64-multislice computed tomography (MSCT) and that there is a direct relationship between the coronary artery volume and left ventricular (LV) mass. However, the relationship of coronary artery volume with LV mass in patients with dilated cardiomyopathy (DCM) is unknown. The present study was designed to investigate this issue. Thirteen patients with DCM and 18 patients with LVCH who underwent MSCT angiography were included in this analysis. The coronary arteries were segmented on a workstation, and the appropriate window settings obtained from the results of the phantom experiments were applied to the volume-rendered images to calculate the total coronary artery volume (right and left coronary arteries). The absolute coronary lengths and volumes in patients with LVCH and DCM were greater than those in controls. The coronary artery volumes adjusted for LV mass in patients with DCM were found to be smaller than those in patients with LVCH or in controls, and these values did not differ between patients with LVCH and controls (DCM 4.1 ± 0.9, LVCH 5.4 ± 1.4, controls 5.5 ± 2.3 ml/100 g of LV mass, P < 0.005; DCM vs LVCH, P < 0.01; and DCM vs control, P < 0.0005). This study showed that the increase in the coronary artery volume in patients with LVCH matched the increase in LV mass, but a decreased coronary volume with regard to LV mass was characteristic of patients with DCM.

  3. Absolute transition probabilities of phosphorus.

    NASA Technical Reports Server (NTRS)

    Miller, M. H.; Roig, R. A.; Bengtson, R. D.

    1971-01-01

    Use of a gas-driven shock tube to measure the absolute strengths of 21 P I lines and 126 P II lines (from 3300 to 6900 A). Accuracy for prominent, isolated neutral and ionic lines is estimated to be 28 to 40% and 18 to 30%, respectively. The data and the corresponding theoretical predictions are examined for conformity with the sum rules.-

  4. Relativistic Absolutism in Moral Education.

    ERIC Educational Resources Information Center

    Vogt, W. Paul

    1982-01-01

    Discusses Emile Durkheim's "Moral Education: A Study in the Theory and Application of the Sociology of Education," which holds that morally healthy societies may vary in culture and organization but must possess absolute rules of moral behavior. Compares this moral theory with current theory and practice of American educators. (MJL)

  5. Absolute Standards for Climate Measurements

    NASA Astrophysics Data System (ADS)

    Leckey, J.

    2016-10-01

    In a world of changing climate, political uncertainty, and ever-changing budgets, the benefit of measurements traceable to SI standards increases by the day. To truly resolve climate change trends on a decadal time scale, on-orbit measurements need to be referenced to something that is both absolute and unchanging. One such mission is the Climate Absolute Radiance and Refractivity Observatory (CLARREO) that will measure a variety of climate variables with an unprecedented accuracy to definitively quantify climate change. In the CLARREO mission, we will utilize phase change cells in which a material is melted to calibrate the temperature of a blackbody that can then be observed by a spectrometer. A material's melting point is an unchanging physical constant that, through a series of transfers, can ultimately calibrate a spectrometer on an absolute scale. CLARREO consists of two primary instruments: an infrared (IR) spectrometer and a reflected solar (RS) spectrometer. The mission will contain orbiting radiometers with sufficient accuracy to calibrate other space-based instrumentation and thus transferring the absolute traceability. The status of various mission options will be presented.

  6. Asteroid absolute magnitudes and slope parameters

    NASA Technical Reports Server (NTRS)

    Tedesco, Edward F.

    1991-01-01

    A new listing of absolute magnitudes (H) and slope parameters (G) has been created and published in the Minor Planet Circulars; this same listing will appear in the 1992 Ephemerides of Minor Planets. Unlike previous listings, the values of the current list were derived from fits of data at the V band. All observations were reduced in the same fashion using, where appropriate, a single basis default value of 0.15 for the slope parameter. Distances and phase angles were computed for each observation. The data for 113 asteroids was of sufficiently high quality to permit derivation of their H and G. These improved absolute magnitudes and slope parameters will be used to deduce the most reliable bias-corrected asteroid size-frequency distribution yet made.

  7. Absolute radiometric calibration of advanced remote sensing systems

    NASA Technical Reports Server (NTRS)

    Slater, P. N.

    1982-01-01

    The distinction between the uses of relative and absolute spectroradiometric calibration of remote sensing systems is discussed. The advantages of detector-based absolute calibration are described, and the categories of relative and absolute system calibrations are listed. The limitations and problems associated with three common methods used for the absolute calibration of remote sensing systems are addressed. Two methods are proposed for the in-flight absolute calibration of advanced multispectral linear array systems. One makes use of a sun-illuminated panel in front of the sensor, the radiance of which is monitored by a spectrally flat pyroelectric radiometer. The other uses a large, uniform, high-radiance reference ground surface. The ground and atmospheric measurements required as input to a radiative transfer program to predict the radiance level at the entrance pupil of the orbital sensor are discussed, and the ground instrumentation is described.

  8. Coronary Flow Impacts Aortic Leaflet Mechanics and Aortic Sinus Hemodynamics.

    PubMed

    Moore, Brandon L; Dasi, Lakshmi Prasad

    2015-09-01

    Mechanical stresses on aortic valve leaflets are well-known mediators for initiating processes leading to calcific aortic valve disease. Given that non-coronary leaflets calcify first, it may be hypothesized that coronary flow originating from the ostia significantly influences aortic leaflet mechanics and sinus hemodynamics. High resolution time-resolved particle image velocimetry (PIV) measurements were conducted to map the spatiotemporal characteristics of aortic sinus blood flow and leaflet motion with and without physiological coronary flow in a well-controlled in vitro setup. The in vitro setup consists of a porcine aortic valve mounted in a physiological aorta sinus chamber with dynamically controlled coronary resistance to emulate physiological coronary flow. Results were analyzed using qualitative streak plots illustrating the spatiotemporal complexity of blood flow patterns, and quantitative velocity vector and shear stress contour plots to show differences in the mechanical environments between the coronary and non-coronary sinuses. It is shown that the presence of coronary flow pulls the classical sinus vorticity deeper into the sinus and increases flow velocity near the leaflet base. This creates a beneficial increase in shear stress and washout near the leaflet that is not seen in the non-coronary sinus. Further, leaflet opens approximately 10% farther into the sinus with coronary flow case indicating superior valve opening area. The presence of coronary flow significantly improves leaflet mechanics and sinus hemodynamics in a manner that would reduce low wall shear stress conditions while improving washout at the base of the leaflet.

  9. Management of Coronary Artery Calcium and Coronary CTA Findings.

    PubMed

    Thomas, Dustin M; Divakaran, Sanjay; Villines, Todd C; Nasir, Khurram; Shah, Nishant R; Slim, Ahmad M; Blankstein, Ron; Cheezum, Michael K

    Coronary artery calcium (CAC) testing and coronary computed tomography angiography (CTA) have significant data supporting their ability to identify coronary artery disease (CAD) and classify patient risk for atherosclerotic cardiovascular disease (ASCVD). Evidence regarding CAC use for screening has established an excellent prognosis in patients with no detectable CAC, and the ability to risk re-classify the majority of asymptomatic patients considered intermediate risk by traditional risk scores. While data regarding the ideal management of CAC findings are limited, evidence supports statin consideration in patients with CAC > 0 and individualized aspirin therapy accounting for CAD risk factors, CAC severity, and factors which increase a patient's risk of bleeding. In patients with stable or acute symptoms undergoing coronary CTA, a normal CTA predicts excellent prognosis, allowing reassurance and disposition without further testing. When CTA identifies nonobstructive CAD (<50 % stenosis), observational data support consideration of statin use/intensification in patients with extensive plaque (at least four coronary segments involved) and patients with high-risk plaque features. In patients with both nonobstructive and obstructive CAD, multiple studies have now demonstrated an ability of CTA to guide management and improve CAD risk factor control. Still, significant under-treatment of cardiovascular risk factors and high-risk image findings remain, among concerns that CTA may increase invasive angiography and revascularization. To fully realize the impact of atherosclerosis imaging for ASCVD prevention, patient engagement in lifestyle changes and the modification of ASCVD risk factors remain the foundation of care. This review provides an overview of available data and recommendations in the management of CAC and CTA findings.

  10. Arginine methylation dysfunction increased risk of acute coronary syndrome in coronary artery disease population

    PubMed Central

    Zhang, Shengyu; Zhang, Shuyang; Wang, Hongyun; Wu, Wei; Ye, Yicong

    2017-01-01

    Abstract The plasma levels of asymmetric dimethylarginine (ADMA) had been proved to be an independent cardiovascular risk factor. Few studies involved the entire arginine methylation dysfunction. This study was designed to investigate whether arginine methylation dysfunction is associated with acute coronary syndrome risk in coronary artery disease population. In total 298 patients undergoing coronary angiography because of chest pain with the diagnosis of stable angina pectoris or acute coronary syndrome from February 2013 to June 2014 were included. Plasma levels of free arginine, citrulline, ornithine, and the methylated form of arginine, ADMA, and symmetric dimethylarginine (SDMA) were measured with high-performance liquid chromatography coupled with tandem mass spectrometry. We examined the relationship between arginine metabolism-related amino acids or arginine methylation index (AMI, defined as ratio of [arginine + citrulline + ornithine]/[ADMA + SDMA]) and acute coronary events. We found that plasma ADMA levels were similar in the stable angina pectoris group and the acute coronary syndrome group (P = 0.88); the AMI differed significantly between 2 groups (P < 0.001). Multivariate logistic regression demonstrated that AMI was an independent risk factor of acute coronary events in patients with coronary artery disease (OR = 0.975, 95% confidence interval 0.956–0.993; P = 0.008). Our study suggested that ADMA levels were very similar in the stable angina and acute coronary syndrome patients; AMI might be an independent risk factor of acute coronary events in coronary artery disease population. PMID:28207514

  11. Absolute calibration of optical flats

    DOEpatents

    Sommargren, Gary E.

    2005-04-05

    The invention uses the phase shifting diffraction interferometer (PSDI) to provide a true point-by-point measurement of absolute flatness over the surface of optical flats. Beams exiting the fiber optics in a PSDI have perfect spherical wavefronts. The measurement beam is reflected from the optical flat and passed through an auxiliary optic to then be combined with the reference beam on a CCD. The combined beams include phase errors due to both the optic under test and the auxiliary optic. Standard phase extraction algorithms are used to calculate this combined phase error. The optical flat is then removed from the system and the measurement fiber is moved to recombine the two beams. The newly combined beams include only the phase errors due to the auxiliary optic. When the second phase measurement is subtracted from the first phase measurement, the absolute phase error of the optical flat is obtained.

  12. The Absolute Spectrum Polarimeter (ASP)

    NASA Technical Reports Server (NTRS)

    Kogut, A. J.

    2010-01-01

    The Absolute Spectrum Polarimeter (ASP) is an Explorer-class mission to map the absolute intensity and linear polarization of the cosmic microwave background and diffuse astrophysical foregrounds over the full sky from 30 GHz to 5 THz. The principal science goal is the detection and characterization of linear polarization from an inflationary epoch in the early universe, with tensor-to-scalar ratio r much greater than 1O(raised to the power of { -3}) and Compton distortion y < 10 (raised to the power of{-6}). We describe the ASP instrument and mission architecture needed to detect the signature of an inflationary epoch in the early universe using only 4 semiconductor bolometers.

  13. Physics of negative absolute temperatures

    NASA Astrophysics Data System (ADS)

    Abraham, Eitan; Penrose, Oliver

    2017-01-01

    Negative absolute temperatures were introduced into experimental physics by Purcell and Pound, who successfully applied this concept to nuclear spins; nevertheless, the concept has proved controversial: a recent article aroused considerable interest by its claim, based on a classical entropy formula (the "volume entropy") due to Gibbs, that negative temperatures violated basic principles of statistical thermodynamics. Here we give a thermodynamic analysis that confirms the negative-temperature interpretation of the Purcell-Pound experiments. We also examine the principal arguments that have been advanced against the negative temperature concept; we find that these arguments are not logically compelling, and moreover that the underlying "volume" entropy formula leads to predictions inconsistent with existing experimental results on nuclear spins. We conclude that, despite the counterarguments, negative absolute temperatures make good theoretical sense and did occur in the experiments designed to produce them.

  14. Optomechanics for absolute rotation detection

    NASA Astrophysics Data System (ADS)

    Davuluri, Sankar

    2016-07-01

    In this article, we present an application of optomechanical cavity for the absolute rotation detection. The optomechanical cavity is arranged in a Michelson interferometer in such a way that the classical centrifugal force due to rotation changes the length of the optomechanical cavity. The change in the cavity length induces a shift in the frequency of the cavity mode. The phase shift corresponding to the frequency shift in the cavity mode is measured at the interferometer output to estimate the angular velocity of absolute rotation. We derived an analytic expression to estimate the minimum detectable rotation rate in our scheme for a given optomechanical cavity. Temperature dependence of the rotation detection sensitivity is studied.

  15. Conduit options in coronary artery bypass surgery.

    PubMed

    Canver, C C

    1995-10-01

    The choice of graft conduit is crucial to the success of coronary artery bypass grafting (CABG) because the patency of a coronary conduit is closely associated with an uneventful postoperative course and a better long-term patient survival. The standard conduits used for CABG are the greater saphenous vein (GSV) and the internal thoracic artery (ITA). An excellent substitute conduit for coronary bypass operations that can be taken "off the shelf" is certainly the dream of every practicing cardiac surgeon. However, virtually every synthetic and biologic alternative to arterial conduits or autologous fresh saphenous vein has proved disappointing. Fortunately, patients with absolutely no autologous conduit alternatives are uncommon. Circumstances exist, however, that often necessitate the use of alternative conduits such as young hyperlipemic patients, absent or unsuitable autologous ITAs and GSV as a result of previous myocardial revascularization, peripheral arterial reconstruction, and varicose vein ligation procedures. This review provides an update on the clinical work done with all coronary conduits available for myocardial surgical revascularization.

  16. High-pitch dual-source CT coronary angiography: analysis of the impact on image quality of altered electrocardiography waves during data acquisition.

    PubMed

    Wang, Xiaoling; Fang, Jiliang; Tong, Haibin; Zhao, Qing; Song, Qingqiao; Luo, Ping; Xue, Chao; Zhang, Min; Yang, Shuhua; Wang, Qun; Wang, Ping; Shi, Fengxiang; Xu, Lei; Rong, Peijing

    2012-06-01

    Electrocardiography (ECG) "altered waves" sometimes occur during data acquisition when computed tomography coronary angiography (CTCA) is performed with the prospectively ECG-triggered high-pitch (Flash spiral) mode using a second-generation dual-source CT. The aim of this study was to assess the effect of the ECG altered waves on image quality. Seventy-three consecutive patients with stable sinus rhythm ≤ 65 beats per minute were retrospectively enrolled in this study. CTCA was performed using the Flash spiral mode in which the data acquisition was prospectively triggered at 60 % of the R-R interval and completed within one cardiac cycle. The ECG waves before and during data acquisition were analyzed for grouping purposes. Image quality was evaluated using a four-point scale (1 = best, 4 = unevaluatable). Thirty patients (group 1) were found to have ECG altered waves during data acquisition, while 43 patients (group 2) had ECG "stable waves." The altered waves were seen as the baseline drifting; the broad, erected, or inverted P wave or QRS complexes; and a new wave. However, the length of the R-R interval did not change during the data acquisition. There were no significant differences in image quality scores between the two groups on the per-patient (2 ± 0.87 vs. 2.2 ± 0.74, P = 0.273) or per-segment (1.27 ± 0.54 vs. 1.32 ± 0.55, P = 0.577) basis. There were no significant differences in coronary evaluatability as well (per-patient; 93.3 vs. 95.3 %, P = 0.352; per-segment; 99.4 vs. 99.6 %, P = 1.0). CTCA image quality is not affected by ECG altered waves during data acquisition using the Flash spiral mode in low and stable heart rate patients. Thus, the ECG altered waves are considered artifacts.

  17. The 14 bp Del/Ins HLA-G Polymorphism Is Related with High Blood Pressure in Acute Coronary Syndrome and Type 2 Diabetes Mellitus

    PubMed Central

    García-González, Ilian Janet; Valle, Yeminia; Rivas, Fernando; Figuera-Villanueva, Luis Eduardo; Muñoz-Valle, José Francisco; Flores-Salinas, Hector Enrique; Gutiérrez-Amavizca, Bianca Ethel; Dávalos-Rodríguez, Nory Omayra; Padilla-Gutiérrez, Jorge Ramón

    2014-01-01

    Immunologic and inflammatory processes are involved in the pathogenesis of acute coronary syndrome (ACS) and type 2 diabetes mellitus (DM2). Human leukocyte antigen-G (HLA-G) is a negative regulator of the immune response. This study evaluates the 14 bp Del/Ins HLA-G polymorphism in ACS and DM2. Three hundred and seventy individuals from Western Mexico were recruited and categorized into three groups: ACS (86), DM2 without coronary complications (70), and healthy subjects (214). Genotyping of the 14 bp Del/Ins HLA-G polymorphism was performed by PCR and Native-PAGE. The most common risk factors were hypertension and overweight in ACS and DM2, respectively. The genetic distribution of the 14 bp Del/Ins HLA-G polymorphism showed no significant differences between groups (P ≥ 0.23). Nonetheless, the Ins/Ins genotype was associated with high blood pressure (HBP) in the DM2 group (ORc = 1.65, P = 0.02). The genetic recessive model showed similar findings (ORc = 3.03, P = 0.04). No association was found in ACS, with a P of 0.05; nevertheless, the prevalence of Ins/Ins carriers was quite similar to that found in the DM2-HBP group. The 14 bp Del/Ins HLA-G polymorphism was not a susceptibility factor for ACS or DM2; however, the Ins/Ins genotype might have contributed to the development of HBP in the studied groups. PMID:24689061

  18. The 14 bp Del/Ins HLA-G polymorphism is related with high blood pressure in acute coronary syndrome and type 2 diabetes mellitus.

    PubMed

    García-González, Ilian Janet; Valle, Yeminia; Rivas, Fernando; Figuera-Villanueva, Luis Eduardo; Muñoz-Valle, José Francisco; Flores-Salinas, Hector Enrique; Gutiérrez-Amavizca, Bianca Ethel; Dávalos-Rodríguez, Nory Omayra; Padilla-Gutiérrez, Jorge Ramón

    2014-01-01

    Immunologic and inflammatory processes are involved in the pathogenesis of acute coronary syndrome (ACS) and type 2 diabetes mellitus (DM2). Human leukocyte antigen-G (HLA-G) is a negative regulator of the immune response. This study evaluates the 14 bp Del/Ins HLA-G polymorphism in ACS and DM2. Three hundred and seventy individuals from Western Mexico were recruited and categorized into three groups: ACS (86), DM2 without coronary complications (70), and healthy subjects (214). Genotyping of the 14 bp Del/Ins HLA-G polymorphism was performed by PCR and Native-PAGE. The most common risk factors were hypertension and overweight in ACS and DM2, respectively. The genetic distribution of the 14 bp Del/Ins HLA-G polymorphism showed no significant differences between groups (P ≥ 0.23). Nonetheless, the Ins/Ins genotype was associated with high blood pressure (HBP) in the DM2 group (OR(c) = 1.65, P = 0.02). The genetic recessive model showed similar findings (OR(c) = 3.03, P = 0.04). No association was found in ACS, with a P of 0.05; nevertheless, the prevalence of Ins/Ins carriers was quite similar to that found in the DM2-HBP group. The 14 bp Del/Ins HLA-G polymorphism was not a susceptibility factor for ACS or DM2; however, the Ins/Ins genotype might have contributed to the development of HBP in the studied groups.

  19. High Precision, Absolute Total Column Ozone Measurements from the Pandora Spectrometer System: Comparisons with Data from a Brewer Double Monochromator and Aura OMI

    NASA Technical Reports Server (NTRS)

    Tzortziou, Maria A.; Herman, Jay R.; Cede, Alexander; Abuhassan, Nader

    2012-01-01

    We present new, high precision, high temporal resolution measurements of total column ozone (TCO) amounts derived from ground-based direct-sun irradiance measurements using our recently deployed Pandora single-grating spectrometers. Pandora's small size and portability allow deployment at multiple sites within an urban air-shed and development of a ground-based monitoring network for studying small-scale atmospheric dynamics, spatial heterogeneities in trace gas distribution, local pollution conditions, photochemical processes and interdependencies of ozone and its major precursors. Results are shown for four mid- to high-latitude sites where different Pandora instruments were used. Comparisons with a well calibrated double-grating Brewer spectrometer over a period of more than a year in Greenbelt MD showed excellent agreement and a small bias of approximately 2 DU (or, 0.6%). This was constant with slant column ozone amount over the full range of observed solar zenith angles (15-80), indicating adequate Pandora stray light correction. A small (1-2%) seasonal difference was found, consistent with sensitivity studies showing that the Pandora spectral fitting TCO retrieval has a temperature dependence of 1% per 3K, with an underestimation in temperature (e.g., during summer) resulting in an underestimation of TCO. Pandora agreed well with Aura-OMI (Ozone Measuring Instrument) satellite data, with average residuals of <1% at the different sites when the OMI view was within 50 km from the Pandora location and OMI-measured cloud fraction was <0.2. The frequent and continuous measurements by Pandora revealed significant short-term (hourly) temporal changes in TCO, not possible to capture by sun-synchronous satellites, such as OMI, alone.

  20. What Causes Coronary Microvascular Disease?

    MedlinePlus

    ... Living With Clinical Trials Links Related Topics Angina Atherosclerosis Coronary Heart Disease Coronary Heart Disease Risk Factors ... Microvascular Disease? The same risk factors that cause atherosclerosis may cause coronary microvascular disease. Atherosclerosis is a ...

  1. Coronary revascularisation in women

    PubMed Central

    Mikhail, G W

    2006-01-01

    Coronary heart disease is the leading cause of death in men and women worldwide. It is still considered a disease of men and there has been little recognition of its importance in women. Gender differences exist in acute and chronic ischaemia in terms of clinical manifestations, investigations and treatment. There are clear gender differences in coronary revascularisation with a higher mortality seen in women. At the time a woman presents with coronary artery disease she is older and has more co‐morbid factors. Furthermore, women have smaller coronary arteries making them more difficult to revascularise. In recent years there has been a general trend towards improved outcomes in women undergoing both surgical and percutaneous coronary intervention. The increasing use of drug eluting stents and adjunctive medical treatment as well as the use of off‐pump bypass surgery needs further evaluation in terms of gender differences. This article reviews the current literature on coronary revascularisation in women. PMID:16614263

  2. Assessment of coronary thrombolysis

    SciTech Connect

    Geltman, E.M.; Abendschein, D.R.; Devries, S.R.

    1987-02-01

    The efficacy of coronary thrombolysis may be assessed by several invasive and noninvasive means, including coronary angiography, contrast and radionuclide angiography, thallium 201 or /sup 99m/Tc-pyrophosphate scintigraphy, positron emission tomography, cardiac ultrasonography, electrocardiography, and analysis of plasma creatine kinase activity. Each technique has its own strengths and limitations, but when used in concert these methods may provide insight into the physiology of coronary reperfusion and the efficacy of reperfusion in individual patients and populations. 104 references.

  3. Periodontal and coronary heart disease in patients undergoing coronary angiography.

    PubMed

    Berent, Robert; Auer, Johann; Schmid, Peter; Krennmair, Gerald; Crouse, Stephen F; Green, John S; Sinzinger, Helmut; von Duvillard, Serge P

    2011-01-01

    Periodontal inflammation has been implicated in atherosclerosis and coronary heart disease (CHD). Coronary angiography (CA) is used in the assessment of CHD; only a few studies have evaluated periodontal disease (PD) and angiographic measures of coronary atherosclerosis. The aim of this study was to investigate the association between CHD and PD. In this prospective epidemiologic study, 466 patients underwent CA and were assessed for PD. All patients underwent physical, laboratory, cardiac, and dental examination including dental x-rays. Periodontal disease and coronary angiograms were evaluated blindly by a dentist and 2 cardiologists, respectively. A coronary stenosis greater than 50% was ruled as CHD. Periodontal disease was defined and measured with the Community Periodontal Index of Treatment Needs (CPITN); and if at least 2 sextants (segments dividing mandible and maxilla into 6) were recorded as having CPITN of at least 3 (signifying that sextant had periodontal pocket depth ≥ 3.5 mm), the patient was coded as having PD. Three-hundred forty-nine patients (74.9%) had CHD assessed by CA The CHD patients had PD in 55.6% vs 41.9% in the non-CHD patients (P < .01). The CPITN scores were significantly higher in patients with vs without CHD, 2.43 vs 2.16, respectively (P = .023). After adjusting for age, sex, and risk factors for atherosclerosis with additional inclusion of C-reactive protein and erythrocyte sedimentation rate, PD remained significantly related to CHD (odds ratio = 1.9; 95% confidence interval, 1.2-3.1). Other predictors for CHD were male sex, age, high-density lipoprotein cholesterol, and diabetes. Our results demonstrate an increased odds ratio for angiographically determined CHD in patients with PD and that CHD and PD may cluster in particular groups of a population. Our data indicate that PD represents a potentially modifiable risk factor that is both preventable and treatable with predictable treatments that pose negligible risk.

  4. Effect of Fractional Flow Reserve (≤0.90 vs >0.90) on Long-Term Outcome (>10 Years) in Patients With Nonsignificant Coronary Arterial Narrowings.

    PubMed

    Badoz, Marc; Chatot, Marion; Hechema, Rémy; Chopard, Romain; Meneveau, Nicolas; Schiele, François

    2016-08-15

    We assessed the long-term (>10 years) clinical course of patients with documented coronary lesions deemed nonsignificant according to fractional flow reserve (FFR) assessment and investigated whether the initial FFR value impacted on prognosis. From January 2000 to October 2003, all patients submitted to coronary angiography with FFR measurement were included in a single-center, prospective registry. Patients with an FFR value >0.80 were treated medically without revascularization. Major adverse cardiac events (MACE) (death, acute coronary syndrome (ACS), or coronary revascularization) were compared according to initial FFR value (absolute value and by category, ≤0.90 vs >0.90). Analyses were performed using a multivariable Cox model and propensity score matching. Among 257 patients (332 lesions) treated medically initially, 131 (51%, 143 lesions) had FFR ≤0.90 and 126 (49%, 189 lesions) >0.90. During follow-up (median duration, 11.6 years), 82 (31.9%) had a MACE, 38 (14.8%) died, 17 (6.6%) had ACS, 93 (36.2%) had repeat coronary angiography, and 27 (10.5%) had revascularization. There was no clinical, biologic or angiographic difference between patients with initial FFR value ≤0.90 versus >0.90. Adjusted Cox model showed no difference in relative risk of MACE, death, ACS, or revascularization. Coronary angiographies were numerically more frequent in patients with FFR ≤0.90, versus FFR >0.90. These findings were confirmed by propensity score-matched comparison. In patients with coronary narrowings left unrevascularized based on FFR, an FFR value between 0.80 and 0.90 has no impact on long-term outcome compared with those with FFR >0.90. In conclusion, patients with high FFR values should not be considered as having a lower risk of coronary event.

  5. Suture-induced right coronary artery stenosis.

    PubMed

    Seltmann, Martin; Achenbach, Stephan; Muschiol, Gerd; Feyrer, Richard

    2010-01-01

    An 82-year-old patient developed right heart failure in the days after surgical aortic valve replacement. Coronary CT angiography showed a high-grade stenosis of the mid-right coronary artery. Adjacent suture material seen on noncontrast CT suggested that the lesion was related to surgical closure of the right atrial cannulation site. Invasive angiography confirmed the stenosis, and percutaneous intervention was successfully performed.

  6. High resolution spectroscopy of silane with an external-cavity quantum cascade laser: Absolute line strengths of the ν3 fundamental band at 4.6 μm

    NASA Astrophysics Data System (ADS)

    van Helden, J. H.; Lopatik, D.; Nave, A.; Lang, N.; Davies, P. B.; Röpcke, J.

    2015-01-01

    The introduction of room temperature continuous wave external-cavity quantum cascade lasers (EC-QCLs) with narrow linewidths has greatly facilitated high resolution spectroscopy over wide spectral ranges in the mid-infrared (MIR) region. Using the wide tuning range of an EC-QCL we have measured the absolute line strengths of many P-branch transitions of the stretching dyad of the ν3 fundamental band of 28SiH4 between 2096 and 2178 cm-1. Furthermore, the high spectral resolution available has enabled us to resolve and measure representative examples of the tetrahedral splittings associated with each component of the P-branch. The positions of these components are in excellent agreement with spherical top data system (STDS) predictions and theoretical transitions from the TDS spectroscopic database for spherical top molecules. These are the first measurements of these line strengths of 28SiH4 and are an example of the applicability of high-powered, widely tunable EC-QCLs to high resolution spectroscopy.

  7. Recent advances in coronary angioscopy.

    PubMed

    Uchida, Yasumi

    2011-01-01

    Angioscopy enables macroscopic pathological diagnosis of cardiovascular diseases from the inside. This imaging modality has been intensively directed to characterizing vulnerable coronary plaques. Scoring of plaque color was developed, and based on prospective studies; dark yellow or glistening yellow plaques were proposed as vulnerable ones. Colorimetry apparatus was developed to assess the yellow color of the plaques quantitatively. The effects of lipid-lowering therapies on coronary plaques were confirmed by angioscopy. However, since observation is limited to surface color and morphology, pitfalls of this imaging technology became evident. Dye-staining angioscopy and near-infrared fluorescence angioscopy were developed for molecular imaging, and the latter method was successfully applied to patients. Color fluorescence angioscopy was also established for molecular and chemical basis characterization of vulnerable coronary plaques in both in vitro and in vivo. Drug-eluting stents (DES) reduce coronary restenosis significantly, however, late stent thrombosis (LST) occurs, which requires long-term antiplatelet therapy. Angioscopic grading of neointimal coverage of coronary stent struts was established, and it was revealed that neointimal formation is incomplete and prevalence of LST is higher in DES when compared to bare-metal stent. Many new stents were devised and they are now under experimental or clinical investigations to overcome the shortcomings of the stents that have been employed clinically. Endothelial cells are highly anti-thrombotic. Neoendothelial cell damage is considered to be caused by friction between the cells and stent struts due to the thin neointima between them that might act as a cushion. Therefore, development of a DES that causes an appropriate thickness (around 100 μm) of the neointima is a potential option with which to prevent neoendothelial cell damage and consequent LST while preventing restenosis.

  8. Combination of High Ankle–Brachial Index and Hard Coronary Heart Disease Framingham Risk Score in Predicting the Risk of Ischemic Stroke in General Population

    PubMed Central

    Wang, Tong; Kong, Minyi; Chen, Renhua; Liu, Yu; Chen, Jianping; Wang, Zhiyu; Wang, Jingfeng; Huang, Hui

    2014-01-01

    Our previous study showed that the patients with more metabolic risk factors had higher risk of high ankle–brachial index (ABI), but the relationship between high ABI and the risk of severe cardiovascular and cerebrovascular diseases is still under debate. This study aims to evaluate this association in the general population. 1486 subjects of South China were recruited in the study. 61 subjects were defined as high ABI group (ABI≥1.3) and 65 subjects were randomly selected as normal ABI group (0.9coronary heart disease (HCHD) Framingham Risk Score (FRS) were compared between two groups. The results showed that the 10-year HCHD FRS of high ABI group was significantly higher than normal ABI group (7.87±6.11 vs. 3.98±2.90%, P<0.001). There was a positive correlation between ABI value and HCHD FRS in overweight participants (R = 0.576, P<0.01). The prevalence of ischemic stroke was higher in high ABI group than normal ABI group (21.3% vs. 6.2%, P<0.05), and it was higher in participants with HCHD FRS≥6% than those with HCHD FRS<6% (19.1% vs. 6.9%, P<0.05). Moreover, the prevalence of ischemic stroke was higher in participants with high ABI and HCHD FRS≥6% than those with normal ABI and HCHD FRS<6% (26.7% vs. 4.1%, P<0.05). BMI, hypertension, hsCRP and smoking were proved to be the independent factors and effective predictors for high ABI (P<0.05). In conclusion, high ABI combined with high HCHD FRS should be a potential predictor of ischemic stroke in the general population of South China. PMID:25198106

  9. Achieving Climate Change Absolute Accuracy in Orbit

    NASA Technical Reports Server (NTRS)

    Wielicki, Bruce A.; Young, D. F.; Mlynczak, M. G.; Thome, K. J; Leroy, S.; Corliss, J.; Anderson, J. G.; Ao, C. O.; Bantges, R.; Best, F.; Bowman, K.; Brindley, H.; Butler, J. J.; Collins, W.; Dykema, J. A.; Doelling, D. R.; Feldman, D. R.; Fox, N.; Huang, X.; Holz, R.; Huang, Y.; Jennings, D.; Jin, Z.; Johnson, D. G.; Jucks, K.; Kato, S.; Kratz, D. P.; Liu, X.; Lukashin, C.; Mannucci, A. J.; Phojanamongkolkij, N.; Roithmayr, C. M.; Sandford, S.; Taylor, P. C.; Xiong, X.

    2013-01-01

    The Climate Absolute Radiance and Refractivity Observatory (CLARREO) mission will provide a calibration laboratory in orbit for the purpose of accurately measuring and attributing climate change. CLARREO measurements establish new climate change benchmarks with high absolute radiometric accuracy and high statistical confidence across a wide range of essential climate variables. CLARREO's inherently high absolute accuracy will be verified and traceable on orbit to Système Internationale (SI) units. The benchmarks established by CLARREO will be critical for assessing changes in the Earth system and climate model predictive capabilities for decades into the future as society works to meet the challenge of optimizing strategies for mitigating and adapting to climate change. The CLARREO benchmarks are derived from measurements of the Earth's thermal infrared spectrum (5-50 micron), the spectrum of solar radiation reflected by the Earth and its atmosphere (320-2300 nm), and radio occultation refractivity from which accurate temperature profiles are derived. The mission has the ability to provide new spectral fingerprints of climate change, as well as to provide the first orbiting radiometer with accuracy sufficient to serve as the reference transfer standard for other space sensors, in essence serving as a "NIST [National Institute of Standards and Technology] in orbit." CLARREO will greatly improve the accuracy and relevance of a wide range of space-borne instruments for decadal climate change. Finally, CLARREO has developed new metrics and methods for determining the accuracy requirements of climate observations for a wide range of climate variables and uncertainty sources. These methods should be useful for improving our understanding of observing requirements for most climate change observations.

  10. Swarm's Absolute Scalar Magnetometers Burst Mode Results

    NASA Astrophysics Data System (ADS)

    Coisson, P.; Vigneron, P.; Hulot, G.; Crespo Grau, R.; Brocco, L.; Lalanne, X.; Sirol, O.; Leger, J. M.; Jager, T.; Bertrand, F.; Boness, A.; Fratter, I.

    2014-12-01

    Each of the three Swarm satellites embarks an Absolute Scalar Magnetometer (ASM) to provide absolute scalar measurements of the magnetic field with high accuracy and stability. Nominal data acquisition of these ASMs is 1 Hz. But they can also run in a so-called "burst mode" and provide data at 250 Hz. During the commissioning phase of the mission, seven burst mode acquisition campaigns have been run simultaneously for all satellites, obtaining a total of ten days of burs-mode data. These campaigns allowed the identification of issues related to the operations of the piezo-electric motor and the heaters connected to the ASM, that do not impact the nominal 1 Hz scalar data. We analyze the burst mode data to identify high frequency geomagnetic signals, focusing the analysis in two regions: the low latitudes, where we seek signatures of ionospheric irregularities, and the high latitudes, to identify high frequency signals related to polar region currents. Since these campaigns have been conducted during the initial months of the mission, the three satellites where still close to each other, allowing to analyze the spatial coherency of the signals. Wavelet analysis have revealed 31 Hz signals appearing in the night-side in the equatorial region.

  11. High-resolution magnetic resonance coronary angiography of the entire heart using a new blood-pool agent, NC100150 injection: comparison with invasive x-ray angiography in pigs.

    PubMed

    Johansson, L O; Nolan, M M; Taniuchi, M; Fischer, S E; Wickline, S A; Lorenz, C H

    1999-01-01

    Recent developments of novel magnetic resonance intravascular contrast agents with low T1 in blood and a long intravascular half-life will rapidly position magnetic resonance coronary angiography (MRCA) at the threshold of clinical application. This article describes the use of one such intravascular contrast agent for noninvasive coronary angiography and comparison with routine invasive x-ray angiography. Six domestic farm pigs with an artificial stenoses at the left circumflex were studied. NC100150 Injection, a new ultra-small superparmagnetic iron oxide (Nycomed Amersham Imaging, Oslo, Norway), was injected using a dose of 5.0 mg Fe/kg body weight. Scanning was done using a 1.5-T Gyroscan ACS-NT. A high-resolution electrocardiogram-triggered scan covering the entire heart was applied. Navigator echoes were used for respiratory triggering. In all animals the location of the stenoses detected with MRCA correlated well with x-ray angiography. The correlation factor between the grade of stenoses determined by MRCA and x-ray angiography was 0.993. MRCA using NC100150 Injection can depict the major coronary arteries and branches well. Decreases in vessel caliber detected by MRCA correlate well with x-ray angiography. The use of such intravascular contrast agents show great promise for clinical applications for noninvasive detection of coronary artery disease in humans.

  12. The carotid intima-media thickness as a marker of the presence of severe symptomatic coronary artery disease.

    PubMed

    Geroulakos, G; O'Gorman, D J; Kalodiki, E; Sheridan, D J; Nicolaides, A N

    1994-06-01

    High resolution ultrasound can be used for the accurate measurement of intima-media thickness (IMT). The within-observer coefficient of variation of the IMT of two carotids measured seven times each on different days by two different observers was between 4% and 8%, and the mean absolute difference of the IMT of 68 carotids measured independently by two observers was 0.11 +/- 0.11 mm (mean value +/- SD). Seventy-five consecutive male patients who underwent coronary angiography for assessment of chest pain and 40 normal controls matched for age and sex, were examined with high resolution B-mode ultrasound. The IMT of the common carotid artery for the controls was 0.71 +/- 0.16 mm and for the patients 0.91 +/- 0.18 mm (P < 0.005). In patients with normal coronary angiogram the IMT was 0.73 +/- 0.1 mm, and this increased in each of the subgroups with coronary stenosis compared to patients who had a normal coronary angiogram. In the group with one-vessel disease it was 0.91 +/- 0.17 mm (P < 0.05, ANOVA), in the group with two-vessel disease it was 0.96 +/- 0.17 mm (P < 0.01), and in the group with three-vessel disease it was 0.99 +/- 0.21 mm (P < 0.01). There was a significant linear trend between IMT and the number of involved vessels (P < 0.0001, r = 0.44). An IMT > or = 0.85 mm was derived from the studied population of 75 patients as a criterion for the prediction of coronary artery disease (CAD).(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Post-Hoc Study: Intravenous Hydration Treatment in Chinese Patients with High Risk of Contrast-Induced Nephropathy Following Percutaneous Coronary Intervention

    PubMed Central

    Bei, Weijie; Li, Hualong; Lin, Kaiyang; Wang, Kun; Chen, Shiqun; Guo, Xiaosheng; Liu, Yong; Tan, Ning; Chen, Jiyan; Yang, Xiangtai; Su, Xi; Du, Zhimin; Zeng, Qiutang; Fang, Zhenfei; Wang, Yan; Jiang, Hong; Xiong, Longgen; Hou, Yuqing; Yuan, Yong; Li, Tianfa; Hong, Lang; Wu, Yanqing; Liu, Yin; Lin, Wenhua; Jiang, Tiemin; Fu, Junhua; An, Yi; Yu, Bo; Tian, Ye; Zheng, Yang; Liu, Bin; Yang, Ping; Jiang, Xianyan; Wang, Hao; Qu, Peng; Cui, Lianqun; Li, Xueqi; Qi, Xiaoyong; Ma, Zengcai; Li, Jifu; Zhang, Lili; Liu, Shengquan; Pang, Wenyue; Li, Yibo; Yang, Manguang; Ji, Zheng; Zhao, Pitian; Li, Lu; Ge, Junbo; Jin, Huigen; Pan, Weimin; Song, Yaoming; Li, Jianmei; Xiao, Jianming; Liu, Hanxiong; Tao, Jianhong; Wu, Zhongdong; Tuo, Buxiong; Li, Wei; Xu, Yixian; Zhang, Zhaoqi; Chen, Yundai; Wang, Lefeng; Zhang, Jinying; Wang, Fengling; Jia, Yongping; Wang, Bin; Tang, Fakuan; Tang, Qiang; Wang, Wei; Sun, Yuemin; Su, Weiqing

    2017-01-01

    Contrast-induced nephropathy (CIN) develops after the injection of iodinated contrast media. This is a post hoc analysis of the data obtained from the TRUST study, which was a prospective, multicentre, observational study conducted to evaluate the safety and tolerability of the contrast medium iopromide in patients undergoing cardiac catheterization from August 2010 to September 2011 in China, conducted to explore the current status, trends and risk predictors of hydration treatment. The status of hydration to prevent CIN in each patient was recorded. Of the total 17,139 patients from the TRUST study (mean age, 60.33 ± 10.38 years), the overall hydration usage was 46.1% in patients undergoing percutaneous coronary intervention (PCI) and 77.4%, 51.7%, and 48.5% in patients with pre-existing renal disease, diabetes mellitus, and hypertension, respectively. The proportion of hydration use increased from 36.5% to 55.5% from August 2010 to September 2011, which was independently associated with risk predictors like older age, pre-existing renal disease, hypertension, diabetes mellitus, prior myocardial infarction, ST segment elevation MI, high contrast dose, multi-vessel disease and reduced LVEF (<45%). Overall, the usage of intravenous hydration treatment for patients with a high risk of CIN following PCI was high in China. PMID:28337989

  14. Absolute calibration of optical tweezers

    SciTech Connect

    Viana, N.B.; Mazolli, A.; Maia Neto, P.A.; Nussenzveig, H.M.; Rocha, M.S.; Mesquita, O.N.

    2006-03-27

    As a step toward absolute calibration of optical tweezers, a first-principles theory of trapping forces with no adjustable parameters, corrected for spherical aberration, is experimentally tested. Employing two very different setups, we find generally very good agreement for the transverse trap stiffness as a function of microsphere radius for a broad range of radii, including the values employed in practice, and at different sample chamber depths. The domain of validity of the WKB ('geometrical optics') approximation to the theory is verified. Theoretical predictions for the trapping threshold, peak position, depth variation, multiple equilibria, and 'jump' effects are also confirmed.

  15. Noninvasive assessment of coronary blood flow by transthoracic Doppler echocardiography: basic to practical use in the emergency room.

    PubMed

    Watanabe, Nozomi

    2017-01-23

    Echo Doppler is widely available in the clinical setting, and the feasibility of coronary flow detection in the left anterior descending coronary artery has been reported as >90% with the use of a high-frequency transducer. Coronary flow detection takes only a few minutes by skilled echocardiologists, and this noninvasive technique can provide useful physiological information in patients with various types of coronary artery disease. Coronary flow velocity reserve measurement by echo Doppler is a simple and easy technique. It is available in the echo laboratory as well as in the outpatient clinic, and can be used as an alternative examination to screen for significant coronary stenosis in patients with stable angina. Moreover, physiological information provided by coronary flow velocity reserve can be used in combination with other imaging modalities that can provide anatomical information of the coronary arteries such as coronary computed tomography or coronary angiography. Coronary flow velocity in patients with acute coronary syndrome (ACS) enables rapid noninvasive differentiation of TIMI-III from TIMI-II coronary reperfusion before emergency coronary intervention. Transthoracic coronary flow detection by echo Doppler contributes to the assessment of the coronary reperfusion status in the emergency room for patients with ACS, prior to invasive coronary angiography.

  16. High incidence of abnormal glucose metabolism in acute coronary syndrome patients at a moderate altitude: A sub-Himalayan study

    PubMed Central

    Mokta, Jitender; Kumar, Subash; Ganju, Neeraj; Mokta, Kiran; Panda, Prashant Kumar; Gupta, Swatantra

    2017-01-01

    Background: Abnormal glucose metabolic status at admission is an important marker of future cardiovascular events and long-term mortality after acute coronary syndrome (ACS), whether or not they are known diabetics. Objective: The aims were to study the prevalence of abnormal glucose metabolism in ACS patients and to compare the different methods of diagnosing diabetes in ACS patients. Methods: We did a prospective study. About 250 consecutive nondiabetic patients (200 men and 50 women) with ACS admitted to a tertiary care institute of Himachal Pradesh in 1 year were enrolled. Admission plasma glucose, next morning fasting plasma glucose (FPG), A1C, and a standardized 75-g oral glucose tolerance test (OGTT) 72 h after admission were done. Glucose metabolism was categorized as normal glucose metabolism, impaired glucose metabolism (impaired fasting glucose or impaired glucose tolerance [IGT]), and diabetes. Diabetes was arbitrarily classified further as undiagnosed (HBA1c ≥6.5%) or possibly stress diabetes (HBA1c <6.5%). A repeat OGTT after 3 months in objects with IGT and stress hyperglycemia at a time of admission was done. Results: The mean age was 54 ± 12.46 years. The mean plasma glucose at admission was 124 ± 53.96 mg/dL, and the mean FPG was 102 ± 27.07 mg/dL. The mean 2-h postglucose load concentration was 159.5 ± 56.58 mg/dL. At baseline, 95 (38%) had normal glucose metabolism, 95 (38%) had impaired glucose metabolism (IGT and or IGT) and 60 (24%) had diabetes; 48 (19.2%) were undiagnosed diabetes and 12 (4.8%) had stress hyperglycemia. At follow up 58.66% and 55.55% of patients with impaired glucose tolerance and stress hyperglycemia continued to have impaired glucose tolerance respectively. About 75 gm OGTT has highest sensitivity and specificity to diagnose diabetes, whereas A1C most specific to rule out stress hyperglycemia. Conclusions: In this small hilly state of India, abnormal glucose metabolism (previously undiagnosed diabetes and IGT) is

  17. Progress in coronary angioplasty.

    PubMed

    Silverton, P

    1986-10-01

    Angioplasty offers an alternative to bypass grafting for an increasing number of patients with coronary artery disease. Improvements in catheter design and manufacture have been responsible for an enlargement of the indications which now include patients with multiple vessel coronary artery disease and those with acute evolving myocardial infarction. The application of laser technology may assist in the reopening of chronically occluded arteries.

  18. Coronary Stent Infection Presented as Recurrent Stent Thrombosis

    PubMed Central

    Lai, Chih-Hung; Lin, Yung-Kai; Lee, Wen-Lieng

    2017-01-01

    Percutaneous transluminal coronary angioplasty with metal stent placement has become a well-developed treatment modality for coronary stenotic lesions. Although infection involving implanted stents is rare, it can, however, occur with high morbidity and mortality. We describe herein a case of an inserted coronary stent that was infected and complicated with recurrent stent thrombosis, pseudoaneurysm formation and severe sepsis. Despite repeated intervention and bypass surgery, the patient died from severe sepsis. PMID:28120580

  19. Prevalence of contraindications and conditions for precaution for prasugrel administration in a real world acute coronary syndrome population.

    PubMed

    Alexopoulos, Dimitrios; Xanthopoulou, Ioanna; Mylona, Panagiota; Perperis, Angelos; Panagiotou, Aggeliki; Dimitropoulos, Gerasimos; Tsigkas, Grigorios; Hahalis, George; Davlouros, Periklis

    2011-10-01

    The prevalence of prasugrel contraindications and specific conditions requiring precaution for its use in a real world acute coronary syndrome (ACS) population is not known. We performed a prospective descriptive study in 1016 consecutive moderate to high risk ACS patients. In 646 patients (63.6%) subjected to percutaneous coronary intervention, analysis of absolute contraindications (history of stroke/transient ischemic attack or active bleeding), relative contraindications and specific conditions (age ≥ 75 years and/or weight < 60 kg) for prasugrel theoretical administration was performed. In 242 (37.5%) patients there was at least one absolute or relative contraindication or specific condition requiring attention for its use. Overall, 23.1% of patients in our cohort had a prior stroke/transient ischemic attack and/or specific condition to be considered for prasugrel administration. Specifically, the prevalence of stroke/TIA was 3.6%, the prevalence of patients ≥75 years 20% and the prevalence of patients weighing <60 kg 2.2%. Among patients ≥75 years old, 63 (9.8%) had diabetes mellitus or previous myocardial infarction, consisting a high risk subgroup that might benefit from prasugrel administration. In a real world ACS population a relatively high proportion of patients have a potential contraindication for prasugrel administration or necessitate special attention for its use.

  20. Pathophysiology of coronary collaterals.

    PubMed

    Stoller, Michael; Seiler, Christian

    2014-02-01

    While the existence of structural adaptation of coronary anastomoses is undisputed, the potential of coronary collaterals to be capable of functional adaptation has been questioned. For many years, collateral vessels were thought to be rigid tubes allowing only limited blood flow governed by the pressure gradient across them. This concept was consistent with the notion that although collaterals could provide adequate blood flow to maintain resting levels, they would be unable to increase blood flow sufficiently in situations of increased myocardial oxygen demand. However, more recent studies have demonstrated the capability of the collateral circulation to deliver sufficient blood flow even during exertion or pharmacologic stress. Moreover, it has been shown that increases in collateral flow could be attributed directly to collateral vasomotion. This review summarizes the pathophysiology of the coronary collateral circulation, ie the functional adapation of coronary collaterals to acute alterations in the coronary circulation.

  1. Pathophysiology of Coronary Collaterals#

    PubMed Central

    Stoller, Michael; Seiler, Christian

    2014-01-01

    While the existence of structural adaptation of coronary anastomoses is undisputed, the potential of coronary collaterals to be capable of functional adaptation has been questioned. For many years, collateral vessels were thought to be rigid tubes allowing only limited blood flow governed by the pressure gradient across them. This concept was consistent with the notion that although collaterals could provide adequate blood flow to maintain resting levels, they would be unable to increase blood flow sufficiently in situations of increased myocardial oxygen demand. However, more recent studies have demonstrated the capability of the collateral circulation to deliver sufficient blood flow even during exertion or pharmacologic stress. Moreover, it has been shown that increases in collateral flow could be attributed directly to collateral vasomotion. This review summarizes the pathophysiology of the coronary collateral circulation, ie the functional adapation of coronary collaterals to acute alterations in the coronary circulation. PMID:23701025

  2. Coronary plaque imaging by coronary computed tomography angiography

    PubMed Central

    Sato, Akira

    2014-01-01

    Coronary computed tomography angiography (CTA) has become the useful noninvasive imaging modality alternative to the invasive coronary angiography for detecting coronary artery stenoses in patients with suspected coronary artery disease (CAD). With the development of technical aspects of coronary CTA, clinical practice and research are increasingly shifting toward defining the clinical implication of plaque morphology and patients outcomes by coronary CTA. In this review we discuss the coronary plaque morphology estimated by CTA beyond coronary angiography including the comparison to the currently available other imaging modalities used to examine morphological characteristics of the atherosclerotic plaque. Furthermore, this review underlies the value of a combined assessment of coronary anatomy and myocardial perfusion in patients with CAD, and adds to an increasing body of evidence suggesting an added diagnostic value when combining both modalities. We hope that an integrated, multi-modality imaging approach will become the gold standard for noninvasive evaluation of coronary plaque morphology and outcome data in clinical practice. PMID:24876919

  3. Complete rupture of the anterolateral papillary muscle caused by coronary spasm.

    PubMed

    Yamazaki, Masataka; Fukui, Toshihiro; Mahara, Keitaro; Takanashi, Shuichiro

    2015-12-01

    Papillary muscle rupture usually occurs as a catastrophic complication of acute myocardial infarction in patients with coronary artery stenosis; it is therefore less common in patients without coronary artery stenosis. We report the case of a 67-year old woman without coronary artery stenosis who suffered an acute anterolateral papillary muscle rupture and was successfully treated with mitral valve replacement. Evidence of coronary spasm was found on a coronary vasomotion test, suggesting that a high sensitivity to coronary spasm may explain a mechanism of isolated papillary muscle infarction.

  4. Absolute Antenna Calibration at the US National Geodetic Survey

    NASA Astrophysics Data System (ADS)

    Mader, G. L.; Bilich, A. L.

    2012-12-01

    Geodetic GNSS applications routinely demand millimeter precision and extremely high levels of accuracy. To achieve these accuracies, measurement and instrument biases at the centimeter to millimeter level must be understood. One of these biases is the antenna phase center, the apparent point of signal reception for a GNSS antenna. It has been well established that phase center patterns differ between antenna models and manufacturers; additional research suggests that the addition of a radome or the choice of antenna mount can significantly alter those a priori phase center patterns. For the more demanding GNSS positioning applications and especially in cases of mixed-antenna networks, it is all the more important to know antenna phase center variations as a function of both elevation and azimuth in the antenna reference frame and incorporate these models into analysis software. Determination of antenna phase center behavior is known as "antenna calibration". Since 1994, NGS has computed relative antenna calibrations for more than 350 antennas. In recent years, the geodetic community has moved to absolute calibrations - the IGS adopted absolute antenna phase center calibrations in 2006 for use in their orbit and clock products, and NGS's CORS group began using absolute antenna calibration upon the release of the new CORS coordinates in IGS08 epoch 2005.00 and NAD 83(2011,MA11,PA11) epoch 2010.00. Although NGS relative calibrations can be and have been converted to absolute, it is considered best practice to independently measure phase center characteristics in an absolute sense. Consequently, NGS has developed and operates an absolute calibration system. These absolute antenna calibrations accommodate the demand for greater accuracy and for 2-dimensional (elevation and azimuth) parameterization. NGS will continue to provide calibration values via the NGS web site www.ngs.noaa.gov/ANTCAL, and will publish calibrations in the ANTEX format as well as the legacy ANTINFO

  5. Absence of left ventricular concentric hypertrophy: a prerequisite for zero coronary calcium score.

    PubMed

    Ehara, Shoichi; Shirai, Nobuyuki; Okuyama, Takuhiro; Matsumoto, Kenji; Matsumura, Yoshiki; Yoshiyama, Minoru

    2011-09-01

    The identification and intervention of factors associated with a coronary artery calcification (CAC) score of zero, suggesting the absence of significant coronary artery disease (CAD) with high probability, would be meaningful in the clinical setting. Thus far, the relationship between CAC and left ventricular (LV) hypertrophy has not been documented. We identified factors associated with a CAC score of zero and evaluated the relationship between this score and LV concentric hypertrophy in 309 consecutive patients with suspected CAD who were clinically indicated to undergo multislice computed tomography angiography for coronary artery evaluation. The quantitative CAC score was calculated according to Agatston's method. The total coronary calcium score (TCS) was defined as the sum of the scores for each lesion. Four absolute TCS categories were considered: zero, mild (0-100), moderate (100-400), and severe (>400). LV hypertrophy was classified into concentric (LV mass index >104 g/m(2) in women or >116 g/m(2) in men; LV end-diastolic volume index ≤109.2 mL/m(2)) and eccentric (LV end-diastolic volume index >109.2 mL/m(2)) patterns. In the zero-TCS group, the frequency of LV concentric hypertrophy was extremely low (zero 6%, mild 17%, moderate 26%, severe 19%). Multivariate analysis revealed that age, hypercholesterolemia, diabetes mellitus, LV concentric hypertrophy, and LV mass index, but not hypertension, were the independent factors associated with a CAC score of zero. The present study demonstrated that the absence of LV concentric hypertrophy was a prerequisite for a CAC score of zero. That is, the presence of LV concentric hypertrophy, which indicated more severe underlying hypertension, long duration, or poor control of blood pressure, implicates the presence of CAC.

  6. [Estimation of absolute risk for fracture].

    PubMed

    Fujiwara, Saeko

    2009-03-01

    Osteoporosis treatment aims to prevent fractures and maintain the QOL of the elderly. However, persons at high risk of future fracture cannot be effectively identified on the basis of bone density (BMD) alone, although BMD is used as an diagnostic criterion. Therefore, the WHO recommended that absolute risk for fracture (10-year probability of fracture) for each individual be evaluated and used as an index for intervention threshold. The 10-year probability of fracture is calculated based on age, sex, BMD at the femoral neck (body mass index if BMD is not available), history of previous fractures, parental hip fracture history, smoking, steroid use, rheumatoid arthritis, secondary osteoporosis and alcohol consumption. The WHO has just announced the development of a calculation tool (FRAX: WHO Fracture Risk Assessment Tool) in February this year. Fractures could be prevented more effectively if, based on each country's medical circumstances, an absolute risk value for fracture to determine when to start medical treatment is established and persons at high risk of fracture are identified and treated accordingly.

  7. Absolute Radiometric Calibration of EUNIS-06

    NASA Technical Reports Server (NTRS)

    Thomas, R. J.; Rabin, D. M.; Kent, B. J.; Paustian, W.

    2007-01-01

    The Extreme-Ultraviolet Normal-Incidence Spectrometer (EUNIS) is a soundingrocket payload that obtains imaged high-resolution spectra of individual solar features, providing information about the Sun's corona and upper transition region. Shortly after its successful initial flight last year, a complete end-to-end calibration was carried out to determine the instrument's absolute radiometric response over its Longwave bandpass of 300 - 370A. The measurements were done at the Rutherford-Appleton Laboratory (RAL) in England, using the same vacuum facility and EUV radiation source used in the pre-flight calibrations of both SOHO/CDS and Hinode/EIS, as well as in three post-flight calibrations of our SERTS sounding rocket payload, the precursor to EUNIS. The unique radiation source provided by the Physikalisch-Technische Bundesanstalt (PTB) had been calibrated to an absolute accuracy of 7% (l-sigma) at 12 wavelengths covering our bandpass directly against the Berlin electron storage ring BESSY, which is itself a primary radiometric source standard. Scans of the EUNIS aperture were made to determine the instrument's absolute spectral sensitivity to +- 25%, considering all sources of error, and demonstrate that EUNIS-06 was the most sensitive solar E W spectrometer yet flown. The results will be matched against prior calibrations which relied on combining measurements of individual optical components, and on comparisons with theoretically predicted 'insensitive' line ratios. Coordinated observations were made during the EUNIS-06 flight by SOHO/CDS and EIT that will allow re-calibrations of those instruments as well. In addition, future EUNIS flights will provide similar calibration updates for TRACE, Hinode/EIS, and STEREO/SECCHI/EUVI.

  8. Cosmology with negative absolute temperatures

    NASA Astrophysics Data System (ADS)

    Vieira, J. P. P.; Byrnes, Christian T.; Lewis, Antony

    2016-08-01

    Negative absolute temperatures (NAT) are an exotic thermodynamical consequence of quantum physics which has been known since the 1950's (having been achieved in the lab on a number of occasions). Recently, the work of Braun et al. [1] has rekindled interest in negative temperatures and hinted at a possibility of using NAT systems in the lab as dark energy analogues. This paper goes one step further, looking into the cosmological consequences of the existence of a NAT component in the Universe. NAT-dominated expanding Universes experience a borderline phantom expansion (w < -1) with no Big Rip, and their contracting counterparts are forced to bounce after the energy density becomes sufficiently large. Both scenarios might be used to solve horizon and flatness problems analogously to standard inflation and bouncing cosmologies. We discuss the difficulties in obtaining and ending a NAT-dominated epoch, and possible ways of obtaining density perturbations with an acceptable spectrum.

  9. Distal coronary perforation in patients with prior coronary artery bypass graft surgery: The importance of early treatment.

    PubMed

    Karatasakis, Aris; Akhtar, Yasir N; Brilakis, Emmanouil S

    2016-09-01

    In patients with prior coronary artery bypass graft (CABG) surgery, distal coronary perforations are commonly considered to be at low risk for causing cardiac tamponade due to a potential protective role of pericardial adhesions, which obliterate the pericardial space. Loculated effusions can however form in such patients, compressing various cardiac structures and causing hemodynamic compromise. We present two cases of distal coronary perforation in prior CABG patients undergoing chronic total occlusion percutaneous coronary intervention. In the first case a distal coronary perforation was initially observed, resulting in a loculated pericardial effusion that caused ST-segment elevation and death, despite successful sealing of the perforation. In the second case a similar perforation was immediately sealed with a covered stent, followed by uneventful patient recovery. A literature review of coronary perforation leading to hemodynamic compromise in patients with prior CABG surgery revealed high mortality (22%), suggesting that prompt sealing of the perforation is critical in these patients.

  10. Trends in Percutaneous Coronary Intervention and Coronary Artery Bypass Surgery in Korea

    PubMed Central

    Lee, Heeyoung; Lee, Kun Sei; Sim, Sung Bo; Jeong, Hyo Seon; Ahn, Hye Mi; Chee, Hyun Keun

    2016-01-01

    Background Coronary angioplasty has been replacing coronary artery bypass grafting (CABG) because of the relative advantage in terms of recovery time and noninvasiveness of the procedure. Compared to other Organization for Economic Cooperation and Development (OECD) countries, Korea has experienced a rapid increase in coronary angioplasty volumes. Methods We analyzed changes in procedure volumes of CABG and of percutaneous coronary intervention (PCI) from three sources: the OECD Health Data, the National Health Insurance Service (NHIS) surgery statistics, and the National Health Insurance claims data. Results We found the ratio of procedure volume of PCI to that of CABG per 100,000 population was 19.12 in 2014, which was more than triple the OECD average of 5.92 for the same year. According to data from NHIS statistics, this ratio was an increase from 11.4 to 19.3 between 2006 and 2013. Conclusion We found that Korea has a higher ratio of total procedure volumes of PCI with respect to CABG and also a more rapid increase of volumes of PCI than other countries. Prospective studies are required to determine whether this increase in absolute volumes of PCI is a natural response to a real medical need or representative of medical overuse. PMID:28035299

  11. Physical and mathematical aspects of blood-glucose- and insulin-level kinetics in patients with coronary heart disease and high risk of its development

    NASA Astrophysics Data System (ADS)

    Denisova, Tatyana P.; Malinova, Lidia I.; Malinov, Igor A.

    2001-05-01

    The intravenous glucose tolerance test was performed to estimate the kinetics of blood glucose and insulin levels. Glucose was injected in individual standardized dose (0.5 g. per 1 kg of body weight). Three groups of patients were checked up: 1) patients with coronary heart disease verified by cicatricial alterations in myocardium found by electrocardiographic and echocardiographic methods; 2) children of patients with transmural myocardial infarction practically healthy at the moment of study; 3) persons practically healthy at the moment of study without any indications on cardiovascular diseases and non-insulin dependent diabetes mellitus among all ancestors and relatives who frequently were long-livers. Last groups didn't differ by age and sex. Peripheral blood glucose level, immunoreactive and free insulin (tested by muscular tissue) were studied just before glucose injection (on an empty stomach) and 4 times after it. The received discrete data were approximated by high degree polynomials, the estimation of blood glucose and insulin time functions symmetric was performed. The deceleration of degradation of insulin circulating in peripheral blood and the time decrease of second phase of insulin secretion were analytically established. This fact proves the complicated mechanism of insulin alterations in atherosclerosis, consisting not only of insulin resistance of peripheral tissues but of decrease of plastic processes in insulin- generating cells.

  12. Natriuretic Peptide and High-Sensitive Troponin T Concentrations Correlate with Effectiveness of Short-Term CPAP in Patients with Obstructive Sleep Apnea and Coronary Artery Disease

    PubMed Central

    Strehmel, Ralf; Valo, Misa; Teupe, Claudius

    2016-01-01

    The risk of cardiovascular complications is increased in patients with obstructive sleep apnea (OSA). Continuous positive airway pressure (CPAP) is the most effective way to treat clinically significant OSA. We hypothesized that the concentrations of the cardiac risk markers N-terminal brain natriuretic peptide (NT-proBNP) and high-sensitive troponin T (hs-TropT) correlate with the effectiveness of CPAP therapy in patients with OSA and coexisting coronary artery disease (CAD). Twenty-one patients with severe OSA and coexisting CAD (group 1) and 20 control patients with severe OSA alone (group 2) were treated with CPAP and monitored by laboratory-based polysomnography. NT-proBNP and hs-TropT levels were measured before and after CPAP. Apnea–hypopnea index (AHI) and oxygen desaturation were similar in both groups. In group 1, hs-TropT levels correlated with AHI and oxygen desaturation upon CPAP. Elevated NT-proBNP levels in group 1 were significantly reduced by CPAP. NT-proBNP levels correlated with AHI and showed negative correlation with ST-segment depression. No such correlations were found in group 2. CPAP has the potential to normalize elevated NT-proBNP serum levels in patients with severe OSA and coexisting CAD. Levels of NT-proBNP and hs-TropT correlated with AHI and oxygen desaturation. PMID:27980444

  13. Platelet-to-lymphocyte ratio but not neutrophil-to-lymphocyte ratio predicts high on-treatment platelet reactivity in clopidogrel-treated patients with acute coronary syndrome

    PubMed Central

    Efe, Edem; Kocayiğit, Ibrahim; Türker, Pabuccu Mustafa; Murat, Küçükukur; Erkan, Alpaslan; Sedat, Taş; Alper, Çil; Necati, Aksoy Murat; Gökhan, Vural Mustafa; Bahri, Akdeniz

    2016-01-01

    Objectives: Dual antiplatelet therapy (DAPT), consisting of clopidogrel and aspirin, is the main-stay treatment of acute coronary syndromes (ACS). However, major adverse cardiovascular events may occur even in patients undergoing DAPT, and this has been related to the variable pharmacodynamic efficacy of these drugs, especially clopidogrel. Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) are novel inflammatory markers for cardiovascular risk stratification, which may reflect an inflammatory state and thus high on-treatment platelet reactivity (HPR). Methods: We investigated the usefulness of PLR and NLR in predicting HPR in clopidogrel-treated patients with ACS. A total of 244 patients were enrolled in this study, and 43 of them were nonresponsive to clopidogrel. Results: Logistic regression analysis indicated that PLR was significantly associated with HPR (P < 0.001). Using a cutoff level of 331, PLR predicted HPR with a sensitivity of 73% and a specificity of 69% (odds ratio: 376.15, 95% confidence interval = 37.813–3741.728 P < 0.001, receiver operating characteristic curve: 0.885). Conclusions: We suggest that more attention should be paid to the PLR values of these patients on admission to identify individuals who may not benefit from clopidogrel during the course of ACS. PMID:27756943

  14. Effects of High Intensity Interval versus Moderate Continuous Training on Markers of Ventilatory and Cardiac Efficiency in Coronary Heart Disease Patients

    PubMed Central

    Cardozo, Gustavo G.; Oliveira, Ricardo B.; Farinatti, Paulo T. V.

    2015-01-01

    Background. We tested the hypothesis that high intensity interval training (HIIT) would be more effective than moderate intensity continuous training (MIT) to improve newly emerged markers of cardiorespiratory fitness in coronary heart disease (CHD) patients, as the relationship between ventilation and carbon dioxide production (VE/VCO2 slope), oxygen uptake efficiency slope (OUES), and oxygen pulse (O2P). Methods. Seventy-one patients with optimized treatment were randomly assigned into HIIT (n = 23, age = 56 ± 12 years), MIT (n = 24, age = 62 ± 12 years), or nonexercise control group (CG) (n = 24, age = 64 ± 12 years). MIT performed 30 min of continuous aerobic exercise at 70–75% of maximal heart rate (HRmax), and HIIT performed 30 min sessions split in 2 min alternate bouts at 60%/90% HRmax (3 times/week for 16 weeks). Results. No differences among groups (before versus after) were found for VE/VCO2 slope or OUES (P > 0.05). After training the O2P slope increased in HIIT (22%, P < 0.05) but not in MIT (2%, P > 0.05), while decreased in CG (−20%, P < 0.05) becoming lower versus HIIT (P = 0.03). Conclusion. HIIT was more effective than MIT for improving O2P slope in CHD patients, while VE/VCO2 slope and OUES were similarly improved by aerobic training regimens versus controls. PMID:25741531

  15. High-intensity cardiac rehabilitation training of a commercial pilot who, after percutaneous coronary intervention, wanted to continue participating in a rigorous strength and conditioning program

    PubMed Central

    Shrestha, Sanjay; Lawrence, Anne; Schussler, Jeffrey M.

    2016-01-01

    After undergoing elective percutaneous coronary intervention, a 64-year-old commercial pilot was referred to cardiac rehabilitation. His stated goals were to continue participating in a rigorous strength and conditioning program at a community workout facility and to resume working as a pilot. To help him meet those goals, we designed and implemented a regimen of high-intensity exercises, with quick transitions between a variety of tasks that are not typically included in cardiac rehabilitation programs (e.g., medicine ball throws, push-ups, dead lifts, squats, military presses, sprints, and lunges). The training was symptom limited, enabling the patient to reach extreme levels of physical exertion in a controlled, monitored setting. By studying his training data (heart rate, blood pressure, and rating of perceived exertion), we were able to give him specific recommendations for controlling his exercise intensity after graduating from our program. More than 18 months later, he continues to exercise vigorously 3 days per week and is working as a commercial pilot. PMID:26722183

  16. A US Claims-Based Analysis of Real-World Lipid-Lowering Treatment Patterns in Patients With High Cardiovascular Disease Risk or a Previous Coronary Event.

    PubMed

    Quek, Ruben G W; Fox, Kathleen M; Wang, Li; Li, Lu; Gandra, Shravanthi R; Wong, Nathan D

    2016-02-15

    The objective was to examine real-world treatment patterns of lipid-lowering therapies and their possible associated intolerance and/or ineffectiveness in patients with high cardiovascular disease (CVD) risk initiating statins and/or ezetimibe. Patients aged ≥18 years who initiated statins and/or ezetimibe from January 01, 2007, to June 30, 2011, were retrospectively identified from the IMS LifeLink PharMetrics Plus commercial claims database. Patients were further classified into 2 cohorts: (1) history of cardiovascular event (CVE) and (2) history of coronary heart disease risk equivalent (CHD RE). Patients had continuous health plan enrollment ≥1 year pre- and post-index date (statin and/or ezetimibe initiation date). Primary outcomes were index statin intensity, treatment modifications, possible associated statin/nonstatin intolerance and/or ineffectiveness issues (based on treatment modification), and time-to-treatment modifications. Analyses for each cohort were stratified by age group (<65 and ≥65 years). A total of 41,934 (history of CVE) and 170,344 patients (history of CHD RE) were included. On the index date, 8.8% to 25.1% of patients were initiated on high-intensity statin. Among patients aged <65, 79.2% and 48.8% of those with history of CVE and 78.6% and 47.3% of those with a history of CHD RE had ≥1 and 2 treatment modifications, respectively. Among all patients, 24.6% to 25.6% had possible statin intolerance and/or ineffectiveness issues after accounting for second treatment modification (if any). In conclusion, in patients with high CVD risk, index statin treatment modifications that imply possible statin intolerance and/or ineffectiveness were frequent; low use of high-intensity statins indicates unmet need in the management of hyperlipidemia and possible remaining unaccounted CVD residual risk.

  17. Restenosis of the coronary stenotic lesions treated by holmium:YAG laser coronary angioplasty

    NASA Astrophysics Data System (ADS)

    Miyazaki, Shunichi; Nonogi, Hiroshi; Goto, Yoichi; Itoh, Akira; Ozono, Keizaburo; Daikoku, Satoshi; Haze, Kazuo

    1994-07-01

    Clinical efficacy of newly developed Holmium YAG laser coronary angioplasty (HLCA) was assessed for 30 patients with angina. There were 12 near left main trunk (LMT) lesions and 4 aorto- ostial lesions. Adjunctive balloon angioplasty was performed for 25 of 30 lesions. Delivered energy ranged from 1.5 to 2.5 watts/pulse and the total exposure time ranged from 6 to 55 seconds. External diameter of laser catheter was 1.5 mm for 13 lesions, 1.4 mm for 17 lesions, and 1.7 mm for 5 lesions. Laser success, defined as 20% reduction of stenotic ratio, was obtained in 21 of 30 (70%) and overall procedural success rate was 93%. There were 3 cases with acute coronary occlusions relieved by adjunctive balloon angioplasty and one coronary perforation without manifestation of cardiac tamponade. There were no large coronary dissection which involved more than 5 mm of the coronary artery. Follow up coronary angiography after 3 months showed restenosis in 14 of 27 patients (52%). Percent stenosis after lasering (56%) was similar to that at 3 months after (62%). HLCA is acutely effective treatment for lesions near LMT, because of low incidence of large coronary dissection. However, angiographical restenosis rate is high at 3 months after HLCA. This may be attributed to the relatively large residual stenosis after the procedure and vessel injury caused by shock wave.

  18. Genomic prediction of coronary heart disease

    PubMed Central

    Abraham, Gad; Havulinna, Aki S.; Bhalala, Oneil G.; Byars, Sean G.; De Livera, Alysha M.; Yetukuri, Laxman; Tikkanen, Emmi; Perola, Markus; Schunkert, Heribert; Sijbrands, Eric J.; Palotie, Aarno; Samani, Nilesh J.; Salomaa, Veikko; Ripatti, Samuli; Inouye, Michael

    2016-01-01

    Aims Genetics plays an important role in coronary heart disease (CHD) but the clinical utility of genomic risk scores (GRSs) relative to clinical risk scores, such as the Framingham Risk Score (FRS), is unclear. Our aim was to construct and externally validate a CHD GRS, in terms of lifetime CHD risk and relative to traditional clinical risk scores. Methods and results We generated a GRS of 49 310 SNPs based on a CARDIoGRAMplusC4D Consortium meta-analysis of CHD, then independently tested it using five prospective population cohorts (three FINRISK cohorts, combined n = 12 676, 757 incident CHD events; two Framingham Heart Study cohorts (FHS), combined n = 3406, 587 incident CHD events). The GRS was associated with incident CHD (FINRISK HR = 1.74, 95% confidence interval (CI) 1.61–1.86 per S.D. of GRS; Framingham HR = 1.28, 95% CI 1.18–1.38), and was largely unchanged by adjustment for known risk factors, including family history. Integration of the GRS with the FRS or ACC/AHA13 scores improved the 10 years risk prediction (meta-analysis C-index: +1.5–1.6%, P < 0.001), particularly for individuals ≥60 years old (meta-analysis C-index: +4.6–5.1%, P < 0.001). Importantly, the GRS captured substantially different trajectories of absolute risk, with men in the top 20% of attaining 10% cumulative CHD risk 12–18 y earlier than those in the bottom 20%. High genomic risk was partially compensated for by low systolic blood pressure, low cholesterol level, and non-smoking. Conclusions A GRS based on a large number of SNPs improves CHD risk prediction and encodes different trajectories of lifetime risk not captured by traditional clinical risk scores. PMID:27655226

  19. Linear ultrasonic motor for absolute gravimeter.

    PubMed

    Jian, Yue; Yao, Zhiyuan; Silberschmidt, Vadim V

    2017-02-01

    Thanks to their compactness and suitability for vacuum applications, linear ultrasonic motors are considered as substitutes for classical electromagnetic motors as driving elements in absolute gravimeters. Still, their application is prevented by relatively low power output. To overcome this limitation and provide better stability, a V-type linear ultrasonic motor with a new clamping method is proposed for a gravimeter. In this paper, a mechanical model of stators with flexible clamping components is suggested, according to a design criterion for clamps of linear ultrasonic motors. After that, an effect of tangential and normal rigidity of the clamping components on mechanical output is studied. It is followed by discussion of a new clamping method with sufficient tangential rigidity and a capability to facilitate pre-load. Additionally, a prototype of the motor with the proposed clamping method was fabricated and the performance tests in vertical direction were implemented. Experimental results show that the suggested motor has structural stability and high dynamic performance, such as no-load speed of 1.4m/s and maximal thrust of 43N, meeting the requirements for absolute gravimeters.

  20. Effects of the New Aldose Reductase Inhibitor Benzofuroxane Derivative BF-5m on High Glucose Induced Prolongation of Cardiac QT Interval and Increase of Coronary Perfusion Pressure

    PubMed Central

    Di Filippo, C.; Ferraro, B.; Maisto, R.; Trotta, M. C.; Di Carluccio, N.; Sartini, S.; La Motta, C.; Ferraraccio, F.; Rossi, F.; D'Amico, M.

    2016-01-01

    This study investigated the effects of the new aldose reductase inhibitor benzofuroxane derivative 5(6)-(benzo[d]thiazol-2-ylmethoxy)benzofuroxane (BF-5m) on the prolongation of cardiac QT interval and increase of coronary perfusion pressure (CPP) in isolated, high glucose (33.3 mM D-glucose) perfused rat hearts. BF-5m was dissolved in the Krebs solution at a final concentration of 0.01 μM, 0.05 μM, and 0.1 μM. 33.3 mM D-glucose caused a prolongation of the QT interval and increase of CPP up to values of 190 ± 12 ms and 110 ± 8 mmHg with respect to the values of hearts perfused with standard Krebs solution (11.1 mM D-glucose). The QT prolongation was reduced by 10%, 32%, and 41%, respectively, for the concentration of BF-5m 0.01 μM, 0.05 μM, and 0.1 μM. Similarly, the CPP was reduced by 20% for BF-5m 0.05 μM and by 32% for BF-5m 0.1 μM. BF-5m also increased the expression levels of sirtuin 1, MnSOD, eNOS, and FOXO-1, into the heart. The beneficial actions of BF-5m were partly abolished by the pretreatment of the rats with the inhibitor of the sirtuin 1 activity EX527 (10 mg/kg/day/7 days i.p.) prior to perfusion of the hearts with high glucose + BF-5m (0.1 μM). Therefore, BF-5m supplies cardioprotection from the high glucose induced QT prolongation and increase of CPP. PMID:26839893

  1. Coronary risk in a cohort of Paralympic athletes

    PubMed Central

    Filho, J A O; Salvetti, X M; de Mello, M T; da Silva, A C; Filho, B L

    2006-01-01

    Objective To determine the prevalence of coronary risk factors in Paralympic athletes and evaluate their risk of coronary events. Method An observational prospective cross sectional study of 79 consecutive Brazilian Paralympic athletes (mean (SD) age 27.8 (6.7) years (median 26 years)). There were 56 men and 23 women, 67 with physical and 12 with visual disabilities. The occurrence of systemic hypertension, hypercholesterolaemia, diabetes mellitus, smoking, familial antecedents, obesity, and hypertriglyceridaemia was investigated. The risk of coronary events was calculated using the American Heart Association Coronary risk handbook, and also the 10 year probability of a coronary event using the Framingham risk score. Results The prevalence of risk factors was: systemic hypertension, 11%; familial antecedents, 10%; smoking, 9%; hypertriglyceridaemia, 6%; hypercholesterolaemia, 1.3%; obesity, 4%; diabetes, 0%. They occurred in 51% of the Paralympic athletes: one factor (41%), two factors (4%), and three factors (6%). The risk of coronary events was absent in 80%, slight in 17%, and moderate in 3%. This could only be evaluated in 81% of the athletes, as 8% had amputations, 9% were young, and 2% had unknown familial antecedents. The Framingham risk score ranged from −14 to +6, predicting a 10 year probability of a coronary event of 3.3 (3.8)%. Conclusion This study shows a reasonably high prevalence of coronary risk factors (51%), despite a low probability of coronary events in Paralympic athletes. The lipid and blood pressure profiles were similar in ambulatory and wheelchair athletes. PMID:16950883

  2. Coronary Artery Disease

    MedlinePlus

    Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death ... both men and women. CAD happens when the arteries that supply blood to heart muscle become hardened ...

  3. Coronary artery fistulas

    PubMed Central

    Said, S.A.M.; Thiadens, A.A.H.J.; Fieren, M.J.C.H.; Meijboom, E.J.; van der Werf, T.; Bennink, G.B.W.E.

    2002-01-01

    The aetiology of congenital coronary artery fistulas remains a challenging issue. Coronary arteries with an anatomically normal origin may, for obscure reasons, terminate abnormally and communicate with different single or multiple cardiac chambers or great vessels. When this occurs, the angiographic morphological appearance may vary greatly from discrete channels to plexiform network of vessels. Coronary arteriovenous fistulas (CAVFs) have neither specific signs nor pathognomonic symptoms; the spectrum of clinical features varies considerably. The clinical presentation of symptomatic cases can include angina pectoris, myocardial infarction, fatigue, dyspnoea, CHF, SBE, ventricular and supraventricular tachyarrhythmias or even sudden cardiac death. CAVFs may, however, be a coincidental finding during diagnostic coronary angiography (CAG). CAG is considered the gold standard for diagnosing and delineating the morphological anatomy and pathway of CAVFs. There are various tailored therapeutic modalities for the wide spectrum of clinical manifestations of CAVFs, including conservative pharmacological strategy, percutaneous transluminal embolisation and surgical ligation. ImagesFigure 1Figure 2Figure 3Figure 4 PMID:25696067

  4. Acute Coronary Syndrome

    MedlinePlus

    ... angina? This content was last reviewed July 2015. Heart Attack • Home • About Heart Attacks Acute Coronary Syndrome (ACS) ... Recovery FAQs • Heart Attack Tools & Resources • Support Network Heart Attack Tools & Resources What Is a Heart Attack? How ...

  5. Percutaneous Coronary Intervention

    MedlinePlus

    ... to open coronary arteries that are narrowed or blocked by the buildup of atherosclerotic plaque. PCI may ... that will highlight the blockage. To open a blocked artery, your doctor will insert another catheter over ...

  6. Coronary artery spasm

    MedlinePlus

    ... blocker or a long-acting nitrate long-term. Beta-blockers are another type of medicine that is used with other coronary artery problems. However, beta-blockers may make this problem worse. They should be ...

  7. Massive systemic air embolism during off-pump coronary artery surgery.

    PubMed

    Kuralay, Erkan

    2009-01-01

    In OPCAB (off-pump coronary artery bypass) operations, development of cardiac arrest during the distal anastomosis to obtuse marginal coronary artery leads to significantly low blood pressure in the ascending aorta. Therefore, blowing of compressed air in high flow on not-slinged coronary artery may cause air mobilization from the coronary artery system into the ascending aorta that may result in severe brain damage.

  8. Low high-density lipoprotein cholesterol is a residual risk factor associated with long-term clinical outcomes in diabetic patients with stable coronary artery disease who achieve optimal control of low-density lipoprotein cholesterol.

    PubMed

    Ogita, Manabu; Miyauchi, Katsumi; Miyazaki, Tadashi; Naito, Ryo; Konishi, Hirokazu; Tsuboi, Shuta; Dohi, Tomotaka; Kasai, Takatoshi; Yokoyama, Takayuki; Okazaki, Shinya; Kurata, Takeshi; Daida, Hiroyuki

    2014-01-01

    Diabetes mellitus is recognized an independent risk factor for coronary artery disease (CAD) and mortality. Clinical trials have shown that statins significantly reduce cardiovascular events in diabetic patients. However, residual cardiovascular risk persists despite the achievement of target low-density lipoprotein cholesterol (LDL-C) levels with statin. High-density lipoprotein cholesterol (HDL-C) is an established coronary risk factor that is independent of LDL-C levels. We evaluated the impact of HDL-C on long-term mortality in diabetic patients with stable CAD who achieved optimal LDL-C. We enrolled 438 consecutive diabetic patients who were scheduled for percutaneous coronary intervention between 2004 and 2007 at our institution. We identified 165 patients who achieved target LDL-C <100 mg/dl. Patients were stratified into two groups according to HDL-C levels (low HDL-C group, baseline HDL-C <40 mg/dl; high HDL-C group, ≥40 mg/dl). Major adverse cardiac events (MACE) that included all-cause death, acute coronary syndrome, and target lesion revascularization were evaluated between the two groups. The median follow-up period was 946 days. The rate of MACE was significantly higher in diabetic patients with low-HDL-C who achieved optimal LDL-C (6.9 vs 17.9 %, log-rank P = 0.030). Multivariate Cox regression analysis showed that HDL-C is significantly associated with clinical outcomes (adjusted hazard ratio for MACE 1.33, 95 % confidence interval 1.01-1.75, P = 0.042). Low HDL-C is a residual risk factor that is significantly associated with long-term clinical outcomes among diabetic patients with stable CAD who achieve optimal LDL-C levels.

  9. Association between cholesterol synthesis/absorption markers and effects of cholesterol lowering by atorvastatin among patients with high risk of coronary heart disease.

    PubMed

    Qi, Yue; Liu, Jing; Ma, Changsheng; Wang, Wei; Liu, Xiaohui; Wang, Miao; Lv, Qiang; Sun, Jiayi; Liu, Jun; Li, Yan; Zhao, Dong

    2013-11-01

    No indices are currently available to facilitate clinicians to identify patients who need either statin monotherapy or statin-ezetimibe combined treatment. We aimed to investigate whether cholesterol synthesis and absorption markers can predict the cholesterol-lowering response to statin. Total 306 statin-naïve patients with high risk of coronary heart disease (CHD) were treated with atorvastatin 20 mg/day for 1 month. Cholesterol synthesis and absorption markers and LDL cholesterol (LDL-C) levels were measured before and after treatment. Atorvastatin decreased LDL-C by 36.8% (range: decrease of 74.5% to increase of 31.9%). Baseline cholesterol synthesis marker lathosterol and cholesterol absorption marker campesterol codetermined the effect of atorvastatin treatment. The effect of cholesterol lowering by atorvastatin was significantly associated with baseline lathosterol levels but modified bidirectionally by baseline campesterol levels. In patients with the highest baseline campesterol levels, atorvastatin treatment decreased cholesterol absorption by 46.1%, which enhanced the effect of LDL-C lowering. Atorvastatin treatment increased cholesterol absorption by 52.3% in those with the lowest baseline campesterol levels, which attenuated the effect of LDL-C reduction. Especially those with the highest lathosterol but the lowest campesterol levels at baseline had significantly less LDL-C reduction than those with the same baseline lathosterol levels but the highest campesterol levels (27.3% versus 42.4%, P = 0.002). These results suggest that combined patterns of cholesterol synthesis/absorption markers, rather than each single marker, are potential predictors of the LDL-C-lowering effects of atorvastatin in high-risk CHD patients.

  10. Evaluation of Short- and Long-Term Efficacy of Combined Intracoronary Administration of High-Dose Adenosine and Tirofiban during Primary Percutaneous Coronary Intervention

    PubMed Central

    Li, Yanbing; Li, Qiang; Li, Feiou; Zong, Min; Miao, Guobin; Yang, Xinchun; Tong, Zichuan; Zhang, Jianjun

    2016-01-01

    Background To assess the influence of combined intracoronary application of high-dose adenosine and tirofiban in primary percutaneous coronary intervention (PCI) on clinical events and cardiac function. Methods Our study evaluated consecutive patients with acute ST-segment elevation myocardial infarction undergoing primary PCI, who were randomly divided into adenosine group (n = 130) and control group (n = 128). Combined with thrombus aspiration and then intracoronary tirofiban, the adenosine group received intracoronary adenosine (2 mg) through the aspiration catheter 2 times. After thrombus aspiration and stenting of the infarct- related artery, the control group received placebo. The primary endpoint of our investigation was major adverse cardiac events (MACE) at the 1-year and 3-year marks. The secondary endpoint comprised left ventricular remodeling (LVR) at 6 months, myocardial blush grade (MBG), thrombolysis in myocardial infarction (TIMI) flow grade and corrected TIMI frame count (CTFC) after PCI. Results Our study found that TIMI flow grade post-PCI did not differ significantly between the 2 groups, while CTFC favored the adenosine-treated patients (21.6 ± 6.5 vs. 25.1 ± 7.8, p = 0.001). Although the adenosine group achieved a higher rate of MBG 3 (45.1% vs. 32.0%, p = 0.035) and MBG 2-3 (76.2% vs. 62.3%, p = 0.018) than the control group, the incidences of MACE at 1 year (20.0% vs. 25.0%, p = 0.373) and 3 years (26.9% vs. 32.0%, p = 0.413) were comparable. LVR occurred in 23.1% (27/117) of adenosine-treated patients and in 29.8% (43/114) of the controls (p = 0.296). Conclusions Intracoronary administration of high-dose adenosine combined with intracoronary tirofiban and thrombus aspiration may further improve myocardial perfusion after primary PCI. PMID:27899850

  11. High prevalence of severe coronary artery disease in elderly patients with non-operable chronic thromboembolic pulmonary hypertension referred for balloon pulmonary angioplasty

    PubMed Central

    Wretowski, Dominik; Kostrubiec, Maciej; Dzikowska-Diduch, Olga; Łabyk, Andrzej; Irzyk, Katarzyna; Lichodziejewska, Barbara; Wyzgał, Anna; Jankowski, Krzysztof; Pruszczyk, Piotr

    2016-01-01

    Introduction Balloon pulmonary angioplasty (BPA) is a new emerging catheter-based alternative treatment option for patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). Aim To show that all elderly CTEPH patients referred for BPA are at higher risk of obstructive coronary artery disease and that, in daily practice, they should undergo invasive coronary angiography. Material and methods Eleven patients at the age of at least 65 years (6 males, 5 females, 77.2 ±5.9 years) with confirmed non-operable type II or type III CTEPH, considered for BPA, underwent elective coronary angiography. Severe obstructive coronary artery disease (CAD) was diagnosed when stenosis of left main coronary artery ≥ 50% or stenosis of ≥ 70% of epicardial arteries was angiographically confirmed. We also screened for CAD consecutive age- and sex-matched 114 PE survivors (52 males, 62 females, 74.8 ±7.2 years) with excluded CTEPH. Results Severe CAD was more frequent in elderly patients with non-operable type II or type III CTEPH candidates for BPA than in elderly acute PE survivors with excluded CTEPH (54.5% vs. 16.7%, p < 0.01), and therefore elderly CTEPH patients referred for BPA were at higher risk of CAD (OR = 5.9, 95% CI: 1.64–21.46, p = 0.007) when compared to elderly survivors after acute PE with excluded CTEPH. Conclusions All elderly CTEPH patients referred for BPA are at higher risk of severe CAD and should routinely undergo invasive coronary angiography before BPA. PMID:27980550

  12. Coronary Artery Fistula

    DTIC Science & Technology

    2007-04-01

    Figure 1A; oblique, Figure 1B), the left circumflex artery was identified by its black central lumen and noted to arise normally from the left main...but the mid left circumflex coronary artery was less well seen because of volume averaging with the left atrium and pulmonary venous confluence which...Figures 1C-D. Select oblique conventional x-ray views (C, early phase; D, late phase) from a coronary catheterization study following injection of

  13. [Cognitive functions in elderly high-risk patients after off-pump coronary artery bypass grafting versus conventional bypass grafting - a randomised study - Secondary publication].

    PubMed

    Jensen, Birte Østergaard; Hughest, Pia; Rasmussen, Lars S; Pedersen, Preben U; Steinbrüchel, Daniel A

    2006-10-30

    It has been suggested that the risk of cerebral dysfunction is less with off-pump coronary artery bypass grafting (OPCAB) than with conventional coronary artery bypass grafting (CCAB). The study is a part of the Best Bypass Surgery Trial. A total of 120 elderly patients underwent psychometric testing with a neuropsychological test battery before as well as 3 months after surgery. Cognitive dysfunction was identified in 7.4% of the patients in the OPCAB group and 9.8% in the CCAB group. We found no significant difference after either OPCAB or CCAB.

  14. Beneficial effect of preventative intra-aortic balloon pumping in high-risk patients undergoing first-time coronary artery bypass grafting-a single center experience.

    PubMed

    Gong, Qingcheng; Xing, Jialin; Miao, Na; Zhao, Yanyan; Jia, Zaishen; Li, Jiawei; Chen, Yu; Gao, Quanxin; Liu, Anxin; Sun, Zhiquan; Liu, Xiaojun; Ji, Bingyang

    2009-08-01

    Although intra-aortic balloon pumping (IABP) has been used widely as a routine cardiac assist device for perioperative support in coronary artery bypass grafting (CABG), the optimal timing for high-risk patients undergoing first-time CABG using IABP is unknown. The purpose of this investigation is to compare preoperative and preventative IABP insertion with intraoperative or postoperative obligatory IABP insertion in high-risk patients undergoing first-time CABG. We reviewed our IABP patients' database from 2002 to 2007; there were 311 CABG patients who received IABP treatment perioperatively. Of 311 cases, 41 high-risk patients who had first-time on-pump or off-pump CABG (presenting with three or more of the following criteria: left ventricular ejection fraction less than 0.45, unstable angina, CABG combined with aneurysmectomy, or left main stenosis greater than 70%) entered the study. We compared perioperatively the clinical results of 20 patients who underwent preoperative IABP placement (Group 1) with 21 patients who had obligatory IABP placement intraoperatively or postoperatively during CABG (Group 2). There were no differences in preoperative risk factors, except left ventricular aneurysm resection, between the two groups. There were no differences in indications for high-risk patients between the two groups. The mean number of grafts was similar. There were no significant differences in the need for inotropes, or in cerebrovascular, gastrointestinal, renal, and infective complications postoperatively. There were no IABP-related complications in either group. Major adverse cardiac event (severe hypotension and/or shock, myocardial infarction, and severe hemodynamic instability) was higher in Group 2 (14 [66.4%] vs. 1 [5%], P < 0.0001) during surgery. The time of IABP pumping in Group 1 was shorter than in Group 2 (72.5 +/- 28.9 h vs. 97.5 +/- 47.7 h, P < 0.05). The duration of ventilation and intensive care unit stay in Group 1 was significantly shorter

  15. Value of left ventricular ejection fraction during exercise in predicting the extent of coronary artery disease.

    PubMed

    DePace, N L; Iskandrian, A S; Hakki, A H; Kane, S A; Segal, B L

    1983-04-01

    To determine the relation between left ventricular performance during exercise and the extent of coronary artery disease, the results of exercise radionuclide ventriculography were analyzed in 65 patients who also underwent cardiac catheterization. A scoring system was used to quantitate the extent of coronary artery disease. This system takes into account the number and site of stenoses of the major coronary vessels and their secondary branches. The conventional method of interpreting the coronary angiograms indicated that 26 patients had significant coronary artery disease (defined as 70% or more narrowing of luminal diameter) of one vessel, 21 had multivessel disease and 18 had no significant coronary artery disease. Although the exercise left ventricular ejection fraction was significantly higher in patients with no coronary artery disease than in patients with one or multivessel disease (probability [p] less than 0.001), there was considerable overlap among the three groups. With the scoring system, a good correlation was found between the coronary artery disease score and the exercise left ventricular ejection fraction (r = -0.70; p less than 0.001). If the exercise heart rate was 130 beats/min or greater or the age of the patient was 50 years or less, an even better correlation was found (r = -0.73 and r = -0.82, respectively). The exercise ejection fraction (but not the change in ejection fraction, end-diastolic volume and end-systolic volume from rest to exercise) correlated with the extent of coronary artery disease. The exercise ejection fraction is the most important exercise variable that correlates with the extent of coronary artery disease when the latter is assessed quantitatively by a scoring system rather than the conventional method of reporting coronary angiograms. Young age and greater exercise heart rate strengthened the correlation. The change in ejection fraction from rest to exercise is useful in the diagnosis of coronary artery disease

  16. Absolute measurements of fast neutrons using yttrium.

    PubMed

    Roshan, M V; Springham, S V; Rawat, R S; Lee, P; Krishnan, M

    2010-08-01

    Yttrium is presented as an absolute neutron detector for pulsed neutron sources. It has high sensitivity for detecting fast neutrons. Yttrium has the property of generating a monoenergetic secondary radiation in the form of a 909 keV gamma-ray caused by inelastic neutron interaction. It was calibrated numerically using MCNPX and does not need periodic recalibration. The total yttrium efficiency for detecting 2.45 MeV neutrons was determined to be f(n) approximately 4.1x10(-4) with an uncertainty of about 0.27%. The yttrium detector was employed in the NX2 plasma focus experiments and showed the neutron yield of the order of 10(8) neutrons per discharge.

  17. Platelet to lymphocyte ratio is associated with the severity of coronary artery disease and clinical outcomes of percutaneous coronary intervention in the Chinese Han population

    PubMed Central

    Zhou, Dong; Wang, Guangyao; Fan, Yan; Wan, Zhaofei; Liu, Xiaojun

    2017-01-01

    The aim of the present study was to evaluate whether the ratio of the absolute number of platelets to the number of lymphocytes (PLR) correlates with the severity of coronary artery disease (CAD) and major adverse cardiovascular disease (CVD) events in Chinese patients with CAD. PLR was calculated as follows: PLR=platelet count/lymphocyte count, using the complete blood counts of 854 Chinese Han subjects. CAD severity was determined using angiographic evidence by cardiologists unaware of the study aims. The association between PLR and CAD severity was analyzed by logistic regression. Clinical endpoints were evaluated during a median follow-up period of 42 months. The association between PLR and CVD events was assessed using Cox regression models. Patients with PLR>171 exhibited more severe coronary artery stenosis [odds ratio, 2.393; 95% confidence intervals (CI), 1.394–4.108; P=0.002] and worse prognoses, with a higher rate of major adverse CVD events during five years of follow-up (hazard ratio, 1.982; 95% CI, 1.329–2.957; P=0.001). A Kaplan-Meier curve demonstrated that the CVD event rate of 34.27% in patients with PLR>171 was significantly higher than that in patients with PLR<100 (P<0.001). These findings suggest that PLR is independently associated with CAD severity and long-term major adverse CVD events; therefore, high PLR may predict poor prognosis of CAD in the Chinese Han population.

  18. Comprehensive coronary risk determination in primary prevention: an imaging and clinical based definition combining computed tomographic coronary artery calcium score and national cholesterol education program risk score.

    PubMed

    Nasir, Khurram; Vasamreddy, Chandra; Blumenthal, Roger S; Rumberger, John A

    2006-06-16

    Cardiovascular disease (CVD) is the leading cause of mortality and a major cause of morbidity. Coronary heart disease (CHD) accounts for nearly half of all CVD deaths. Currently estimation of risk in primary prevention is based on the Framingham risk equations, which inputs traditional risk factors and is helpful in predicting the development of CHD in asymptomatic individuals. However many individuals suffer events in the absence of established risk factors for atherosclerosis and broad based population risk estimations may have little precision when applied to a given individual. To meet the challenge of CHD risk assessment, several tools have been developed to identify atherosclerotic disease in its preclinical stages. This paper aims to incorporate information from coronary artery calcification (CAC) scoring from a computed tomographic "heartscan" (using Electron Beam Tomography (EBT) as the validated prototype) along with current Framingham risk profiling in order to refine risk on an absolute scale by combining imaging and clinical data to affect a more comprehensive calculation of absolute risk in a given individual. For CAC scores above the 75th percentile but <90th percentile, 10 years is added to chronological age, and for CAC scores above the 90th percentile, 20 years is added to current chronological age. Among those in whom a positive CAC score is the norm such as older individuals (men> or =55 years, women> or =65 years) a CAC = 0 will result in an age point score corresponding to the age-group whose median CAC score is zero i.e., 40-44 years for men and 55-59 years for women. The utilization of CAC scores allows the inclusion of sub-clinical disease definition into the context of modifiable risk factors as well as identifies high-risk individuals requiring aggressive treatment.

  19. Interval training based on ventilatory anaerobic threshold increases cardiac vagal modulation and decreases high-sensitivity c-reative protein: randomized clinical trial in coronary artery disease

    PubMed Central

    Tamburus, Nayara Y.; Paula, Roberta F. L.; Kunz, Vandeni C.; César, Marcelo C.; Moreno, Marlene A.; da Silva, Ester

    2015-01-01

    Background: Autonomic dysfunction and inflammatory activity are involved in the development and progression of coronary artery disease (CAD), and exercise training has been shown to confer a cardiovascular benefit. Objective: To evaluate the effects that interval training (IT) based on ventilatory anaerobic threshold (VAT) has on heart rate variability (HRV) and high-sensitivity C-reactive protein (hs-CRP) levels, as well as the relationship between both levels, in patients with CAD and/or cardiovascular risk factors (RF). Method: Forty-two men (aged 57.88±6.20 years) were divided into two training groups, CAD-T (n= 12) and RF-T (n= 10), and two control groups, CAD-C (n= 10) and RF-C (n=10). Heart rate and RR intervals in the supine position, cardiopulmonary exercise tests, and hs-CRP levels were measured before and after IT. HRV was analyzed by spectral and symbolic analysis. The CAD-T and RF-T underwent a 16-week IT program of three weekly sessions at training intensities based on the VAT. Results: In the RF-T, cardiac sympathetic modulation index and hs-CRP decreased (p<0.02), while cardiac parasympathetic modulation index increased (p<0.02). In the CAD-T, cardiac parasympathetic modulation index increased, while hs-CRP, systolic, and diastolic blood pressures decreased (p<0.02). Both control groups showed increase in hs-CRP parameters (p<0.02). There was a strong and significant association between parasympathetic and sympathetic modulations with hs-CRP. Conclusion: The IT program based on the VAT promoted a decrease in hs-CRP associated with improvement in cardiac autonomic modulation. PMID:26647745

  20. Safety and efficacy of IIb/IIIa inhibitors in combination with highly active oral antiplatelet regimens in acute coronary syndromes: A meta-analysis of pivotal trials.

    PubMed

    Roule, Vincent; Agueznai, Moaad; Sabatier, Rémi; Blanchart, Katrien; Lemaître, Adrien; Ardouin, Pierre; Collet, Jean-Philippe; Milliez, Paul; Montalescot, Gilles; Beygui, Farzin

    2016-09-22

    The risk and benefit of GP-IIb/IIIa Inhibition (GPI) in combination with recent antiplatelet regimens in acute coronary syndromes (ACS) remain unassessed. The advent of fast-acting highly active oral P2Y12 inhibitors questions the additional value and risk of their association with GPI. We studied the effect of GPI in combination with prasugrel and ticagrelor, compared to clopidogrel on major bleeding in pivotal randomized controlled trials in the setting of ACS, using a meta-analytic approach. A similar analysis, further including the comparison of a double versus standard dose clopidogrel regimen, was performed for the risk of the primary efficacy endpoint. The combination of GPI and recent P2Y12 inhibitors was associated with a similar risk of bleeding as compared with GPI and the standard clopidogrel regimen (RR 0.92 [0.74; 1.13]). The benefit of recent regimens, including double dose clopidogrel, in reducing the primary ischemic endpoint (RR 0.86 [0.78; 0.94]) persisted in those treated with GPI. Although GPI use was associated with a consistent increase in the risk of bleeding in both recent (RR 1.27 [1.05-1.55]) and standard regimens (RR 2.01 [1.64-2.47]), the relative magnitude of such an increase was lower in association with prasugrel or ticagrelor as compared with clopidogrel. The risk of bleeding using a combination of GPI and oral antiplatelet regimens is mainly related to the use of GPI and not the oral antiplatelet regimen. Considering the absence of increased risk of bleeding and the persistence of the benefit of recent P2Y12 regimens in combination with GPI as compared with the standard clopidogrel regimen, the use of such a combination within the guidelines is supported by our findings.

  1. Prasugrel Results in Higher Decrease in High-Sensitivity C-Reactive Protein Level in Patients Undergoing Percutaneous Coronary Intervention Comparing to Clopidogrel

    PubMed Central

    Hajsadeghi, Shokoufeh; Chitsazan, Mandana; Chitsazan, Mitra; Salehi, Negar; Amin, Ahmad; Bidokhti, Arash Amin; Babaali, Nima; Bordbar, Armin; Hejrati, Maral; Moghadami, Samar

    2016-01-01

    OBJECTIVES A growing body of clinical and laboratory evidence indicates that inflammation plays a crucial role in atherosclerosis. In the present study, we compared the effects of clopidogrel and prasugrel on high-sensitivity C-reactive protein (hs-CRP) in patients undergoing percutaneous coronary intervention (PCI). METHODS The present randomized, double-blind clinical trial included 120 patients who underwent PCI. Eligible patients were randomly assigned 2:1 to one of the two groups: 80 patients in the first group received clopidogrel (Plavix®; loading dose and maintenance dose of 300 and 75 mg daily, respectively) and 40 patients in the second group received prasugrel (Effient®; loading dose and maintenance dose of 60 and 10 mg, respectively) for 12 weeks. The hs-CRP levels between baseline and 12th week were compared. RESULTS Of the 120 patients, 69 patients (57.5%) were male. Pretreatment hs-CRP level was statistically comparable in clopidogrel (median, 15.10 mg/dL; interquartile range [IQR], 9.62–23.75 mg/dL) and prasugrel groups (median, 18 mg/dL; IQR, 14.25–22 mg/dL; P = 0.06). Patients taking clopidogrel showed a significant reduction in hs-CRP level compared with the baseline values (P < 0.001). Prasugrel administration also resulted in a significant reduction in hs-CRP level (P < 0.001). A significant 73% overall reduction in the hs-CRP level was seen with prasugrel compared with 39% overall reduction in hs-CRP level with clopidogrel (P = 0.002). CONCLUSION Prasugrel seems to be superior to clopidogrel in the reduction of hs-CRP in patients undergoing PCI. PMID:27597810

  2. Prognostic Impact of Baseline High-Sensitivity C-Reactive Protein in Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention Based on Body Mass Index

    PubMed Central

    Ahmed, Khurshid; Chakraborty, Rabin; Cho, Kyung Hoon; Sim, Doo Sun; Hong, Young Joon; Ahn, Youngkeun; Hachinohe, Daisuke; Cho, Myeong Chan; Kim, Chong Jin; Kim, Young Jo

    2012-01-01

    Background and Objectives Serum high sensitivity C-reactive protein (hs-CRP) is a marker of inflammation and may lead to the development of atherosclerosis, adversely affecting mortality. The aim of this study was to evaluate the relationship between baseline hs-CRP level and 12-month clinical outcomes in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) according to their body mass index (BMI) status. Subjects and Methods Using data from the Korea Acute Myocardial Infarction Registry from November 2005 to September 2008, a total of 8174 consecutive AMI patients were studied. Cox proportional hazard model revealed that higher baseline levels of hs-CRP was associated with 12-month all-cause mortality (p=0.045). To further understand this association, patients were divided into 3 groups based on their body mass index: 1) overweight/obese, 2) normal weight, and 3) underweight patients. Then each group was stratified into quartiles based on their hs-CRP. Results In overweight/obese patients, Cox model showed significant association of hs-CRP with 12-month mortality when adjusted for age and gender (p<0.001), however, after adjustment with multiple covariates, mortality was highest in the 4th quartile {HR 2.382, (1.079-5.259), p=0.032} though statistically insignificant (p=0.172). We observed no significant association of serum hs-CRP with 12-month mortality in normal weight (p=0.681) and underweight (p=0.760) patients. Conclusion Higher baseline hs-CRP level (≥4.08 mg/dL) in overweight/obese AMI patients showed significant association with 12-month all-cause mortality independent of other prognostic markers. PMID:22493611

  3. Comparative Efficacy and Safety of Prasugrel, Ticagrelor, and Standard-Dose and High-Dose Clopidogrel in Patients Undergoing Percutaneous Coronary Intervention: A Network Meta-analysis.

    PubMed

    Singh, Sukhchain; Singh, Mukesh; Grewal, Navsheen; Khosla, Sandeep

    2016-01-01

    Authors aimed to compare efficacy and safety of prasugrel, ticagrelor, and standard-dose (SD) and high-dose (HD) clopidogrel in patients undergoing percutaneous coronary intervention (PCI). PubMed, EMBASE, CENTRAL, and clinicaltrials.gov were searched for studies comparing prasugrel, ticagrelor, SD and HD clopidogrel in patients undergoing PCI. Frequentist and Bayesian network meta-analyses were performed besides direct pairwise comparisons. Thirty trials, comprising 34,563 person-year data, were included. Prasugrel emerged as a best drug to prevent definite or probable stent thrombosis, followed by HD clopidogrel and ticagrelor, with SD clopidogrel being the worst. Myocardial infarction was least likely to be prevented by SD clopidogrel after PCI, and remaining 3 were superior to it with little difference among them. SD clopidogrel was least effective in preventing cardiovascular deaths after PCI. Prasugrel was most effective in preventing cardiovascular deaths, although having only small advantage over ticagrelor and HD clopidogrel. Ticagrelor reduced all-cause mortality by a small margin compared with rest of treatments. SD clopidogrel, followed by ticagrelor, resulted in significantly lower thrombolysis in myocardial infarction major bleeding complications compared with prasugrel. Analysis of any bleeding revealed similar trend. HD clopidogrel performed better than prasugrel in terms of bleeding complications. In conclusion, Prasugrel is likely most effective drug to prevent post-PCI ischemic events but at the expense of higher bleeding. Ticagrelor followed by HD clopidogrel seems to strike the right balance between efficacy and safety. HD clopidogrel can be considered as an alternative to newer P2Y12 inhibitors.

  4. Low MMP-8/TIMP-1 reflects left ventricle impairment in takotsubo cardiomyopathy and high TIMP-1 may help to differentiate it from acute coronary syndrome

    PubMed Central

    Parkkonen, Olavi; Nieminen, Mikko T.; Vesterinen, Paula; Tervahartiala, Taina; Perola, Markus; Salomaa, Veikko; Jousilahti, Pekka; Sorsa, Timo; Pussinen, Pirkko J.; Sinisalo, Juha

    2017-01-01

    Background Matrix metalloproteinase 8 (MMP-8) is the most potent type-I collagen protease. Such collagen mainly constitutes the transient fibrosis in takotsubo cardiomyopathy (TTC) endomyocardial biopsies. High MMP-8 and tissue-inhibitor of matrix metalloproteinase-1 (TIMP-1) levels are implicated in acute coronary syndrome (ACS). We compared MMP-8 and TIMP-1 levels in consecutive TTC and ACS patients, and their association to TTC severity. Methods and results In 45 acute serum samples of TTC, 2072 ACS and 1000 controls, TIMP-1 differed between ACS 146.7ng/mL (115.0–186.3) (median (interquartile range)), TTC 115.7 (94.3–137.7) and controls 80.9 (73.2–90.4), (p<0.0001). MMP-8 levels were similar between ACS and TTC. In receiver-operating characteristics analysis, TIMP-1 differentiated TTC from ACS with an area under the curve (AUC) of 0.679 (p<0.0001) surpassing troponin T (TnT) at 0.522 (p = 0.66). Compared to other differing factors (age, sex, smoking), TIMP-1 improved diagnostic specificity and sensitivity from AUC of 0.821 to 0.844 (p = 0.007). The MMP8/TIMP-1 molar ratio differentiated normal ejection fraction (EF) at 0.27 (0.13–0.51) from decreased EF<50% at 0.08 (0.05–0.20), (p = 0.04) in TTC, but not in ACS. Conclusions Even with other differing factors considered, TIMP-1 differentiated TTC from ACS better than TnT. In TTC, the low MMP-8/TIMP-1 molar ratio may reflect decreased proteolysis and increased transient fibrosis, perhaps in part explaining the left-ventricle impairment. PMID:28278213

  5. High-sensitivity cardiac troponin T and secondary events in outpatients with coronary heart disease from the Heart and Soul Study

    PubMed Central

    Beatty, Alexis L.; Ku, Ivy A.; Christenson, Robert H.; DeFilippi, Christopher R.; Schiller, Nelson B.; Whooley, Mary A.

    2013-01-01

    Context Levels of high-sensitivity cardiac troponin T (hs-cTnT) predict secondary cardiovascular events in patients with stable coronary heart disease (CHD). Objectives To determine the association of hs-cTnT with structural and functional measures of heart disease and the extent to which these measures explain the relationship between hs-cTnT and secondary events. Design, Setting, and Participants We measured serum concentrations of hs-cTnT and performed exercise treadmill testing with stress echocardiography in a prospective cohort study of 984 outpatients with CHD who were enrolled between September 2000 and December 2002 and followed for a median of 8.2 years. Main Outcomes Measures Cardiovascular events (myocardial infarction, heart failure, or cardiovascular death), determined by review of medical records and death certificates. Results Of 984 participants, 794 (80.7%) had detectable hs-cTnT levels. At baseline, higher hs-cTnT was associated with greater inducible ischemia and with worse left ventricular ejection fraction, left atrial function, diastolic function, left ventricular mass, and treadmill exercise capacity. During follow-up, 317 participants (32.2%) experienced a cardiovascular event. After adjustment for clinical risk factors, baseline cardiac structure and function, and other biomarkers (NT-proBNP and C-reactive protein), each doubling in hs-cTnT remained associated with a 37% higher rate of cardiovascular events (HR 1.37, 95%CI 1.14, 1.65; P=0.001). Conclusions In outpatients with stable CHD, higher hs-cTnT levels were associated with multiple abnormalities of cardiac structure and function but remained independently predictive of secondary events. These findings suggest that hs-cTnT may detect an element of risk that is not captured by existing measures of cardiac disease severity. PMID:23568589

  6. Beneficial Effects of Reconstituted High-Density Lipoprotein (rHDL) on Circulating CD34+ Cells in Patients after an Acute Coronary Syndrome

    PubMed Central

    Berry, Colin; Brand, Geneviève; Kernaleguen, Anne-Elen; Théberge-Julien, Gabriel; Alam, Mohammad Afaque; Lee, Candace Y. W.; Boileau, Laurianne; Chabot-Blanchet, Malorie; Guertin, Marie-Claude; Lavoie, Marc-André; Grégoire, Jean; Ibrahim, Réda; L'Allier, Philippe

    2017-01-01

    Background High-density lipoproteins (HDL) favorably affect endothelial progenitor cells (EPC). Circulating progenitor cell level and function are impaired in patients with acute coronary syndrome (ACS). This study investigates the short-term effects of reconstituted HDL (rHDL) on circulating progenitor cells in patients with ACS. Methods and Findings The study population consisted of 33 patients with recent ACS: 20 patients from the ERASE trial (randomized to receive 4 weekly intravenous infusions of CSL-111 40 mg/kg or placebo) and 13 additional patients recruited as controls using the same enrolment criteria. Blood was collected from 16 rHDL (CSL-111)-treated patients and 17 controls at baseline and at 6–7 weeks (i.e. 2–3 weeks after the fourth infusion of CSL-111 in ERASE). CD34+ and CD34+/kinase insert domain receptor (KDR+) progenitor cell counts were analyzed by flow cytometry. We found preserved CD34+ cell counts in CSL-111-treated subjects at follow-up (change of 1.6%), while the number of CD34+ cells was reduced (-32.9%) in controls (p = 0.017 between groups). The level of circulating SDF-1 (stromal cell-derived factor-1), a chemokine involved in progenitor cell recruitment, increased significantly (change of 21.5%) in controls, while it remained unchanged in CSL-111-treated patients (p = 0.031 between groups). In vitro exposure to CSL-111 of early EPC isolated from healthy volunteers significantly increased CD34+ cells, reduced early EPC apoptosis and enhanced their migration capacity towards SDF-1. Conclusions The relative increase in circulating CD34+ cells and the low SDF-1 levels observed following rHDL infusions in ACS patients point towards a role of rHDL in cardiovascular repair mechanisms. PMID:28060837

  7. [Optimal dose of bivalirudin in dialysis patients at high risk of heparin-induced thrombocytopenia undergoing percutaneous coronary intervention: case report].

    PubMed

    Notarangelo, Maria Francesca; Coppini, Lucia; Bontardelli, Federico; Boffetti, Francesca; Vignali, Luigi; Ardissino, Diego

    2013-02-01

    Bivalirudin is a direct thrombin inhibitor that has been approved for use in patients with or at risk for heparin-induced thrombocytopenia undergoing percutaneous coronary intervention. The efficacy of bivalirudin has been well documented in the setting of percutaneous coronary intervention, but there are only few data on its use in chronic dialysis-dependent patients. Bivalirudin is mainly eliminated enzymatically (80%) and to a lesser extent renally (20%). Nevertheless, in patients with chronic kidney disease a substantial increase in coagulation time and bleeding complications has been reported. Therefore, dosage adjustments may be necessary in patients with renal impairment. Dosing and monitoring recommendations in dialysis patients have not yet been established. We describe the case of a 77-year-old man with non-ST-elevation acute coronary syndrome complicated by heparin-induced thrombocytopenia and acute renal failure requiring dialysis treatment. During percutaneous coronary intervention, anticoagulant therapy with bivalirudin was administered at non-standard doses, though already documented in the literature.

  8. Grading atherosclerosis in aorta and coronary arteries obtained at autopsy

    PubMed Central

    Uemura, Kazuo; Sternby, Nils; Vaněček, Rudolf; Vihert, Anatoli; Kagan, Aubrey

    1964-01-01

    A method of assessing “atherosclerosis”, if used according to certain rules, was shown in an earlier study to be capable of discriminating between groups of aortas or coronary arteries according to the quantity of certain defined lesions. It would not measure absolute amounts, but would show whether one group of specimens had more or less of the factor assessed than another and would indicate the statistical significance of this finding according to the number of specimens in each group. The method has now been applied to a study of material from six communities in three countries. This paper outlines how the rules of procedure were applied. Intra-observer and inter-observer calibration tests carried out in a routine manner during four “grading sessions” and inter-sessional tests are described. The discriminatory power in comparing groups of specimens from nearly 3000 subjects is calculated and shown according to artery (thoracic aorta, descending aorta, right coronary, left anterior descending coronary, left circumflex coronary) and type of lesion (“total amount of atherosclerosis”, “fatty streak”, “fibrous plaque”, “complicated lesion” and “calcification”). Observations on “coronary stenosis” were also made. The discriminatory power of the method was calculated for this factor and, contrary to many expectations, was found to be of practical value. Definitions and general procedure are described in annexes. ImagesFIG. 13FIG. 14FIG. 15PLATE 1PLATE 2 PMID:14267740

  9. Percutaneous transluminal coronary angioplasty (PTCA)

    MedlinePlus Videos and Cool Tools

    Percutaneous transluminal coronary angioplasty (PTCA) is a minimally invasive procedure to open up blocked coronary arteries, allowing blood to circulate unobstructed to the heart muscle. The procedure begins with ...

  10. Functional Testing Underlying Coronary Revascularisation

    ClinicalTrials.gov

    2016-10-04

    Multivessel Coronary Artery Disease; Vessel Disease; Stable Angina; Unstable Angina or Stabilized Non-ST Elevated Myocardial Infarction; Patients With ST-elevated Myocardial Infarction; Revascularization of Culprit Coronary Artery

  11. Coronary artery balloon angioplasty - slideshow

    MedlinePlus

    ... page: //medlineplus.gov/ency/presentations/100160.htm Coronary artery balloon angioplasty - series—Normal anatomy To use the ... slide 9 out of 9 Overview The coronary arteries supply blood to the heart muscle. The right ...

  12. ON A SUFFICIENT CONDITION FOR ABSOLUTE CONTINUITY.

    DTIC Science & Technology

    The formulation of a condition which yields absolute continuity when combined with continuity and bounded variation is the problem considered in the...Briefly, the formulation is achieved through a discussion which develops a proof by contradiction of a sufficiently theorem for absolute continuity which uses in its hypothesis the condition of continuity and bounded variation .

  13. Introducing the Mean Absolute Deviation "Effect" Size

    ERIC Educational Resources Information Center

    Gorard, Stephen

    2015-01-01

    This paper revisits the use of effect sizes in the analysis of experimental and similar results, and reminds readers of the relative advantages of the mean absolute deviation as a measure of variation, as opposed to the more complex standard deviation. The mean absolute deviation is easier to use and understand, and more tolerant of extreme…

  14. Absolute GPS Positioning Using Genetic Algorithms

    NASA Astrophysics Data System (ADS)

    Ramillien, G.

    A new inverse approach for restoring the absolute coordinates of a ground -based station from three or four observed GPS pseudo-ranges is proposed. This stochastic method is based on simulations of natural evolution named genetic algorithms (GA). These iterative procedures provide fairly good and robust estimates of the absolute positions in the Earth's geocentric reference system. For comparison/validation, GA results are compared to the ones obtained using the classical linearized least-square scheme for the determination of the XYZ location proposed by Bancroft (1985) which is strongly limited by the number of available observations (i.e. here, the number of input pseudo-ranges must be four). The r.m.s. accuracy of the non -linear cost function reached by this latter method is typically ~10-4 m2 corresponding to ~300-500-m accuracies for each geocentric coordinate. However, GA can provide more acceptable solutions (r.m.s. errors < 10-5 m2), even when only three instantaneous pseudo-ranges are used, such as a lost of lock during a GPS survey. Tuned GA parameters used in different simulations are N=1000 starting individuals, as well as Pc=60-70% and Pm=30-40% for the crossover probability and mutation rate, respectively. Statistical tests on the ability of GA to recover acceptable coordinates in presence of important levels of noise are made simulating nearly 3000 random samples of erroneous pseudo-ranges. Here, two main sources of measurement errors are considered in the inversion: (1) typical satellite-clock errors and/or 300-metre variance atmospheric delays, and (2) Geometrical Dilution of Precision (GDOP) due to the particular GPS satellite configuration at the time of acquisition. Extracting valuable information and even from low-quality starting range observations, GA offer an interesting alternative for high -precision GPS positioning.

  15. Lower coronary plaque burden in patients with HIV presenting with acute coronary syndrome

    PubMed Central

    O'Dwyer, E J; Bhamra-Ariza, P; Rao, S; Emmanuel, S; Carr, A; Holloway, C J

    2016-01-01

    Objective Treated HIV infection is associated with a higher incidence of coronary artery disease and myocardial infarction, although the mechanisms remain unclear. We sought to characterise the burden of coronary artery disease in men with HIV using retrospective data from invasive coronary angiograms in patients presenting with acute coronary syndrome (ACS). Methods Demographic and coronary angiographic data were obtained from 160 men with ST elevation myocardial infarction, non-STEMI or high-risk chest pain; 73 HIV-infected cases and 87 age-matched controls. The burden of coronary disease was calculated using the Gensini Angiographic Scoring System by 2 independent cardiologists blinded to HIV status. Results The 2 groups were matched for age, sex and cardiac event subtype and there was no difference in rates of smoking or cholesterol levels. Compared with control participants, patients with HIV had higher usage of antihypertensives (46 (63%) vs 30 (35%), p<0.001) and statins (47 (64%) vs 29 (33%), p<0.001). There was no difference in plaque distribution between both groups; however, the Gensini score was 42% lower in cases with HIV than in controls (p<0.03). C reactive protein was higher in cases with HIV (13.4±15.4 vs 3.7±3.6). Conclusions Men with HIV presenting with ACS paradoxically had a lower burden of coronary plaque than matched controls, despite more aggressive risk factor management, suggesting that plaque vulnerability, rather than total burden of atherosclerosis, may be important in the pathophysiology of coronary artery disease in men with HIV. PMID:28123757

  16. LPA rs10455872 polymorphism is associated with coronary lesions in Brazilian patients submitted to coronary angiography

    PubMed Central

    2014-01-01

    Background Polymorphisms in the LPA gene were associated with coronary artery disease (CAD). However, there are differences in the allelic frequencies, Lp(a) levels, and significant association with CAD according to ethnic groups. In this scenario, the main aim of this study was to assess the influence of the LPA polymorphisms on coronary lesions in Brazilian patients. Methods 1,394 consecutive patients submitted to coronary angiography to study suggestive CAD and twenty coronary segments were scored. Genotyping for the LPA rs10455872 and rs3798220 polymorphisms were performed by high resolution melting analysis. Results The frequencies of the rs10455872 G and rs3798220 C variant alleles were 6.4% and 6.2%, respectively. LPA rs10455872 G variant allele was associated with higher odds ratio of having coronary lesions in an adjusted model (OR = 2.02, 95% CI = 1.10-3.72, p = 0.02). Scores of coronary lesions (extension, severity, and Gensini scores) were significantly different among rs10455872 genotype groups. Coronary lesions was not associated with LPA rs3798220 (OR = 1.09, 95% CI = 0.67-1.76, p = 0.73) and scores of coronary lesions were not different among rs3798220 genotypes. Conclusions We confirmed the association of the LPA rs10455872 with CAD in a large sample of Brazilian patients. For the LPA rs3798220, our finding is consistent with studies which showed the lack of this genetic association. PMID:24776095

  17. Evaluation of Coronary Artery Status by Coronary Angiography after First Survival of Acute Myocardial Infarction

    PubMed Central

    Jain, Siddhant; Sarkar, Piyabi; Modi, Nitin; Tilkar, Mahendra

    2015-01-01

    Introduction Acute Myocardial Infarction (AMI) is a life threatening medical emergency which needs urgent medical attention. It is one of the major cause of mortality and morbidity throughout the world. Aim The aim of the present study was to assess the coronary artery status by Coronary Angiography (CAG) after first survival of the Acute Myocardial Infarction (AMI) and to correlate the CAG findings with Coronary Artery Disease (CAD) Risk Factor (RF) and effect of early thrombolysis. Materials and Methods CAG was done on 870 patients consecutively from June 2013 to May 2015. Age, Gender, Body Mass Index (BMI), CAD risk factors (RF) such as Type 2 diabetes mellitus (T2 DM), hypertension, dyslipidaemia, smoking status and history of thrombolyctic status were recorded. The correlation between the CAD risk factors (RF) and the CAG findings were statistically analyzed. Results Coronary heart disease risk factors analysis revealed ≥ three RF in 23.88%, two RF in 29.88% and one RFin 45.86% of patients. CAG showed Single Vessel Disease (SVD) in 236 (27.1%) patients, double vessel disease (DVD) in 220(25.2%) patients, Triple Vessel Disease (TVD) in 252 (28.9%) patients. Multiple coronary artery involvement were found in the high risk group patients, which was found statistically significant (p-value<0.0001). A total of 348/870 (40%) patients were thrombolysed amongst them 80 (22.9%) revealed minimal and/or normal coronary artery which was found statistically significant (p-value<0.0001). Conclusion Higher the coronary risk factors, more the chance of the multiple coronary arteries involvement. All AMI patients should be thrombolysed as early as possible to get the benefit of recanalization of the culprit vessel. PMID:26816930

  18. Computational fluid dynamics in coronary artery disease.

    PubMed

    Sun, Zhonghua; Xu, Lei

    2014-12-01

    Computational fluid dynamics (CFD) is a widely used method in mechanical engineering to solve complex problems by analysing fluid flow, heat transfer, and associated phenomena by using computer simulations. In recent years, CFD has been increasingly used in biomedical research of coronary artery disease because of its high performance hardware and software. CFD techniques have been applied to study cardiovascular haemodynamics through simulation tools to predict the behaviour of circulatory blood flow in the human body. CFD simulation based on 3D luminal reconstructions can be used to analyse the local flow fields and flow profiling due to changes of coronary artery geometry, thus, identifying risk factors for development and progression of coronary artery disease. This review aims to provide an overview of the CFD applications in coronary artery disease, including biomechanics of atherosclerotic plaques, plaque progression and rupture; regional haemodynamics relative to plaque location and composition. A critical appraisal is given to a more recently developed application, fractional flow reserve based on CFD computation with regard to its diagnostic accuracy in the detection of haemodynamically significant coronary artery disease.

  19. Reducing time to angiography and hospital stay for patients with high-risk non-ST-elevation acute coronary syndrome: retrospective analysis of a paramedic-activated direct access pathway

    PubMed Central

    Koganti, S; Patel, N; Seraphim, A; Kotecha, T; Whitbread, M; Rakhit, R D

    2016-01-01

    Objective To assess whether a novel ‘direct access pathway’ (DAP) for the management of high-risk non-ST-elevation acute coronary syndromes (NSTEACS) is safe, results in ‘shorter time to intervention and shorter admission times’. This pathway was developed locally to enable London Ambulance Service to rapidly transfer suspected high-risk NSTEACS from the community to our regional heart attack centre for consideration of early angiography. Methods This is a retrospective case–control analysis of 289 patients comparing patients with high-risk NSTEACS admitted via DAP with age-matched controls from the standard pan-London high-risk ACS pathway (PLP) and the conventional pathway (CP). The primary end point of the study was time from admission to coronary angiography/intervention. Secondary end point was total length of hospital stay. Results Over a period of 43 months, 101 patients were admitted by DAP, 109 matched patients by PLP and 79 matched patients through CP. Median times from admission to coronary angiography for DAP, PLP and CP were 2.8 (1.5–9), 16.6 (6–50) and 60 (33–116) hours, respectively (p<0.001). Median length of hospital stay for DAP and PLP was similar at 3.0 (2.0–5.0) days in comparison to 5 (3–7) days for CP (p<0.001). Conclusions DAP resulted in a significant reduction in time to angiography for patients with high-risk NSTEACS when compared to existing pathways. PMID:27324709

  20. Absolute instability of the Gaussian wake profile

    NASA Technical Reports Server (NTRS)

    Hultgren, Lennart S.; Aggarwal, Arun K.

    1987-01-01

    Linear parallel-flow stability theory has been used to investigate the effect of viscosity on the local absolute instability of a family of wake profiles with a Gaussian velocity distribution. The type of local instability, i.e., convective or absolute, is determined by the location of a branch-point singularity with zero group velocity of the complex dispersion relation for the instability waves. The effects of viscosity were found to be weak for values of the wake Reynolds number, based on the center-line velocity defect and the wake half-width, larger than about 400. Absolute instability occurs only for sufficiently large values of the center-line wake defect. The critical value of this parameter increases with decreasing wake Reynolds number, thereby indicating a shrinking region of absolute instability with decreasing wake Reynolds number. If backflow is not allowed, absolute instability does not occur for wake Reynolds numbers smaller than about 38.

  1. [Coronary angioplasty today].

    PubMed

    Metzger, J P

    1991-10-01

    The rise of coronary angioplasty has been rapid in the last ten years. It is a method of myocardial revascularisation without thoracotomy or cardiopulmonary bypass and is curative in the absence of restenosis. Recent advances concern the development of the material and the pharmacological support which reduce the risk of coronary thrombosis during the procedure. The primary success rate now approaches 90%, that of emergency bypass surgery less than 5%. The use of autoperfusion catheters and the use of intra-aortic balloon pumping improve the safety of the procedure but surgical stand-by remains a necessity in cases of dilatation of proximal main coronary stenosis. Stable and unstable angina are the main indications of a technique particularly appropriate for elderly patients and the treatment of residual post-thrombolytic stenoses, post-radic stenosis or stenosis of a single functional coronary artery. Restenosis is observed in 30 to 40% of cases during the first six months after the dilatation. Its occurrence is not influenced by any of the drugs tested but it could be reduced by the insertion of an endocoronary stent. Abrasive endocoronary techniques and laser angioplasty are alternative methods of treating coronary stenoses inaccessible to conventional balloon angioplasty but they do not reduce the risk of restenosis.

  2. STS-9 Shuttle grow - Ram angle effect and absolute intensities

    NASA Technical Reports Server (NTRS)

    Swenson, G. R.; Mende, S. B.; Clifton, K. S.

    1986-01-01

    Visible imagery from Space Shuttle mission STS-9 (Spacelab 1) has been analyzed for the ram angle effect and the absolute intensity of glow. The data are compared with earlier measurements and the anomalous high intensities at large ram angles are confirmed. Absolute intensities of the ram glow on the shuttle tile, at 6563 A, are observed to be about 20 times more intense than those measured on the AE-E spacecraft. Implications of these observations for an existing theory of glow involving NO2 are presented.

  3. Cardiovascular magnetic resonance of anomalous coronary arteries.

    PubMed

    Varghese, Anitha; Keegan, Jennifer; Pennell, Dudley J

    2005-09-01

    Cardiovascular magnetic resonance of anomalous coronary arteries is a class I indication. The term anomalous coronary artery encompasses those with an abnormal origin (from the incorrect sinus, too-high or too-low from the correct sinus, or from the pulmonary artery) and/or number of ostia. Their clinical significance results from the increased risk of myocardial infarction and sudden cardiac death associated with those traversing an interarterial course between the aorta and main pulmonary artery/right ventricular outflow tract. In this article, we review the role and practice of cardiovascular magnetic resonance in this field.

  4. Intravascular Optical Imaging Technology for Investigating the Coronary Artery

    PubMed Central

    Suter, Melissa J.; Nadkarni, Seemantini K.; Weisz, Giora; Tanaka, Atsushi; Jaffer, Farouc A.; Bouma, Brett E.; Tearney, Guillermo J.

    2012-01-01

    There is an ever-increasing demand for new imaging methods that can provide additional information about the coronary wall to better characterize and stratify high-risk plaques, and to guide interventional and pharmacologic management of patients with coronary artery disease. While there are a number of imaging modalities that facilitate the assessment of coronary artery pathology, this review paper focuses on intravascular optical imaging modalities that provide information on the microstructural, compositional, biochemical, biomechanical, and molecular features of coronary lesions and stents. The optical imaging modalities discussed include angioscopy, optical coherence tomography, polarization sensitive-optical coherence tomography, laser speckle imaging, near-infrared spectroscopy, time-resolved laser induced fluorescence spectroscopy, Raman spectroscopy, and near-infrared fluorescence molecular imaging. Given the wealth of information that these techniques can provide, optical imaging modalities are poised to play an increasingly significant role in the evaluation of the coronary artery in the future. PMID:21920342

  5. Northern contaminant mixtures induced morphological and functional changes in human coronary artery endothelial cells under culture conditions typifying high fat/sugar diet and ethanol exposure.

    PubMed

    Florian, Maria; Yan, Jin; Ulhaq, Saad; Coughlan, Melanie; Laziyan, Mahemuti; Willmore, William; Jin, Xiaolei

    2013-11-16

    It has been reported that Northern populations are exposed to mixtures of various environmental contaminants unique to the Arctic (Northern contaminant mixtures - NCM) at a large range of concentrations, depending on their geological location, age, lifestyle and dietary habits. To determine if these contaminants may contribute to a cardiovascular health risk, especially when combined with a high fat and sugar diet and ethanol exposure, we treated human coronary artery endothelial cells (HCAEC) with two mixtures of 4 organic (NCM1) or 22 organic and inorganic (NCM2) chemicals detected in Northerners' blood during 2004-2005 in the presence or absence of low-density lipoprotein (1.5mg/ml), very-low-density lipoprotein (1.0mg/ml) and glucose (10mmol/L) (LVG), and in the absence or presence of 0.1% ethanol. After 24h of exposure, cell morphology and markers of cytotoxicity and endothelial function were examined. NCM1 treatment did not affect cell viability, but increased cell size, disrupted cell membrane integrity, and decreased cell density, uptake of small peptides, release of endothelin-1 (ET-1) and plasminogen activator inhibitor (PAI), while causing no changes in endothelial nitric oxide synthase (eNOS) protein expression and nitric oxide (NO) release. In contrast, NCM2 decreased cell viability, total protein yield, uptake of small peptides, eNOS protein expression, and NO release and caused membrane damage, but caused no changes in the secretion of ET-1, prostacyclin and PAI. The presence of LVG and/or alcohol did or did not influence the effects of NCM1 or NCM2 depending on the endpoint and the mixture examined. These results suggested that the effects of one or one group of contaminants may be altered by the presence of other contaminants, and that with or without the interaction of high fat and sugar diet and/or ethanol exposure, NCMs at the concentrations used caused endothelial dysfunction in vitro. It remains to be investigated if these effects of NCMs also

  6. Spontaneous coronary artery dissection.

    PubMed

    Giacoppo, Daniele; Capodanno, Davide; Dangas, George; Tamburino, Corrado

    2014-07-15

    Spontaneous coronary artery dissection (SCAD) is a relatively rare and unexplored type of coronary disease. Although atherosclerosis, hormonal changes during pregnancy and connective tissue disorders might represent a sufficiently convincing explanation for some patients with SCAD, the many remaining cases display only a weak relationship with these causes. While on one side the clinical heterogeneity of SCAD masks a full understanding of their underlying pathophysiologic process, on the other side paucity of data and misleading presentations hamper the quick diagnosis and optimal management of this condition. A definite diagnosis of SCAD can be significantly facilitated by endovascular imaging techniques. In fact, intravascular ultrasound (IVUS) and optical coherence tomography (OCT) overcome the limitations of coronary angiography providing detailed endovascular morphologic information. In contrast, optimal treatment strategies for SCAD still represent a burning controversial question. Herein, we review the published data examining possible causes and investigating the best therapy for SCAD in different clinical scenarios.

  7. Absolute realization of low BRDF value

    NASA Astrophysics Data System (ADS)

    Liu, Zilong; Liao, Ningfang; Li, Ping; Wang, Yu

    2010-10-01

    Low BRDF value is widespread used in many critical domains such as space and military fairs. These values below 0.1 Sr-1 . So the Absolute realization of these value is the most critical issue in the absolute measurement of BRDF. To develop the Absolute value realization theory of BRDF , defining an arithmetic operators of BRDF , achieving an absolute measurement Eq. of BRDF based on radiance. This is a new theory method to solve the realization problem of low BRDF value. This theory method is realized on a self-designed common double orientation structure in space. By designing an adding structure to extend the range of the measurement system and a control and processing software, Absolute realization of low BRDF value is achieved. A material of low BRDF value is measured in this measurement system and the spectral BRDF value are showed within different angles allover the space. All these values are below 0.4 Sr-1 . This process is a representative procedure about the measurement of low BRDF value. A corresponding uncertainty analysis of this measurement data is given depend on the new theory of absolute realization and the performance of the measurement system. The relative expand uncertainty of the measurement data is 0.078. This uncertainty analysis is suitable for all measurements using the new theory of absolute realization and the corresponding measurement system.

  8. Socioeconomic inequalities in coronary heart disease risk in older age: contribution of established and novel coronary risk factors

    PubMed Central

    RAMSAY, S E; MORRIS, R W; WHINCUP, P H; PAPACOSTA, O; RUMLEY, A; LENNON, L; LOWE, G; WANNAMETHEE, S G

    2009-01-01

    Background:Evidence on socioeconomic inequalities in coronary heart disease (CHD) and their pathways in the elderly is limited. Little is also known about the contributions that novel coronary risk factors (particularly inflammatory/hemostatic markers) make to socioeconomic inequalities in CHD. Objectives:To examine the extent of socioeconomic inequalities in CHD in older age, and the contributions (relative and absolute) of established and novel coronary risk factors. Methods:A population-based cohort of 3761 British men aged 60–79 years was followed up for 6.5 years for CHD mortality and incidence (fatal and non-fatal). Social class was based on longest-held occupation recorded at 40–59 years. Results:There was a graded relationship between social class and CHD incidence. The hazard ratio for CHD incidence comparing social class V (unskilled workers) with social class I (professionals) was 2.70 [95% confidence interval (CI) 1.37–5.35; P-value for trend = 0.008]. This was reduced to 2.14 (95% CI 1.06–4.33; P-value for trend = 0.11) after adjustment for behavioral factors (cigarette smoking, physical activity, body mass index, and alcohol consumption), which explained 38% of the relative risk gradient (41% of absolute risk). Additional adjustment for inflammatory markers (C-reactive protein, interleukin-6, and von Willebrand factor) explained 55% of the relative risk gradient (59% of absolute risk). Blood pressure and lipids made little difference to these estimates; results were similar for CHD mortality. Conclusions:Socioeconomic inequalities in CHD persist in the elderly and are at least partly explained by behavioral risk factors; novel (inflammatory) coronary risk markers made some further contribution. Reducing inequalities in behavioral factors (especially cigarette smoking) could reduce these social inequalities by at least one-third. PMID:20015318

  9. Elevation correction factor for absolute pressure measurements

    NASA Technical Reports Server (NTRS)

    Panek, Joseph W.; Sorrells, Mark R.

    1996-01-01

    With the arrival of highly accurate multi-port pressure measurement systems, conditions that previously did not affect overall system accuracy must now be scrutinized closely. Errors caused by elevation differences between pressure sensing elements and model pressure taps can be quantified and corrected. With multi-port pressure measurement systems, the sensing elements are connected to pressure taps that may be many feet away. The measurement system may be at a different elevation than the pressure taps due to laboratory space or test article constraints. This difference produces a pressure gradient that is inversely proportional to height within the interface tube. The pressure at the bottom of the tube will be higher than the pressure at the top due to the weight of the tube's column of air. Tubes with higher pressures will exhibit larger absolute errors due to the higher air density. The above effect is well documented but has generally been taken into account with large elevations only. With error analysis techniques, the loss in accuracy from elevation can be easily quantified. Correction factors can be applied to maintain the high accuracies of new pressure measurement systems.

  10. Age, dental infections, and coronary heart disease.

    PubMed

    Mattila, K J; Asikainen, S; Wolf, J; Jousimies-Somer, H; Valtonen, V; Nieminen, M

    2000-02-01

    Epidemiological and intervention studies have suggested that infections are risk factors for coronary heart disease (CHD). Dental infections have appeared as cardiovascular risk factors in cross-sectional and in follow-up studies, and the association has been independent of the "classic" coronary risk factors. This case-control study aimed at detailed assessment of the dental pathology found in various CHD categories (including elderly patients). Altogether, 85 patients with proven coronary heart disease and 53 random controls, matched for sex, age, geographic area, and socio-economic status, were compared with regard to dental status, assessed blindly with four separate scores, and to the "classic" coronary risk factors (seven of the controls had CHD, and they were not included in the analyses). The dental indices were higher among CHD patients than in the controls, but, contrary to previous studies, the differences were not significant (between the CHD patients and their matched controls or among the different CHD categories). This result could not be explained by potential confounding factors. The participants in the present study were older and had more often undergone recent dental treatment in comparison with subjects in our earlier studies. Age correlated with the severity of dental infections only in the random controls but not in the coronary patients who, although young, already had high dental scores. We believe that the higher age of the participants in the present study is the most likely reason for the results. Other possible explanations include an age-related selection bias among older CHD patients, and the fact that those participating in studies like this may have better general health and thus also less severe dental infections. Thus, the role of dental infections as a coronary risk factor varies according to the characteristics of the population studied.

  11. The relationship between ischemia-induced left ventricular dysfunction, coronary flow reserve, and coronary steal on regadenoson stress-gated 82Rb PET myocardial perfusion imaging

    PubMed Central

    Van Tosh, Andrew; Votaw, John R.; Reichek, Nathaniel; Palestro, Christopher J.; Nichols, Kenneth J.

    2014-01-01

    Background Gated rubidium-82 (82Rb) positron emission tomography (PET) imaging studies are acquired both at rest and during pharmacologic stress. Stress-induced ischemic left ventricular dysfunction (LVD) can produce a significant decrease in left ventricular ejection fraction (LVEF) from rest to stress. We determined the prevalence on PET of stress LVD with reduced ejection fraction (EF) and its association with absolute global and regional coronary flow reserve (CFR), and with relative perfusion defect summed difference score (SDS). Methods and Results We studied 205 patients with known or suspected coronary disease (120 M, 75 F, age 69 ± 13 years) who had clinically indicated rest/regadenoson stress 82Rb PET/CT studies. Data were acquired in dynamic gated list mode. Global and 17-segment regional CFR values were computed from first-pass flow data using a 2-compartment model and factor analysis applied to auto-generated time-activity curves. Rest and stress LVEF and SDS were quantified from gated equilibrium myocardial perfusion tomograms using Emory Cardiac Toolbox software. LVD was defined as a change in LVEF of ≤−5% from rest to stress. A subgroup of 109 patients also had coronary angiography. Stress LVD developed in 32 patients (16%), with mean EF change of −10 ± 5%, vs +6 ± 7% for patients without LVD (P < .0001). EF was similar at rest in patients with and without stress LVD (57 ± 18% vs 56 ± 16%, P = .63), but lower during stress for patients with LVD (47 ± 20% vs 61 ± 16%, P = .0001). CFR was significantly lower in patients with LVD (1.61 ± 0.67 vs 2.21 ± 1.03, Wilcoxon P = .002), and correlated significantly with change in EF (r = 0.35, P < .0001), but not with SDS (r = −0.13, P = .07). The single variable most strongly associated with high risk of CAD (i.e., left main stenosis ≥50%, LAD % stenosis ≥70%, and/or 3-vessel disease) was stress EF (χ2 = 17.3, P < .0001). There was a higher prevalence of patients with territorial CFR

  12. A New Gimmick for Assigning Absolute Configuration.

    ERIC Educational Resources Information Center

    Ayorinde, F. O.

    1983-01-01

    A five-step procedure is provided to help students in making the assignment absolute configuration less bothersome. Examples for both single (2-butanol) and multi-chiral carbon (3-chloro-2-butanol) molecules are included. (JN)

  13. Magnifying absolute instruments for optically homogeneous regions

    SciTech Connect

    Tyc, Tomas

    2011-09-15

    We propose a class of magnifying absolute optical instruments with a positive isotropic refractive index. They create magnified stigmatic images, either virtual or real, of optically homogeneous three-dimensional spatial regions within geometrical optics.

  14. The Simplicity Argument and Absolute Morality

    ERIC Educational Resources Information Center

    Mijuskovic, Ben

    1975-01-01

    In this paper the author has maintained that there is a similarity of thought to be found in the writings of Cudworth, Emerson, and Husserl in his investigation of an absolute system of morality. (Author/RK)

  15. Transradial artery coronary angioplasty.

    PubMed

    Kiemeneij, F; Laarman, G J; de Melker, E

    1995-01-01

    This study explored the feasibility and safety of percutaneous coronary balloon angioplasty (PTCA) with miniaturized PTCA equipment via the radial artery. Coronary angioplasty (PTCA) via the femoral or brachial arteries may be associated with rare vascular complications such as bleeding and damage to the artery and adjacent structures. It was postulated that PTCA via the radial artery with miniaturized angioplasty equipment is feasible and that no major puncture site-related complications occur because hemostasis is obtained easily and because no major structures are near the radial artery. With double blood supply to the hand, radial artery occlusion is well tolerated. In 100 patients with collateral blood supply to the right hand, PTCA was attempted with 6F guiding catheters and rapid-exchange balloon catheters for exertional angina (87 patients) or nonexertional angina (13 patients). Angioplasty was attempted in 122 lesions (type A n = 67 [55%], Type B n = 37 [30%], and type C n = 18 [15%]). Pre- and post-PTCA computerized quantitative coronary analysis was performed. Radial artery function and structure were assessed clinically and with Doppler and two-dimensional ultrasound on the day of discharge. Coronary catheterization via the radial artery was successful in 94 patients (94%). The 6 remaining patients had successful PTCA via the femoral artery (n = 5) or the brachial artery (n = 1). Procedural success (120 of 122 lesions) was achieved in 92 patients (98%) via the radial artery and in 98 patients of the total study population.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Coronary artery disease (image)

    MedlinePlus

    ... through these arteries is critical for the heart. Coronary artery disease usually results from the build-up of fatty material and plaque, a condition called atherosclerosis. As the ... blood to the heart can slow or stop, causing chest pain (stable ...

  17. Coronary covered stents.

    PubMed

    Kilic, Ismail Dogu; Fabris, Enrico; Serdoz, Roberta; Caiazzo, Gianluca; Foin, Nicolas; Abou-Sherif, Sara; Di Mario, Carlo

    2016-11-20

    Covered stents offer an effective bail-out strategy in vessel perforations, are an alternative to surgery for the exclusion of coronary aneurysms, and have a potential role in the treatment of friable embolisation-prone plaques. The aim of this manuscript is to offer an overview of currently available platforms and to report results obtained in prior studies.

  18. Absolute cross sections of compound nucleus reactions

    NASA Astrophysics Data System (ADS)

    Capurro, O. A.

    1993-11-01

    The program SEEF is a Fortran IV computer code for the extraction of absolute cross sections of compound nucleus reactions. When the evaporation residue is fed by its parents, only cumulative cross sections will be obtained from off-line gamma ray measurements. But, if one has the parent excitation function (experimental or calculated), this code will make it possible to determine absolute cross sections of any exit channel.

  19. Kelvin and the absolute temperature scale

    NASA Astrophysics Data System (ADS)

    Erlichson, Herman

    2001-07-01

    This paper describes the absolute temperature scale of Kelvin (William Thomson). Kelvin found that Carnot's axiom about heat being a conserved quantity had to be abandoned. Nevertheless, he found that Carnot's fundamental work on heat engines was correct. Using the concept of a Carnot engine Kelvin found that Q1/Q2 = T1/T2. Thermometers are not used to obtain absolute temperatures since they are calculated temperatures.

  20. [Noninvasive diagnostic of coronary artery disease].

    PubMed

    Zuber, Michel; Zellweger, Michael; Bremerich, Jens; Auf der Mauer, Christoph; Buser, Peter T

    2009-04-01

    investigator independent, does not apply any biologically hazardous energy and has the largest potential for tissue characterization due to its high contrast resolution. It therefore is an excellent technique to investigate all the aspects of coronary artery disease. Its availability is increasing, however in order to fully utilize its large potential an optimal collaboration among -specialist (cardiologists, radiologists, physicists) is mandatory. Cardiac CT has evolved as an excellent method for the depiction of the coronary arteries. Due to its high spatial and time resolution it provides high quality luminography of the coronaries and newer technique are also -investigating plaque composition of diseased coronary arteries. Overestimation of coronary artery stenosis in calcified vessels is an inherent problem of the technique and the risk of radiation exposure has to be weighted against the benefit of non-invasively depicting the coronary arteries. It will be the future task of all specialists in this field to define the most efficient and cost-effective way to apply these excellent techniques for the investigation of all the different aspects of patients with coronary artery disease.

  1. [Digital thermo-coronary angiography--development and validation of the method in comparison with conventional cine-coronary angiography].

    PubMed

    Mohr, F W; Grundfest, W; Litvack, F; Forrester, J; Matloff, J; Kirchhoff, P G

    1989-07-01

    We describe the technique-thermal coronary angiography (TCA)-for real-time assessment of coronary anatomy and flow. The goal of this study was to compare thermal coronary angiography to cine coronary angiography and to validate its value for detecting stenoses. We studied the exposed LAD both in beating and arrested hearts in 11 open-chest pigs by TCA and cine angiography. We used an AGA 782 Thermovision system combined with a TIC 8000 digital image processor providing coronary images with 0.1-0.2 mm spatial and 0.1 degrees C thermal resolution, and a CFR x-ray system. The coronary arteries were catheterized via the right carotid artery, using standard 5F catheters. The thermal camera was focused at a 1m-distance to the heart surface and the x-ray was angled to LAO position. We performed simultaneous thermal and cine angiography using Angiovist 370 at different temperatures (10-40 degrees C) and injection rates (1-2.5 ml/s). Different grades of stenoses were created by snares. Thermistor probe readings of the epimyocardium and the left atrial blood were performed to reference the thermal camera measurements. We obtained high resolution TCA images of both the coronaries and of the myocardial perfusion beds whenever there was greater than 4 degrees C difference between injectate and epicardial temperature. The TCA detection of stenoses as compared to cine angiography was 29/30 (96.6%) in arrested and 36/42 (85.7%) in beating hearts. Coronary occlusion produced immediate and dramatic perfusion defects as detected by TCA. TCAs were highly reproducible. Injection rate of 2 ml/s provided optimal thermal coronary images. Thermal angiograms of the LAD were sometimes affected by large crossing coronary veins, myocardial bridges, and excess of fat pretending nonexistent coronary stenosis. TCA is a highly sensitive and reproducible method as compared to standard coronary angiography and allows for detection of coronary stenoses. The image quality was best in arrested hearts.

  2. Subclinical coronary atherosclerosis and neighbourhood deprivation in an urban region.

    PubMed

    Dragano, Nico; Hoffmann, Barbara; Stang, Andreas; Moebus, Susanne; Verde, Pablo E; Weyers, Simone; Möhlenkamp, Stefan; Schmermund, Axel; Mann, Klaus; Jöckel, Karl-Heinz; Erbel, Raimund; Siegrist, Johannes

    2009-01-01

    Inhabitants of deprived neighbourhoods are at higher risk of coronary heart disease. In this study we investigate the hypothesis that social inequalities at neighbourhood level become already manifest in subclinical coronary atherosclerosis, as defined by electron-beam computed tomography derived measures. Coronary artery calcification was assessed as a marker of atherosclerosis in a population based sample of 4301 men and women (45-75 years) without a history of coronary heart disease. Participants lived in three adjacent cities in Germany and were examined between 2000 and 2003 as part of the Heinz Nixdorf Recall Study. Individual level data was combined with neighbourhood level information about unemployment, welfare and living space per inhabitant. This dataset was analysed with descriptive and multilevel regression methods. An association between neighbourhood deprivation and subclinical coronary calcification was observed. After adjustment for age and individual socioeconomic status male inhabitants of high unemployment neighbourhoods had an odds ratio of 1.45 (1.11, 1.96) of exhibiting a high calcification score (>75th percentile) compared to men living in low unemployment areas. The respective odds for women was 1.29 (0.97, 1.70). Additional explorative analyses suggest that clustering of unhealthy lifestyles in deprived neighbourhoods contributes to the observed association. In conclusion, findings suggest that certain neighbourhood characteristics promote the emergence of coronary atherosclerosis. This might point to a pathway from neighbourhood deprivation to manifest coronary heart disease.

  3. Absolute calibration of forces in optical tweezers

    NASA Astrophysics Data System (ADS)

    Dutra, R. S.; Viana, N. B.; Maia Neto, P. A.; Nussenzveig, H. M.

    2014-07-01

    Optical tweezers are highly versatile laser traps for neutral microparticles, with fundamental applications in physics and in single molecule cell biology. Force measurements are performed by converting the stiffness response to displacement of trapped transparent microspheres, employed as force transducers. Usually, calibration is indirect, by comparison with fluid drag forces. This can lead to discrepancies by sizable factors. Progress achieved in a program aiming at absolute calibration, conducted over the past 15 years, is briefly reviewed. Here we overcome its last major obstacle, a theoretical overestimation of the peak stiffness, within the most employed range for applications, and we perform experimental validation. The discrepancy is traced to the effect of primary aberrations of the optical system, which are now included in the theory. All required experimental parameters are readily accessible. Astigmatism, the dominant effect, is measured by analyzing reflected images of the focused laser spot, adapting frequently employed video microscopy techniques. Combined with interface spherical aberration, it reveals a previously unknown window of instability for trapping. Comparison with experimental data leads to an overall agreement within error bars, with no fitting, for a broad range of microsphere radii, from the Rayleigh regime to the ray optics one, for different polarizations and trapping heights, including all commonly employed parameter domains. Besides signaling full first-principles theoretical understanding of optical tweezers operation, the results may lead to improved instrument design and control over experiments, as well as to an extended domain of applicability, allowing reliable force measurements, in principle, from femtonewtons to nanonewtons.

  4. What is Needed for Absolute Paleointensity?

    NASA Astrophysics Data System (ADS)

    Valet, J. P.

    2015-12-01

    Many alternative approaches to the Thellier and Thellier technique for absolute paleointensity have been proposed during the past twenty years. One reason is the time consuming aspect of the experiments. Another reason is to avoid uncertainties in determinations of the paleofield which are mostly linked to the presence of multidomain grains. Despite great care taken by these new techniques, there is no indication that they always provide the right answer and in fact sometimes fail. We are convinced that the most valid approach remains the original double heating Thellier protocol provided that natural remanence is controlled by pure magnetite with a narrow distribution of small grain sizes, mostly single domains. The presence of titanium, even in small amount generates biases which yield incorrect field values. Single domain grains frequently dominate the magnetization of glass samples, which explains the success of this selective approach. They are also present in volcanic lava flows but much less frequently, and therefore contribute to the low success rate of most experiments. However the loss of at least 70% of the magnetization at very high temperatures prior to the Curie point appears to be an essential prerequisite that increases the success rate to almost 100% and has been validated from historical flows and from recent studies. This requirement can easily be tested by thermal demagnetization while low temperature experiments can document the detection of single domain magnetite using the δFC/δZFC parameter as suggested (Moskowitz et al, 1993) for biogenic magnetite.

  5. Coordinated series of studies to evaluate characteristics and mechanisms of acute coronary syndromes in high-risk patients randomly assigned to enoxaparin or unfractionated heparin: design and rationale of the SYNERGY Library.

    PubMed

    Petersen, John L; Mahaffey, Kenneth W; Becker, Richard C; Goodman, Shaun G; Kleiman, Neal S; Marian, A J; Stone, Gregg W; Lansky, Alexandra J; Lincoff, A Michael; Hazen, Stanley L; Nessel, Christopher C; Toro-Figueroa, Luis; Tate, Lynn; Reist, Craig J; Cohen, Marc; Califf, Robert M; Ferguson, James J

    2004-08-01

    Clinical trials and accompanying substudies in patients with acute coronary syndromes (ACS) have over the last several years yielded a wealth of knowledge about the pathophysiology and management of this high-risk condition. The Superior Yield of the New strategy of Enoxaparin, Revascularization, and GlYcoprotein IIb/IIIa inhibitors (SYNERGY) trial is a large-scale, randomized, controlled trial evaluating the effect of enoxaparin and unfractionated heparin on death and myocardial infarction in high-risk patients presenting with non-ST-segment elevation ACS. The SYNERGY Library has been designed as a coordinated series of investigations with simultaneous data acquisition on the same cohort of approximately 500 SYNERGY patients at 60 centers in North America. Specifically, electrocardiograms, coronary arteriograms, inflammatory markers, coagulation studies, and genetic samples will be collected and processed at core laboratory facilities, and the results will be stored in a central repository. This novel strategy for substudy investigation is unprecedented in cardiovascular clinical trials. The goal is to gain significant understanding about this patient population, discover new principles of pathophysiology, identify novel pharmacologic targets, and streamline further drug development. It is hoped that the SYNERGY Library will serve as a model for future substudy design to maximize academic insight within the framework of a large-scale, multicenter trial.

  6. Perioperative utility of goal-directed therapy in high-risk cardiac patients undergoing coronary artery bypass grafting: “A clinical outcome and biomarker-based study”

    PubMed Central

    Kapoor, Poonam Malhotra; Magoon, Rohan; Rawat, Rajinder; Mehta, Yatin

    2016-01-01

    Goal-directed therapy (GDT) encompasses guidance of intravenous (IV) fluid and vasopressor/inotropic therapy by cardiac output or similar parameters to help in early recognition and management of high-risk cardiac surgical patients. With the aim of establishing the utility of perioperative GDT using robust clinical and biochemical outcomes, we conducted the present study. This multicenter randomized controlled study included 130 patients of either sex, with European system for cardiac operative risk evaluation ≥3 undergoing coronary artery bypass grafting on cardiopulmonary bypass. The patients were randomly divided into the control and GDT group. All the participants received standardized care; arterial pressure monitored through radial artery, central venous pressure (CVP) through a triple lumen in the right internal jugular vein, electrocardiogram, oxygen saturation, temperature, urine output per hour, and frequent arterial blood gas (ABG) analysis. In addition, cardiac index (CI) monitoring using FloTrac™ and continuous central venous oxygen saturation (ScVO2) using PreSep™ were used in patients in the GDT group. Our aim was to maintain the CI at 2.5–4.2 L/min/m2, stroke volume index 30–65 ml/beat/m2, systemic vascular resistance index 1500–2500 dynes/s/cm5/m2, oxygen delivery index 450–600 ml/min/m2, continuous ScVO2 >70%, and stroke volume variation <10%; in addition to the control group parameters such as CVP 6–8 mmHg, mean arterial pressure 90–105 mmHg, normal ABG values, oxygen saturation, hematocrit value >30%, and urine output >1 ml/kg/h. The aims were achieved by altering the administration of IV fluids and doses of inotropes or vasodilators. The data of sixty patients in each group were analyzed in view of ten exclusions. The average duration of ventilation (19.89 ± 3.96 vs. 18.05 ± 4.53 h, P = 0.025), hospital stay (7.94 ± 1.64 vs. 7.17 ± 1.93 days, P = 0.025), and Intensive Care Unit (ICU) stay (3.74 ± 0.59 vs. 3.41 ± 0

  7. High-Dose Statin Pretreatment Decreases Periprocedural Myocardial Infarction and Cardiovascular Events in Patients Undergoing Elective Percutaneous Coronary Intervention: A Meta-Analysis of Twenty-Four Randomized Controlled Trials

    PubMed Central

    Wang, Le; Peng, Pingan; Zhang, Ou; Xu, Xiaohan; Yang, Shiwei; Zhao, Yingxin; Zhou, Yujie

    2014-01-01

    Background Evidence suggests that high-dose statin pretreatment may reduce the risk of periprocedural myocardial infarction (PMI) and major adverse cardiac events (MACE) for certain patients; however, previous analyses have not considered patients with a history of statin maintenance treatment. In this meta-analysis of randomized controlled trials (RCTs), we reevaluated the efficacy of short-term high-dose statin pretreatment to prevent PMI and MACE in an expanded set of patients undergoing elective percutaneous coronary intervention. Methods We searched the PubMed/Medline database for RCTs that compared high-dose statin pretreatment with no statin or low-dose statin pretreatment as a prevention of PMI and MACE. We evaluated the incidence of PMI and MACE, including death, spontaneous myocardial infarction, and target vessel revascularization at the longest follow-up for each study for subgroups stratified by disease classification and prior low-dose statin treatment. Results Twenty-four RCTs with a total of 5,526 patients were identified. High-dose statin pretreatment was associated with 59% relative reduction in PMI (odds ratio [OR]: 0.41; 95% confidence interval [CI]: 0.34–0.49; P<0.00001) and 39% relative reduction in MACE (OR: 0.61; 95% CI: 0.45–0.83; P = 0.002). The benefit of high-dose statin pretreatment on MACE was significant for statin-naive patients (OR: 0.69; 95% CI: 0.50–0.95; P = 0.02) and prior low dose statin-treated patients (OR: 0.28; 95% CI: 0.12–0.65; P = 0.003); and for patients with acute coronary syndrome (OR: 0.52; 95% CI: 0.34–0.79; P = 0.003), but not for patients with stable angina (OR: 0.71; 95% CI 0.45–1.10; P = 0.12). Long-term effects on survival were less obvious. Conclusions High-dose statin pretreatment can result in a significant reduction in PMI and MACE for patients undergoing elective PCI. The positive effect of high-dose statin pretreatment on PMI and MACE is significant for statin

  8. Toward The Absolute Age of M92 With MIST

    NASA Astrophysics Data System (ADS)

    Choi, Jieun; Conroy, Charlie; Dotter, Aaron; Weisz, Daniel; Rosenfield, Philip; Dolphin, Andrew

    2016-08-01

    Globular clusters provide a fundamental link between stars and galaxies. For example, it has been suggested that ultra faint dwarf galaxies formed all of their stars prior to the epoch of reionization, but this conclusion hinges entirely on the striking similarity of their stellar populations to the ancient, metal-poor globular cluster M92. The accurate measurement of absolute ages of ancient globular clusters therefore has direct implications for the formation histories of the smallest galaxies in the Universe. However, a reliable determination of the absolute ages of globular clusters has proven to be a challenge due to uncertainties in stellar physics and complications in how the models are compared to observations. I will present preliminary results from a comprehensive study to measure the absolute age of M92 using high-quality HST archival imaging data. We pair our new MESA Isochrones and Stellar Tracks (MIST) models with a full CMD fitting framework to jointly fit multi-color CMDs, taking into account the uncertainties in abundances, distance, and stellar physics. The goal of this project is two-fold. First, we aim to provide the most secure absolute age of M92 to date with robustly estimated uncertainties. Second, we explore and quantify the degeneracies between uncertain physical quantities and model variables, such as the distance, mixing-length-alpha parameter, and helium abundance, with the ultimate goal of better constraining these unknowns with data from ongoing and future surveys such as K2, Gaia, TESS, JWST, and WFIRST.

  9. A mathematical biologist's guide to absolute and convective instability.

    PubMed

    Sherratt, Jonathan A; Dagbovie, Ayawoa S; Hilker, Frank M

    2014-01-01

    Mathematical models have been highly successful at reproducing the complex spatiotemporal phenomena seen in many biological systems. However, the ability to numerically simulate such phenomena currently far outstrips detailed mathematical understanding. This paper reviews the theory of absolute and convective instability, which has the potential to redress this inbalance in some cases. In spatiotemporal systems, unstable steady states subdivide into two categories. Those that are absolutely unstable are not relevant in applications except as generators of spatial or spatiotemporal patterns, but convectively unstable steady states can occur as persistent features of solutions. The authors explain the concepts of absolute and convective instability, and also the related concepts of remnant and transient instability. They give examples of their use in explaining qualitative transitions in solution behaviour. They then describe how to distinguish different types of instability, focussing on the relatively new approach of the absolute spectrum. They also discuss the use of the theory for making quantitative predictions on how spatiotemporal solutions change with model parameters. The discussion is illustrated throughout by numerical simulations of a model for river-based predator-prey systems.

  10. High regression rate of coronary aneurysms developed in patients with immune globulin-resistant Kawasaki disease treated with steroid pulse therapy.

    PubMed

    Adachi, Shinya; Sakaguchi, Heima; Kuwahara, Takashi; Uchida, Yasushi; Fukao, Toshiyuki; Kondo, Naomi

    2010-04-01

    Kawasaki disease is an acute vasculitis syndrome of unknown etiology that mainly affects small and medium-size arteries, particularly the coronary artery. Coronary artery lesions may develop into aneurismal formation and thrombotic occlusion, and progress to ischemic heart disease. The aim of the present study was to investigate the effect of steroid pulse therapy following intravenous immune globulin (IVIG) treatment on the regression rate of aneurysms in Kawasaki disease. Among 93 sequential patients referred to us, because of coronary artery lesions in the acute phase, we found 23 aneurysms in 12 patients during the period from January 1997 to January 2008. We divided them into two groups: a non-steroid group, 7 patients (13 aneurysms) treated with single or multiple IVIG but no steroid pulse therapy; and a steroid group, 5 patients (10 aneurysms) treated with multiple IVIG followed by steroid pulse therapy. We compared the regression rate of the aneurysms between the two groups, retrospectively. The regression rates of the aneurysms in the steroid group were significantly higher than those in the non-steroid group when we analyzed 1) all aneurysms (p = 0.007), 2) giant aneurysms (aneurismal diameter was 4 or more x normal, or > 8 mm) (p = 0.018), and 3) aneurysms in IVIG-resistant patients who were resistant to initial IVIG therapy (p = 0.035). All aneurysms, including the giant aneurysms in the steroid group, regressed, and the regression rate of the aneurysms in the non-steroid group was about 46%(6/13). Steroid pulse therapy may be beneficial for IVIG-resistant patients. Our data suggest that steroid pulse therapy may lead to regression of aneurysms.

  11. Left-sided high-flow arteriovenous hemodialysis fistula combined with a persistent left superior vena cava causing coronary sinus dilatation.

    PubMed

    Wolf, Michael; Scott, Benjamin

    2013-01-01

    We present an interesting case illustrating the possible hemodynamic consequences when a left-sided arteriovenous hemodialysis fistula is combined with the congenital anomaly of a persistent left superior vena cava (PLSVC). Our case illustrates the importance of an echocardiographic examination with attention to the coronary sinus (CS) caliber-raising suspicion of a PLSVC-in the assessment for the hemodialysis access in end-stage renal disease patients. The causes and symptoms of CS dilatation, as well as the literature on PLSVC, are also discussed in detail.

  12. Jasminum flexile flower absolute from India--a detailed comparison with three other jasmine absolutes.

    PubMed

    Braun, Norbert A; Kohlenberg, Birgit; Sim, Sherina; Meier, Manfred; Hammerschmidt, Franz-Josef

    2009-09-01

    Jasminum flexile flower absolute from the south of India and the corresponding vacuum headspace (VHS) sample of the absolute were analyzed using GC and GC-MS. Three other commercially available Indian jasmine absolutes from the species: J. sambac, J. officinale subsp. grandiflorum, and J. auriculatum and the respective VHS samples were used for comparison purposes. One hundred and twenty-one compounds were characterized in J. flexile flower absolute, with methyl linolate, benzyl salicylate, benzyl benzoate, (2E,6E)-farnesol, and benzyl acetate as the main constituents. A detailed olfactory evaluation was also performed.

  13. Activated partial thromboplastin time measurement is not associated with clinical outcomes in patients with high-risk non-ST-segment elevation acute coronary syndromes treated with unfractionated heparin.

    PubMed

    Thomas, Michael P; Mahaffey, Kenneth W; Chiswell, Karen; Cohen, Marc; Kontos, Michael C; Antman, Elliott M; Ferguson, James J; Califf, Robert M; Goodman, Shaun G; Becker, Richard C

    2012-07-01

    Our objective was to determine the association of activated partial thromboplastin time (aPTT) with recurrent ischemic events and non-coronary artery bypass surgery-related thrombolysis in myocardial infarction major bleeding. We studied 4,985 patients with high-risk non-ST-segment elevation acute coronary syndromes (NSTE ACS) participating in SYNERGY, a prospective, randomized, international trial designed to emulate contemporary practice wherein unfractionated heparin (UFH) is given intravenously and titrated according to a weight-adjusted dosing nomogram to a target aPTT of 1.5-2 times the upper limit of normal (approximately 50-70 s). Aspirin was administered to 95% of patients, clopidogrel to 63%, and glycoprotein IIb/IIIa receptor inhibitors to 58%. More than 90% of patients underwent early coronary angiography, and 69% were revascularized. Used as a time-dependent covariate, aPTT was evaluated as a predictor of time to ischemic or major hemorrhagic events in proportional hazards regression models. Using discrete variable analysis, aPTT was categorized as persistently below a lower threshold of anticoagulation (<50 vs. ≥50 s) for recurrent ischemic events and above an upper threshold (>70 vs. ≤70 s) for major hemorrhagic events. UFH treatment lasted a median of 42 (30, 78) h. At >6-12 (n = 3,021), >12-24 (n = 3,406), and >24-48 (n = 2,497) h, 34, 41, and 46% of patients achieved the target aPTT range, respectively. Both before and after adjusting for baseline predictors of anticoagulant response and risk score (age, hypertension, diabetes, smoking, ST depression, and renal function), no significant relationship between aPTT values and recurrent ischemic events or major bleeding was found. No relationship was observed between clinical outcomes and aPTT values persistently above or below the designated thresholds. Measurements of aPTT were not associated with clinical outcomes among patients with NSTE ACS treated with UFH. The required intensity of

  14. Visual-Functional Mismatch Between Coronary Angiography, Fractional Flow Reserve, and Quantitative Coronary Angiography.

    PubMed

    Safi, Morteza; Eslami, Vahid; Namazi, Mohammad Hasan; Vakili, Hossain; Saadat, Habib; Alipourparsa, Saeid; Adibi, Ali; Movahed, Mohammad Reza

    2016-12-01

    Anatomical and functional mismatches are not uncommon in the assessment of coronary lesions. The aim of this study was to identify clinical and lesion-specific factors affecting angiographic, anatomical, and functional mismatch in intermediate coronary lesions. In patients who underwent coronary angiography for clinical reasons, fractional flow reserve (FFR), and quantitative coronary angiography (QCA) analyses for intermediate stenotic lesions were performed simultaneously. Mismatches between the measured values were analyzed. A total of 95 intermediate lesions were assessed simultaneously by visual angiography, FFR, and QCA. The visual-FFR mismatch was found in 40% of the lesions while reverse visual-FFR mismatch was determined in nearly 14% of the lesions. Mismatch and reverse mismatch between FFR and QCA parameters were observed in 10 and 23% of the lesions. FFR value was significant in 32% of the lesions while visually significant stenosis was shown in 61% of the lesions. Among the visual-FFR reverse mismatch group, the prevalence of culprit lesions within the left anterior descending (LAD) was significantly higher than other vessels (p value < 0.02). There were high frequencies of angiographic, QCA, and functional mismatches in analyses of intermediate coronary lesions. LAD lesions showed the highest mismatch. Angiographic or QCA estimation of lesion severity has consistently resulted in inappropriate stenting of functionally nonsignificant lesions or undertreatment of significant lesions based on FFR.

  15. Types of Coronary Artery Bypass Grafting

    MedlinePlus

    ... from the NHLBI on Twitter. Types of Coronary Artery Bypass Grafting There are several types of coronary ... for you based on your needs. Traditional Coronary Artery Bypass Grafting Traditional CABG is used when at ...

  16. Regulation of Coronary Blood Flow.

    PubMed

    Goodwill, Adam G; Dick, Gregory M; Kiel, Alexander M; Tune, Johnathan D

    2017-03-16

    The heart is uniquely responsible for providing its own blood supply through the coronary circulation. Regulation of coronary blood flow is quite complex and, after over 100 years of dedicated research, is understood to be dictated through multiple mechanisms that include extravascular compressive forces (tissue pressure), coronary perfusion pressure, myogenic, local metabolic, endothelial as well as neural and hormonal influences. While each of these determinants can have profound influence over myocardial perfusion, largely through effects on end-effector ion channels, these mechanisms collectively modulate coronary vascular resistance and act to ensure that the myocardial requirements for oxygen and substrates are adequately provided by the coronary circulation. The purpose of this series of Comprehensive Physiology is to highlight current knowledge regarding the physiologic regulation of coronary blood flow, with emphasis on functional anatomy and the interplay between the physical and biological determinants of myocardial oxygen delivery. © 2017 American Physiological Society. Compr Physiol 7:321-382, 2017.

  17. Absolute determination of local tropospheric OH concentrations

    NASA Technical Reports Server (NTRS)

    Armerding, Wolfgang; Comes, Franz-Josef

    1994-01-01

    Long path absorption (LPA) according to Lambert Beer's law is a method to determine absolute concentrations of trace gases such as tropospheric OH. We have developed a LPA instrument which is based on a rapid tuning of the light source which is a frequency doubled dye laser. The laser is tuned across two or three OH absorption features around 308 nm with a scanning speed of 0.07 cm(exp -1)/microsecond and a repetition rate of 1.3 kHz. This high scanning speed greatly reduces the fluctuation of the light intensity caused by the atmosphere. To obtain the required high sensitivity the laser output power is additionally made constant and stabilized by an electro-optical modulator. The present sensitivity is of the order of a few times 10(exp 5) OH per cm(exp 3) for an acquisition time of a minute and an absorption path length of only 1200 meters so that a folding of the optical path in a multireflection cell was possible leading to a lateral dimension of the cell of a few meters. This allows local measurements to be made. Tropospheric measurements have been carried out in 1991 resulting in the determination of OH diurnal variation at specific days in late summer. Comparison with model calculations have been made. Interferences are mainly due to SO2 absorption. The problem of OH self generation in the multireflection cell is of minor extent. This could be shown by using different experimental methods. The minimum-maximum signal to noise ratio is about 8 x 10(exp -4) for a single scan. Due to the small size of the absorption cell the realization of an open air laboratory is possible in which by use of an additional UV light source or by additional fluxes of trace gases the chemistry can be changed under controlled conditions allowing kinetic studies of tropospheric photochemistry to be made in open air.

  18. Universal Cosmic Absolute and Modern Science

    NASA Astrophysics Data System (ADS)

    Kostro, Ludwik

    The official Sciences, especially all natural sciences, respect in their researches the principle of methodic naturalism i.e. they consider all phenomena as entirely natural and therefore in their scientific explanations they do never adduce or cite supernatural entities and forces. The purpose of this paper is to show that Modern Science has its own self-existent, self-acting, and self-sufficient Natural All-in Being or Omni-Being i.e. the entire Nature as a Whole that justifies the scientific methodic naturalism. Since this Natural All-in Being is one and only It should be considered as the own scientifically justified Natural Absolute of Science and should be called, in my opinion, the Universal Cosmic Absolute of Modern Science. It will be also shown that the Universal Cosmic Absolute is ontologically enormously stratified and is in its ultimate i.e. in its most fundamental stratum trans-reistic and trans-personal. It means that in its basic stratum. It is neither a Thing or a Person although It contains in Itself all things and persons with all other sentient and conscious individuals as well, On the turn of the 20th century the Science has begun to look for a theory of everything, for a final theory, for a master theory. In my opinion the natural Universal Cosmic Absolute will constitute in such a theory the radical all penetrating Ultimate Basic Reality and will substitute step by step the traditional supernatural personal Absolute.

  19. Coronary involvement in Churg-Strauss syndrome

    PubMed Central

    Dendramis, Gregory; Paleologo, Claudia; Piraino, Davide; Arrotti, Salvatore; Assennato, Pasquale

    2015-01-01

    Systemic autoimmune diseases are themselves a relevant and independent risk factor for atherosclerosis and coronary ectasia. We describe a case of a 58-year-old Caucasian man who was admitted to our department for unstable angina. History of asthma, paranasal sinus abnormality, and peripheral eosinophilia given a high suspicion of Churg-Strauss syndrome (CSS). Diagnosis was performed with 5 of the 6 American College of Rheumatology criteria. The knowledge that CSS is often associated with significant coronary artery involvement and the persistence of chest pain led us to performing immediately a coronary angiography. Coronary angiography showed diffuse ectasic lesions, chronic occlusion of left anterior descending artery with homocoronary collateral circulation from left circumflex artery and subocclusive stenosis in the proximal tract of posterior descending artery. The early recognition of CSS, an aggressive invasive diagnostic approach, and an early appropriate therapy are important to prevent the progressive and permanent cardiac damage in these patients. In the setting of a multidisciplinary approach, careful cardiac assessment is an essential step in CSS, even in mildly symptomatic patients. PMID:26702692

  20. Emergency coronary artery bypass surgery for failed percutaneous coronary angioplasty. A 10-year experience.

    PubMed Central

    Craver, J M; Weintraub, W S; Jones, E L; Guyton, R A; Hatcher, C R

    1992-01-01

    Six hundred ninety-nine patients have required emergency coronary artery bypass after failed elective percutaneous coronary angioplasty during the decade September 1980 through December 1990. This represents 4% of 9860 patients having 12,146 elective percutaneous coronary angioplasty procedures during this interval. Emergency coronary artery bypass was required for acute refractory myocardial ischemia in 82%. Hospital mortality rate for all patients was 3.1%; 3.7% in patients with refractory myocardial ischemia but 0.8% in patients without refractory myocardial ischemia, p = 0.08. Postprocedural Q-wave myocardial infarctions were observed in 21% versus 2.4%, p less than 0.0001, and intra-aortic balloon pumping was required in 19% with versus 0.8% without refractory myocardial ischemia, p less than 0.0001. Multivessel disease, p = 0.004, age older than 65 years, p = 0.005, and refractory myocardial ischemia, p = 0.08, interacted to produce the highest risk of in-hospital death. Follow-up shows that there have been 28 additional late deaths, including 23 of cardiac causes for a 91% survival at 5 years. Freedom from both late death and Q-wave myocardial infarction at 5 years was 61%. In the group going to emergency coronary artery bypass with refractory myocardial ischemia, the late cardiac survival was 90%, and in those without ischemia, 92% at 5 years, p = not significant. The MI--free survival in the group with refractory ischemia, however, was 56% versus 83% in the group without ischemia, p less than 0.0001. Multivariate analysis showed the highest late event rates for patients with Q-wave myocardial infarction at the initial emergency coronary artery bypass, age older than 65 years, angina class III or IV, and prior coronary bypass surgery. In spite of a continuing high incidence of early acute myocardial infarction and an increasing operative mortality rate (7%) in the latest 3 years cohort of patients, excellent late survival and low subsequent cardiac event

  1. Balloon catheter coronary angioplasty

    SciTech Connect

    Angelini, P.

    1987-01-01

    The author has produced a reference and teaching book on balloon angioplasty. Because it borders in surgery and is performed on an awake patient without circulatory assistance, it is a complex and demanding procedure that requires thorough knowledge before it is attempted. The text is divided into seven sections. The first section describes coronary anatomy and pathophysiology, defines the objectives and mechanisms of the procedure and lists four possible physiologic results. The next section describes equipment in the catheterization laboratory, catheters, guidewires and required personnel. The following section is on the procedure itself and includes a discussion of examination, testing, technique and follow-up. The fourth section details possible complications that can occur during the procedure, such as coronary spasms, occlusion, thrombosis, perforations and ruptures, and also discusses cardiac surgery after failed angioplasty. The fifth section details complex or unusual cases that can occur. The sixth and seventh sections discuss radiation, alternative procedures and the future of angioplasty.

  2. Establishing ion ratio thresholds based on absolute peak area for absolute protein quantification using protein cleavage isotope dilution mass spectrometry.

    PubMed

    Loziuk, Philip L; Sederoff, Ronald R; Chiang, Vincent L; Muddiman, David C

    2014-11-07

    Quantitative mass spectrometry has become central to the field of proteomics and metabolomics. Selected reaction monitoring is a widely used method for the absolute quantification of proteins and metabolites. This method renders high specificity using several product ions measured simultaneously. With growing interest in quantification of molecular species in complex biological samples, confident identification and quantitation has been of particular concern. A method to confirm purity or contamination of product ion spectra has become necessary for achieving accurate and precise quantification. Ion abundance ratio assessments were introduced to alleviate some of these issues. Ion abundance ratios are based on the consistent relative abundance (RA) of specific product ions with respect to the total abundance of all product ions. To date, no standardized method of implementing ion abundance ratios has been established. Thresholds by which product ion contamination is confirmed vary widely and are often arbitrary. This study sought to establish criteria by which the relative abundance of product ions can be evaluated in an absolute quantification experiment. These findings suggest that evaluation of the absolute ion abundance for any given transition is necessary in order to effectively implement RA thresholds. Overall, the variation of the RA value was observed to be relatively constant beyond an absolute threshold ion abundance. Finally, these RA values were observed to fluctuate significantly over a 3 year period, suggesting that these values should be assessed as close as possible to the time at which data is collected for quantification.

  3. High dose rate brachytherapy for prevention of restenosis after percutaneous transluminal coronary angioplasty: Preliminary dosimetric tests of a new source presentation

    SciTech Connect

    Popowski, Y.; Rouzaud, M.; Kurtz, J.M.

    1995-08-30

    Balloon dilatation of coronary artery stenosis has become a standard treatment of atherosclerotic heart disease. Restenosis due to excessive intimal cell proliferation, which subsequently occurs in 20-50% of patients, represents one of the major clinical problems in contemporary cardiology, and no satisfactory method for its prevention has thus far been found. Because modest doses of radiation have proved effective in preventing certain types of abnormal cellular proliferation resulting from surgical trauma, and brachytherapy has already been used successfully after dilatation of peripheral arteries, development of a radioactive source suitable for coronary artery applications would be of great interest. Doses obtained at the surface of the balloon, for a 2-min exposure for the 0.26 mm wire (balloon inflated with air) and the 0.15 mm wire (air or contrast), were 56.5 Gy, 17.8 Gy, 5.4 Gy, respectively. As expected for a beta emitter, the fall-off in dose as a function of depth was rapid. External irradiation from the beta source was negligible. Our experiments indicate that the dose rates attainable at the surface of the angioplasty balloon using this technique allow the doses necessary for the inhibition of intimal cell proliferation to be reached within a relatively short period of time. The thin yttrium-90 wires are very easy to handle, and their mechanical and radioactive properties are well suited to the requirements of the catheterization procedure. 16 refs., 4 figs., 1 tab.

  4. Development of new risk score for pre-test probability of obstructive coronary artery disease based on coronary CT angiography.

    PubMed

    Fujimoto, Shinichiro; Kondo, Takeshi; Yamamoto, Hideya; Yokoyama, Naoyuki; Tarutani, Yasuhiro; Takamura, Kazuhisa; Urabe, Yoji; Konno, Kumiko; Nishizaki, Yuji; Shinozaki, Tomohiro; Kihara, Yasuki; Daida, Hiroyuki; Isshiki, Takaaki; Takase, Shinichi

    2015-09-01

    Existing methods to calculate pre-test probability of obstructive coronary artery disease (CAD) have been established using selected high-risk patients who were referred to conventional coronary angiography. The purpose of this study is to develop and validate our new method for pre-test probability of obstructive CAD using patients who underwent coronary CT angiography (CTA), which could be applicable to a wider range of patient population. Using consecutive 4137 patients with suspected CAD who underwent coronary CTA at our institution, a multivariate logistic regression model including clinical factors as covariates calculated the pre-test probability (K-score) of obstructive CAD determined by coronary CTA. The K-score was compared with the Duke clinical score using the area under the curve (AUC) for the receiver-operating characteristic curve. External validation was performed by an independent sample of 319 patients. The final model included eight significant predictors: age, gender, coronary risk factor (hypertension, diabetes mellitus, dyslipidemia, smoking), history of cerebral infarction, and chest symptom. The AUC of the K-score was significantly greater than that of the Duke clinical score for both derivation (0.736 vs. 0.699) and validation (0.714 vs. 0.688) data sets. Among patients who underwent coronary CTA, newly developed K-score had better pre-test prediction ability of obstructive CAD compared to Duke clinical score in Japanese population.

  5. Absolute Gravity Datum in the Age of Cold Atom Gravimeters

    NASA Astrophysics Data System (ADS)

    Childers, V. A.; Eckl, M. C.

    2014-12-01

    The international gravity datum is defined today by the International Gravity Standardization Net of 1971 (IGSN-71). The data supporting this network was measured in the 1950s and 60s using pendulum and spring-based gravimeter ties (plus some new ballistic absolute meters) to replace the prior protocol of referencing all gravity values to the earlier Potsdam value. Since this time, gravimeter technology has advanced significantly with the development and refinement of the FG-5 (the current standard of the industry) and again with the soon-to-be-available cold atom interferometric absolute gravimeters. This latest development is anticipated to provide improvement in the range of two orders of magnitude as compared to the measurement accuracy of technology utilized to develop ISGN-71. In this presentation, we will explore how the IGSN-71 might best be "modernized" given today's requirements and available instruments and resources. The National Geodetic Survey (NGS), along with other relevant US Government agencies, is concerned about establishing gravity control to establish and maintain high order geodetic networks as part of the nation's essential infrastructure. The need to modernize the nation's geodetic infrastructure was highlighted in "Precise Geodetic Infrastructure, National Requirements for a Shared Resource" National Academy of Science, 2010. The NGS mission, as dictated by Congress, is to establish and maintain the National Spatial Reference System, which includes gravity measurements. Absolute gravimeters measure the total gravity field directly and do not involve ties to other measurements. Periodic "intercomparisons" of multiple absolute gravimeters at reference gravity sites are used to constrain the behavior of the instruments to ensure that each would yield reasonably similar measurements of the same location (i.e. yield a sufficiently consistent datum when measured in disparate locales). New atomic interferometric gravimeters promise a significant

  6. Coronary Atherosclerosis and Interventional Cardiology.

    PubMed

    Peña-Duque, Marco Antonio; Romero-Ibarra, José Luis; Gaxiola-Macías, Manuel Ben Adoniram; Arias-Sánchez, Eduardo A

    2015-07-01

    The atherosclerotic process in coronary arteries begins with endothelial dysfunction and may provoke thrombotic total occlusion and myocardial infarction. In this state-of-the-art review, we discuss recent evidence of atheroslerosis, vulnerable plaque, and hemodynamic changes in the coronary tree, as well as the current techniques we implement in the catheterization lab to evaluate coronary stenosis. It is clear that atherosclerosis is a chronic inflammatory condition with several consequences in the coronary tree, however, we are able now to characterize the plaque and to select the appropriate treatment for many patients.

  7. Left Main Coronary Artery Aneurysm

    PubMed Central

    Doustkami, Hossein; Maleki, Nasrollah; Tavosi, Zahra

    2016-01-01

    Aneurysms of the left main coronary artery are exceedingly rare clinical entities, encountered incidentally in approximately 0.1% of patients who undergo routine angiography. The most common cause of coronary artery aneurysms is atherosclerosis. Angiography is the gold standard for diagnosis and treatment. Depending on the severity of the coexisting coronary stenosis, patients with left main coronary artery aneurysms can be effectively managed either surgically or pharmacologically. We herein report a case of left main coronary artery aneurysm in a 72-year-old man with a prior history of hypertension presenting to our hospital because of unstable angina. The electrocardiogram showed ST-segment depression and T-wave inversion in the precordial leads. All the data of blood chemistry were normal. Echocardiography showed akinetic anterior wall, septum, and apex, mild mitral regurgitation and ejection fraction of 45%. Coronary angiography revealed a saccular aneurysm of the left main coronary artery with significant stenosis in the left anterior descending, left circumflex, and right coronary artery. The patient immediately underwent coronary artery bypass grafting and ligation of the aneurysm. At six months’ follow-up, he remained asymptomatic. PMID:27403190

  8. Quantitative standards for absolute linguistic universals.

    PubMed

    Piantadosi, Steven T; Gibson, Edward

    2014-01-01

    Absolute linguistic universals are often justified by cross-linguistic analysis: If all observed languages exhibit a property, the property is taken to be a likely universal, perhaps specified in the cognitive or linguistic systems of language learners and users. In many cases, these patterns are then taken to motivate linguistic theory. Here, we show that cross-linguistic analysis will very rarely be able to statistically justify absolute, inviolable patterns in language. We formalize two statistical methods--frequentist and Bayesian--and show that in both it is possible to find strict linguistic universals, but that the numbers of independent languages necessary to do so is generally unachievable. This suggests that methods other than typological statistics are necessary to establish absolute properties of human language, and thus that many of the purported universals in linguistics have not received sufficient empirical justification.

  9. Coronary revascularization in Japan. Part 3: percutaneous coronary intervention during 1997.

    PubMed

    Shihara, Miwako; Tsutsui, Hiroyuki; Tsuchihashi, Miyuki; Shigematsu, Hideaki; Yamamoto, Shimako; Koike, George; Kono, Suminori; Takeshita, Akira

    2002-01-01

    A survey by the Japanese Coronary Intervention Study (JCIS) group revealed that 109,788 percutaneous coronary intervention (PCI) procedures were performed at 1,023 laboratories during 1997. The present study aimed to describe the demographic and clinical characteristics, treatment strategies, in-hospital outcomes, and long-term outcomes of these patients. A total of 10,642 PCIs performed in 8,814 patients, which corresponded to approximately 10% of the overall PCIs, were selected at random. The mean patient age was 65 years, and 75% were males. The patients often had extensive coronary risk factors. The most prevalent clinical diagnosis was stable angina (36%), followed by myocardial infarction (MI) excluding acute myocardial infarction (AMI; 28%) and AMI (25%). Plain old balloon angioplasty was used as the sole procedure in 58% of lesions for which an attempt to heal was made, and coronary stent placement in 38%. Angiographic success was achieved in 92% of attempted lesions. Mortality, MI and emergency coronary artery bypass grafting (CABG) rates during the hospitalization were 2.6%, 2.0% and 0.7%, respectively. In-hospital mortality rate for AMI was 7.6%, whereas that for elective PCI in cases without AMI was 0.6%. The overall mortality for 1.8 years was 8%. Repeat PCI was performed for 35% and CABG for 6% during the follow-up period. In Japan, PCI was performed in patients with coronary artery disease and extensive risk factors, but a high rate of angiographic success was achieved. The rates of in-hospital mortality and emergency CABG were low in non-AMI patients, but the 1-year rate of repeat PCI was as high as 32%.

  10. Excimer laser debulking for percutaneous coronary intervention in left main coronary artery disease.

    PubMed

    Topaz, On; Polkampally, Pritam R; Mohanty, Pramod K; Rizk, Maged; Bangs, Julie; Bernardo, Nelson L

    2009-11-01

    Excimer laser has been successfully applied to complex atherosclerotic plaques in acute coronary syndromes; however, its role in debulking in left main coronary artery disease has not been fully explored. Details of a series of 20 patients who underwent excimer laser revascularization of a spectrum of left main coronary artery lesions are presented. Twenty symptomatic patients who received excimer laser debulking were examined for procedural outcome and follow up results. The left main coronary artery was characterized as protected, semi-protected, poorly protected, or unprotected, depending on the presence or absence of patent bypass grafts to the left anterior descending (LAD) and circumflex (CX) arteries. A fully protected left main coronary artery (LMCA) was present in only 20% of the patients. The target lesions included 11(55%) distal LMCA stenoses, six (30%) ostial stenoses, and one (5%) mid-portion lesions. Two (10%) patients had in-stent re-stenosis of the entire length of the LMCA. Small (0.7 mm-1.4 mm) excimer laser catheters were mostly used. A relatively high number of laser energy pulses (1,334 +/- 643) were required to achieve adequate debulking. Successful LMCA intervention was performed in 19 (95%) patients, while in-hospital complications occurred in only one (5%) patient. Subacute/late stent thrombosis developed 3 months after the procedure in one patient, and two patients died from non-cardiac causes during follow-up. Lesions in LMCAs can be revascularized in selected patients by laser debulking and adjunct stenting. Inadequate protection by bypass grafts and decreased left ventricular function do not contradict utilization of excimer laser. Small laser catheters and high energy levels are required during laser debulking of stenoses of left main coronary arteries.

  11. Coronary revascularization after arterial switch operation.

    PubMed

    Prifti, Edvin; Bonacchi, Massimo; Luisi, Stefano Vincenzo; Vanini, Vittorio

    2002-01-01

    We report two cases presenting bilateral coronary artery obstruction after arterial switch operation. The first patient underwent bilateral internal thoracic artery grafting to the left and right coronary arteries. The other patient, presenting a single coronary ostium, underwent surgical coronary ostial angioplasty in concomitance to proximal arterioplasty of both coronary arteries employing a single "pantaloon" shape autologous pericardial patch. Both patients survived and, at 1 year and 9 months after the coronary revascularization procedures, the coronary angiography demonstrated a good patency of the internal thoracic grafts and excellent ostial plasty results, respectively. A complete literature review of patients undergoing different coronary revascularization procedures after arterial switch operation is reported.

  12. Anomalous left coronary artery from pulmonary artery with mitral stenosis.

    PubMed

    Das, Mrinalendu; Mahindrakar, Pallavi; Das, Debasis; Behera, Sukanta Kumar; Chowdhury, Saibal Roy; Bandyopadhyay, Biswajit

    2011-08-01

    The usual presentation of anomalous left coronary artery from pulmonary artery is severe left-sided heart failure and mitral valve insufficiency presenting during the first months of life. The manifestations of left heart failure may be masked if pulmonary artery pressure remains high. We believe this is a rarest of rare case of anomalous left coronary artery from pulmonary artery with severe mitral stenosis and pulmonary hypertension in which pulmonary hypertension, along with good collateral circulation helped to preserve left ventricular function.

  13. Traditional risk factors are predictive on segmental localization of coronary artery disease.

    PubMed

    Tacoy, Gulten; Balcioglu, Akif Serhat; Akinci, Sinan; Erdem, Güliz; Kocaman, Sinan Altan; Timurkaynak, Timur; Cengel, Atiye

    2008-01-01

    The aim of this study was to investigate the relationship between established risk factors and segmental localization of coronary artery disease. A total of 2760 patients who underwent coronary angiography were enrolled into the study. Coronary angiographic segmental evaluation was performed according to the scheme of American Heart Association. Patients were classified into 2 groups (group 1: normal coronary artery segments, group 2: coronary artery segments with coronary artery disease). Smoking was highly related with left main coronary artery disease (odds ratio = 7.5; P = .005). Diabetes mellitus and male sex increased the risk of atherosclerosis in all coronary vasculature (odds ratio = 2.7-2.2; P < .001-P < .001). Hypertension was correlated with distal coronary artery (odds ratio = 1.4; P < .001) and family history with distal circumflex lesions (odds ratio = 4.5; P = .005) High triglyceride levels were associated with right coronary artery lesions (odds ratio = 1.00; P =.03). The effect of advanced age was small (odds ratio = 1.08; P < .001). Risk factors may be predictive for segmental localization.

  14. Absolute Distance Measurement with the MSTAR Sensor

    NASA Technical Reports Server (NTRS)

    Lay, Oliver P.; Dubovitsky, Serge; Peters, Robert; Burger, Johan; Ahn, Seh-Won; Steier, William H.; Fetterman, Harrold R.; Chang, Yian

    2003-01-01

    The MSTAR sensor (Modulation Sideband Technology for Absolute Ranging) is a new system for measuring absolute distance, capable of resolving the integer cycle ambiguity of standard interferometers, and making it possible to measure distance with sub-nanometer accuracy. The sensor uses a single laser in conjunction with fast phase modulators and low frequency detectors. We describe the design of the system - the principle of operation, the metrology source, beamlaunching optics, and signal processing - and show results for target distances up to 1 meter. We then demonstrate how the system can be scaled to kilometer-scale distances.

  15. Absolutely relative or relatively absolute: violations of value invariance in human decision making.

    PubMed

    Teodorescu, Andrei R; Moran, Rani; Usher, Marius

    2016-02-01

    Making decisions based on relative rather than absolute information processing is tied to choice optimality via the accumulation of evidence differences and to canonical neural processing via accumulation of evidence ratios. These theoretical frameworks predict invariance of decision latencies to absolute intensities that maintain differences and ratios, respectively. While information about the absolute values of the choice alternatives is not necessary for choosing the best alternative, it may nevertheless hold valuable information about the context of the decision. To test the sensitivity of human decision making to absolute values, we manipulated the intensities of brightness stimuli pairs while preserving either their differences or their ratios. Although asked to choose the brighter alternative relative to the other, participants responded faster to higher absolute values. Thus, our results provide empirical evidence for human sensitivity to task irrelevant absolute values indicating a hard-wired mechanism that precedes executive control. Computational investigations of several modelling architectures reveal two alternative accounts for this phenomenon, which combine absolute and relative processing. One account involves accumulation of differences with activation dependent processing noise and the other emerges from accumulation of absolute values subject to the temporal dynamics of lateral inhibition. The potential adaptive role of such choice mechanisms is discussed.

  16. Orion Absolute Navigation System Progress and Challenge

    NASA Technical Reports Server (NTRS)

    Holt, Greg N.; D'Souza, Christopher

    2012-01-01

    The absolute navigation design of NASA's Orion vehicle is described. It has undergone several iterations and modifications since its inception, and continues as a work-in-progress. This paper seeks to benchmark the current state of the design and some of the rationale and analysis behind it. There are specific challenges to address when preparing a timely and effective design for the Exploration Flight Test (EFT-1), while still looking ahead and providing software extensibility for future exploration missions. The primary onboard measurements in a Near-Earth or Mid-Earth environment consist of GPS pseudo-range and delta-range, but for future explorations missions the use of star-tracker and optical navigation sources need to be considered. Discussions are presented for state size and composition, processing techniques, and consider states. A presentation is given for the processing technique using the computationally stable and robust UDU formulation with an Agee-Turner Rank-One update. This allows for computational savings when dealing with many parameters which are modeled as slowly varying Gauss-Markov processes. Preliminary analysis shows up to a 50% reduction in computation versus a more traditional formulation. Several state elements are discussed and evaluated, including position, velocity, attitude, clock bias/drift, and GPS measurement biases in addition to bias, scale factor, misalignment, and non-orthogonalities of the accelerometers and gyroscopes. Another consideration is the initialization of the EKF in various scenarios. Scenarios such as single-event upset, ground command, and cold start are discussed as are strategies for whole and partial state updates as well as covariance considerations. Strategies are given for dealing with latent measurements and high-rate propagation using multi-rate architecture. The details of the rate groups and the data ow between the elements is discussed and evaluated.

  17. Regression or reduction in progression of atherosclerosis, and avoidance of coronary events, with lovastatin in patients with or at high risk of cardiovascular disease: a review.

    PubMed

    Frisinghelli, Anna; Mafrici, Antonio

    2007-01-01

    HMG-CoA reductase inhibitors (statins) are the drugs of first choice for treating hypercholesterolaemia in order to prevent or slow the progression of coronary heart disease (CHD). Statins generally reduce the risk of CHD morbidity or mortality by about 30%. Lovastatin is effective in lowering plasma total cholesterol and low-density lipoprotein cholesterol levels, and is widely prescribed for both the primary and secondary prevention of CHD. In the major AFCAPS/TexCAPS primary prevention study of 6605 middle-aged or elderly men and women without symptomatic cardiovascular disease and with only moderately elevated serum lipids, treatment with lovastatin 20-40 mg once daily for a mean of 5.2 years significantly (p < 0.001) reduced the incidence of a first acute major cardiac event by 37% compared with placebo. In the smaller ACAPS study of 919 men and women who were asymptomatic for cardiovascular disease, but with evidence of early atherosclerosis, treatment with lovastatin for 3 years significantly (p = 0.001) slowed or reversed atherosclerosis compared with placebo, as measured by changes in the intimal-medial thickness of carotid arteries on B-mode ultrasound. Three randomised, controlled, secondary prevention trials have demonstrated that in patients with coronary artery disease, treatment with lovastatin 20-80 mg/day alone or in combination with colestipol for 2-2.5 years reduced the severity of stenosis and/or slowed or reversed the progression of atherosclerosis, as assessed by angiography. In the FATS study, the severity of stenosis after 2.5 years in recipients of lovastatin plus colestipol was reduced by 2.8% compared with placebo, while the frequency of lesion progression was halved and the frequency of lesion regression was tripled. Treatment with lovastatin for 2.2 years in the MARS study significantly reduced the mean percent diameter stenosis compared with placebo (p = 0.005) in patients with more severe stenosis, and also significantly (p = 0

  18. Technique of Coronary Transfer for TGA with Single Coronary Artery

    PubMed Central

    Kim, Tae Ho; Jung, Jae Jun; Kim, Yong Han; Yang, Ji-Hyuk; Jun, Tae-Gook

    2014-01-01

    An eight-day-old neonate was diagnosed with dextro-transposition of the great arteries, atrial septal defect, patent ductus arteriosus, and a single sinus origin of the coronary arteries. The single coronary artery originated from the left sinus (sinus 2), had a proximal left circumflex arterial branch, and passed anteriorly to the right side of the aorta, further branching into the right coronary and left anterior descending arteries. We successfully performed an arterial switch operation and coronary transfer by tube graft reconstruction with autologous aortic tissue to treat the dextro-transposition of the great arteries and atrial septal defect with a single-sinus origin of the coronary arteries. PMID:25551074

  19. Comparative vs. Absolute Judgments of Trait Desirability

    ERIC Educational Resources Information Center

    Hofstee, Willem K. B.

    1970-01-01

    Reversals of trait desirability are studied. Terms indicating conservativw behavior appeared to be judged relatively desirable in comparative judgement, while traits indicating dynamic and expansive behavior benefited from absolute judgement. The reversal effect was shown to be a general one, i.e. reversals were not dependent upon the specific…

  20. New Techniques for Absolute Gravity Measurements.

    DTIC Science & Technology

    1983-01-07

    Hammond, J.A. (1978) Bollettino Di Geofisica Teorica ed Applicata Vol. XX. 8. Hammond, J. A., and Iliff, R. L. (1979) The AFGL absolute gravity system...International Gravimetric Bureau, No. L:I-43. 7. Hammond. J.A. (1978) Bollettino Di Geofisica Teorica ed Applicata Vol. XX. 8. Hammond, J.A., and

  1. An Absolute Electrometer for the Physics Laboratory

    ERIC Educational Resources Information Center

    Straulino, S.; Cartacci, A.

    2009-01-01

    A low-cost, easy-to-use absolute electrometer is presented: two thin metallic plates and an electronic balance, usually available in a laboratory, are used. We report on the very good performance of the device that allows precise measurements of the force acting between two charged plates. (Contains 5 footnotes, 2 tables, and 6 figures.)

  2. Stimulus Probability Effects in Absolute Identification

    ERIC Educational Resources Information Center

    Kent, Christopher; Lamberts, Koen

    2016-01-01

    This study investigated the effect of stimulus presentation probability on accuracy and response times in an absolute identification task. Three schedules of presentation were used to investigate the interaction between presentation probability and stimulus position within the set. Data from individual participants indicated strong effects of…

  3. Absolute Positioning Using the Global Positioning System

    DTIC Science & Technology

    1994-04-01

    Global Positioning System ( GPS ) has becom a useful tool In providing relativ survey...Includes the development of a low cost navigator for wheeled vehicles. ABSTRACT The Global Positioning System ( GPS ) has become a useful tool In providing...technique of absolute or point positioning involves the use of a single Global Positioning System ( GPS ) receiver to determine the three-dimenslonal

  4. Balloon angioplasty in acute and chronic coronary artery disease

    SciTech Connect

    Holmes, D.R. Jr.; Vlietstra, R.E. )

    1989-04-14

    Percutaneous transluminal coronary angioplasty has grown exponentially since its introduction. Currently, selection criteria include single-vessel and multivessel disease, stable and unstable angina, and acute infarction. The outcome depends on specific patient and antiographic characteristics. In ideal lesions, success rates should be greater than 90%, with low morbidity and mortality. With more severe and diffuse multivessel disease, success rates are lower and complication rates are higher. In these cases, percutaneous transluminal coronary angioplasty still offers a reasonable option, provided complete revascularization can be achieved or the angina-producing lesion dilated. Numerous issues remain unresolved, including (1) the role of percutaneous transluminal coronary angioplasty vs coronary surgery (currently being tested), (2) restenosis, which occurs in approximately 30% of treated lesions, and (3) organizational adjustments such as training and certification to maintain high standards of care.

  5. Detection of coronary calcifications from computed tomography scans for automated risk assessment of coronary artery disease

    SciTech Connect

    Isgum, Ivana; Rutten, Annemarieke; Prokop, Mathias; Ginneken, Bram van

    2007-04-15

    A fully automated method for coronary calcification detection from non-contrast-enhanced, ECG-gated multi-slice computed tomography (CT) data is presented. Candidates for coronary calcifications are extracted by thresholding and component labeling. These candidates include coronary calcifications, calcifications in the aorta and in the heart, and other high-density structures such as noise and bone. A dedicated set of 64 features is calculated for each candidate object. They characterize the object's spatial position relative to the heart and the aorta, for which an automatic segmentation scheme was developed, its size and shape, and its appearance, which is described by a set of approximated Gaussian derivatives for which an efficient computational scheme is presented. Three classification strategies were designed. The first one tested direct classification without feature selection. The second approach also utilized direct classification, but with feature selection. Finally, the third scheme employed two-stage classification. In a computationally inexpensive first stage, the most easily recognizable false positives were discarded. The second stage discriminated between more difficult to separate coronary calcium and other candidates. Performance of linear, quadratic, nearest neighbor, and support vector machine classifiers was compared. The method was tested on 76 scans containing 275 calcifications in the coronary arteries and 335 calcifications in the heart and aorta. The best performance was obtained employing a two-stage classification system with a k-nearest neighbor (k-NN) classifier and a feature selection scheme. The method detected 73.8% of coronary calcifications at the expense of on average 0.1 false positives per scan. A calcium score was computed for each scan and subjects were assigned one of four risk categories based on this score. The method assigned the correct risk category to 93.4% of all scans.

  6. Efficacy of Patient Selection for Diagnostic Coronary Angiography in Suspected Coronary Artery Disease

    PubMed Central

    Costa Filho, Francisco Flávio; Chaves, Áurea Jacob; Ligabó, Lourenço Teixeira; dos Santos, Eduardo Moreira; da Silva, Danillo Taiguara; Puzzi, Marcelo Aguiar; Braga, Sérgio Luiz; Abizaid, Alexandre; Sousa, Amanda GMR

    2015-01-01

    Background Guidelines recommend that in suspected stable coronary artery disease (CAD), a clinical (non-invasive) evaluation should be performed before coronary angiography. Objective We assessed the efficacy of patient selection for coronary angiography in suspected stable CAD. Methods We prospectively selected consecutive patients without known CAD, referred to a high-volume tertiary center. Demographic characteristics, risk factors, symptoms and non-invasive test results were correlated to the presence of obstructive CAD. We estimated the CAD probability based on available clinical data and the incremental diagnostic value of previous non-invasive tests. Results A total of 830 patients were included; median age was 61 years, 49.3% were males, 81% had hypertension and 35.5% were diabetics. Non-invasive tests were performed in 64.8% of the patients. At coronary angiography, 23.8% of the patients had obstructive CAD. The independent predictors for obstructive CAD were: male gender (odds ratio [OR], 3.95; confidence interval [CI] 95%, 2.70 - 5.77), age (OR for 5 years increment, 1.15; CI 95%, 1.06 - 1.26), diabetes (OR, 2.01; CI 95%, 1.40 - 2.90), dyslipidemia (OR, 2.02; CI 95%, 1.32 - 3.07), typical angina (OR, 2.92; CI 95%, 1.77 - 4.83) and previous non-invasive test (OR 1.54; CI 95% 1.05 - 2.27). Conclusions In this study, less than a quarter of the patients referred for coronary angiography with suspected CAD had the diagnosis confirmed. A better clinical and non-invasive assessment is necessary, to improve the efficacy of patient selection for coronary angiography. PMID:26312552

  7. Ectopic origin of coronary arteries from the aorta in Syrian hamsters (Mesocricetus auratus).

    PubMed

    Durán, A C; Fernández, B; Fernández, M C; López-García, A; Arqué, J M; Sans-Coma, V

    2012-01-01

    An ectopic origin of the coronary artery from the aorta beyond the sinotubular junction, a condition commonly referred to as 'coronary artery high take-off', has been described in man and C57BL/6 mice. The present paper reports this congenital coronary artery anomaly in the Syrian hamster (Mesocricetus auratus). Hearts from 14 individuals, aged 53-350 days, were examined by means of a corrosion-cast technique, scanning electron microscopy or histological and immunohistochemical techniques. In 11 hamsters, the right coronary artery was the ectopic vessel. In the other three animals there was a solitary coronary ostium in the aorta. In all cases, the ectopic coronary artery originated at an acute angle and a valve-like ridge was in front of the coronary artery ostium. The ectopic arteries examined microscopically showed an intramural trajectory within the aortic wall. In the hearts with a solitary ostium in the aorta, the left main coronary artery coursed between the aorta and the pulmonary artery. In man, all of these anomalous conditions place the individual at risk of myocardial ischaemia and sudden death. However, none of the affected hamsters had clinical signs of disease. Intimal thickenings of increasing size with age were present in the intramural coronary artery segment of eight hamsters aged 106 days or older, examined histologically. The present findings fit with the notion that coronary arteries with acute angle take-off and an intramural course are subjected to unusual wear and tear, leading to tissue changes in the vessel wall.

  8. Effect of isolated proximal coronary stenotic lesions on distal myocardial perfusion during exercise

    SciTech Connect

    Nichols, A.B.; Buczek, J.A.; Schwann, T.A.; Esser, P.D.; Blood, D.K.

    1988-07-01

    This study tested the hypothesis that the absolute dimension of a coronary stenotic lesion is a more important determinant of its hemodynamic effect on regional myocardial perfusion during exercise than is relative percent stenosis. In 31 patients with an isolated lesion of the left anterior descending coronary artery, regional myocardial perfusion was determined from thallium-201 scans recorded in the left anterior oblique projection after symptom-limited treadmill exercise. Thallium-201 uptake in the distribution of the left anterior descending coronary artery was expressed as a ratio of thallium-201 uptake in the left circumflex artery distribution. Percent area stenosis, minimal cross-sectional area and mean diameter of each stenotic lesion were measured by computer-assisted cinevideodensitometric analysis of projected coronary arteriograms digitized in a 512 X 512 pixel matrix with 256 gray levels. Thallium-201 uptake in the left anterior descending coronary artery distribution, expressed as a ratio, correlated poorly (r = 0.65) with relative percent stenosis, but correlated significantly (r = 0.83; p less than 0.05) with absolute lesion area. For all 16 patients with reduced regional perfusion in the left anterior descending coronary artery distribution during exercise, lesion cross-sectional area was less than 1.8 mm2 (mean 0.9 +/- 0.6); for 13 of the 15 patients with normal distal perfusion, the area of the stenotic lesion was greater than 1.8 mm2 (mean 2.7 +/- 0.7; p less than 0.001). Percent coronary stenosis failed to predict flow-limiting lesions.

  9. Noninvasive assessment of coronary stenoses by myocardial perfusion imaging during pharmacologic coronary vasodilation. VIII. Clinical feasibility of positron cardiac imaging without a cyclotron using generator-produced rubidium-82

    SciTech Connect

    Gould, K.L.; Goldstein, R.A.; Mullani, N.A.; Kirkeeide, R.L.; Wong, W.H.; Tewson, T.J.; Berridge, M.S.; Bolomey, L.A.; Hartz, R.K.; Smalling, R.W.

    1986-04-01

    The purpose of this study was to determine the clinical feasibility of diagnosing significant coronary artery disease by positron imaging of myocardial perfusion without a cyclotron, using generator-produced rubidium-82 (/sup 82/Rb). Fifty patients underwent positron emission tomography of the entire heart using a multislice positron camera and intravenous /sup 82/Rb or nitrogen-13 ammonia (/sup 13/NH/sub 3/) before and after intravenous dipyridamole combined with handgrip stress. Images were read by two observers blinded as to clinical or arteriographic data. Automated quantitative coronary arteriography was obtained for the arteriographic determination of coronary flow reserve, previously demonstrated to be a single integrated measure of stenosis severity accounting for all its geometric dimensions of length, absolute diameter, percent narrowing and asymmetry by quantitative analysis of cine films. Significant coronary artery disease was defined as an arteriographically determined coronary flow reserve of less than 3.0 based on all stenosis dimensions. Any single geometric measure of stenosis severity alone was an inadequate reference standard for comparison with perfusion images. Sensitivity of identifying patients with coronary artery disease having an arteriographically determined coronary flow reserve of less than 3.0 was 95% by positron imaging with a specificity of 100%. The single case that was missed, studied with /sup 13/NH/sub 3/, had a 43% diameter narrowing of a small ramus intermedius off the left coronary artery with no significant narrowing of the major coronary arteries. Positron emission tomography of myocardial perfusion before and after intravenous dipyridamole combined with handgrip stress utilizing generator-produced /sup 82/Rb provides sensitive and specific diagnosis of reduced coronary flow reserve due to coronary artery disease in humans.

  10. What Is Coronary Microvascular Disease?

    MedlinePlus

    ... narrows the heart's large arteries and reduces the flow of oxygen-rich blood to your heart muscle. The buildup of plaque also makes it more likely that blood clots will form in your arteries. Blood clots can mostly or completely block blood flow through a coronary artery. In coronary MVD, however, ...

  11. Coronary Arteriovenous Fistulae: A Review

    PubMed Central

    Challoumas, Dimitris; Pericleous, Agamemnon; Dimitrakaki, Inetzi A.; Danelatos, Christos; Dimitrakakis, Georgios

    2014-01-01

    Coronary arteriovenous fistulae are a coronary anomaly, presenting in 0.002% of the general population. Their etiology can be congenital or acquired. We present a review of recent literature related to their epidemiology, etiology, pathophysiology, clinical presentation, diagnostic approach, and therapeutic management. PMID:24940026

  12. The Coronary Patient in Industry

    NASA Technical Reports Server (NTRS)

    Schuster, B.

    1971-01-01

    The coronary patient, as he pertains to industry particularly NASA, is discussed. Concepts of precoronary care, acute attacks which may develop while on the job, and the return of the cardiac patient to work are covered. Major emphasis was on the prevention of sudden death due to coronary disease.

  13. Absolute Radiation Thermometry in the NIR

    NASA Astrophysics Data System (ADS)

    Bünger, L.; Taubert, R. D.; Gutschwager, B.; Anhalt, K.; Briaudeau, S.; Sadli, M.

    2017-04-01

    A near infrared (NIR) radiation thermometer (RT) for temperature measurements in the range from 773 K up to 1235 K was characterized and calibrated in terms of the "Mise en Pratique for the definition of the Kelvin" (MeP-K) by measuring its absolute spectral radiance responsivity. Using Planck's law of thermal radiation allows the direct measurement of the thermodynamic temperature independently of any ITS-90 fixed-point. To determine the absolute spectral radiance responsivity of the radiation thermometer in the NIR spectral region, an existing PTB monochromator-based calibration setup was upgraded with a supercontinuum laser system (0.45 μm to 2.4 μm) resulting in a significantly improved signal-to-noise ratio. The RT was characterized with respect to its nonlinearity, size-of-source effect, distance effect, and the consistency of its individual temperature measuring ranges. To further improve the calibration setup, a new tool for the aperture alignment and distance measurement was developed. Furthermore, the diffraction correction as well as the impedance correction of the current-to-voltage converter is considered. The calibration scheme and the corresponding uncertainty budget of the absolute spectral responsivity are presented. A relative standard uncertainty of 0.1 % (k=1) for the absolute spectral radiance responsivity was achieved. The absolute radiometric calibration was validated at four temperature values with respect to the ITS-90 via a variable temperature heatpipe blackbody (773 K ...1235 K) and at a gold fixed-point blackbody radiator (1337.33 K).

  14. Quantitative thallium-201 single-photon emission computed tomography during maximal pharmacologic coronary vasodilation with adenosine for assessing coronary artery disease

    SciTech Connect

    Nishimura, S.; Mahmarian, J.J.; Boyce, T.M.; Verani, M.S. )

    1991-09-01

    The diagnostic value of maximal pharmacologic coronary vasodilation with intravenously administered adenosine in conjunction with thallium-201 single-photon emission computed tomography (SPECT) for detection of coronary artery disease was investigated in 101 consecutive patients who had concomitant coronary arteriography. Tomographic images were assessed visually and from computer-quantified polar maps of the thallium-201 distribution. Significant coronary artery disease, defined as greater than 50% luminal diameter stenosis, was present in 70 patients. The sensitivity for detecting patients with coronary artery disease using quantitative analysis was 87% in the total group, 82% in patients without myocardial infarction and 96% in those with prior myocardial infarction; the specificity was 90%. The sensitivity for diagnosing coronary artery disease in patients without infarction with single-, double-and triple-vessel disease was 76%, 86% and 90%, respectively. All individual stenoses were identified in 68% of patients with double-vessel disease and in 65% of those with triple-vessel disease. The extent of the perfusion defects, as quantified by polar maps, was directly related to the extent of coronary artery disease. In conclusion, quantitative thallium-201 SPECT during adenosine infusion has high sensitivity and specificity for diagnosing the presence of coronary artery disease, localizing the anatomic site of coronary stenosis and identifying the majority of affected vascular regions in patients with multivessel involvement.

  15. Age and forgetfulness: absolute versus comparison decisions about capability.

    PubMed

    Erber, J T; Prager, I G

    1997-01-01

    Perceivers were assigned to one of two decision conditions. In an absolute decision condition, perceivers rated how likely they would be to allow a young or old highly forgetful, slightly forgetful, or nonforgetful target to perform a challenging task. In a comparison decision condition, perceivers rated two targets, one young and one old, who had a similar level of forgetfulness. Separate Decision Type x Target Forgetfulness analyses of variance were conducted on ratings of the two target age groups. Young targets received higher ratings in the comparison than in the absolute condition, whereas old targets were rated the same in the two conditions. There was some preference for young targets in a comparison situation, but it was concluded that forgetfulness was a more important factor than age in perceivers' ratings.

  16. Single-track absolute position encoding method based on spatial frequency of stripes

    NASA Astrophysics Data System (ADS)

    Xiang, Xiansong; Lu, Yancong; Wei, Chunlong; Zhou, Changhe

    2014-11-01

    A new method of single-track absolute position encoding based on spatial frequency of stripes is proposed. Instead of using pseudorandom-sequence arranged stripes as in conventional situations, this kind of encoding method stores the location information in the frequency space of the stripes, which means the spatial frequency of stripes varies with position and indicates position. This encoding method has a strong fault-tolerant capability with single-stripe detecting errors. The method can be applied to absolute linear encoders, absolute photoelectric angle encoders or two-dimensional absolute linear encoders. The measuring apparatus includes a CCD image sensor and a microscope system, and the method of decoding this frequency code is based on FFT algorithm. This method should be highly interesting for practical applications as an absolute position encoding method.

  17. In Vivo Measurements Of Coronary Blood Volumi By Dye And Inert Gas Dilution Technic

    NASA Astrophysics Data System (ADS)

    Hoeft, A.; Korb, H.; Wolpers, H. G.

    1984-10-01

    coronary blood volume during high values of coronary flow are avoided by the described fiberoptic device and the deconvolution technic.

  18. Prognostic Value of Coronary Computed Tomography (CT) Angiography and Coronary Artery Calcium Score Performed Before Revascularization

    PubMed Central

    Fujimoto, Shinichiro; Kondo, Takeshi; Kumamaru, Kanako K; Shinozaki, Tomohiro; Takamura, Kazuhisa; Kawaguchi, Yuko; Matsumori, Rie; Hiki, Makoto; Miyauchi, Katsumi; Daida, Hiroyuki; Rybicki, Frank J

    2015-01-01

    Background Cardiac events after revascularization are equally attributable to recurrence at site of culprit lesions and development of nonculprit lesions. We evaluated the hypothesis that coronary computed tomography (CT) angiography and coronary artery calcium score (CACS) performed before revascularization predicts cardiac events after treatment. Methods and Results Among 2238 consecutive patients without known coronary artery disease who underwent coronary CT angiography and CACS, 359 patients underwent revascularization within 30 days after CT; in 337 of 359 (93.9%) follow-up clinical information was available. In addition to known cardiac risk factors, CT findings were evaluated as predictors of cardiac events after revascularization: CACS and the presence of CT-verified high-risk plaque (CT-HRP). Improvement of predictive accuracy by including CT findings was evaluated from a discrimination (Harrell’s C-statistics) standpoint. During the follow-up period (median: 673, interquartile range: 47 to 1529 days), a total of 98 cardiac events occurred. Cox proportional hazard model revealed that age, diabetes, triglyceride, CACS, and nonculprit CT-HRP were significant predictors of overall cardiac events. Although not statistically significant, discriminatory power was greater for the model with CACS (C-stat: 63.2%) and the model with both CACS and CT-HRP (65.8%) compared to the model including neither CACS nor CT-HRP (60.7%). Conclusions High CACS and the presence of nonculprit CT-HRP performed before revascularization are significant predictors of cardiac events after revascularization. PMID:26296858

  19. Computed tomography coronary angiography with a consistent dose below 2 mSv using double prospectively ECG-triggered high-pitch spiral acquisition in patients with atrial fibrillation: initial experience.

    PubMed

    Wang, Qi; Qin, Jing; He, Bai; Zhou, Yin; Yang, Jun-jie; Hou, Xiao-ling; Yang, Xiao-bo; Chen, Jiu-hong; Chen, Yun-dai

    2013-08-01

    To evaluate the feasibility and imaging quality of double prospectively ECG-triggered high-pitch spiral acquisition mode (double flash mode) for coronary computed tomography angiography (CTCA) in patients with atrial fibrillation (AF). 47 patients (11 women, 36 men; mean age 64.5 ± 12.1 years) were enrolled for CTCA examinations using a dual-source CT with 2 × 128 × 0.6 mm collimation, 0.28 s rotation time and a pitch of 3.4. Double flash mode was prospectively triggered first at 60 % and later at 30 % of the R-R interval within two cardiac cycles. Image quality was evaluated using a four-point scale (1 = excellent, 4 = non-assessable). From 672 coronary artery segments, 77.5 % (521/672) was rated as score of 1, 20.8 % (140/672) as score of 2, 1.2 % (8/672) as score of 3 and 0.4 % (3/672) was rated as 'non-assessable'. The average image quality score was 1.25 ± 0.38 on a per segment basis. Mean dose-length product for CTCA was 92.6 ± 28.2 mGy cm, the effective dose was 1.30 ± 0.39 mSv (0.64-1.97 mSv). In patients with AF, double prospectively ECG-triggered high-pitch spiral acquisition mode could be a feasible and valuable scan mode for CTCA with a consistent dose below 2 mSv as well as diagnostic imaging quality.

  20. Negative calcium score and the presence of obstructive coronary lesions in patients with intermediate CAD probability.

    PubMed

    Sosnowski, M; Pysz, P; Szymański, L; Gola, A; Tendera, M

    2011-04-01

    We intended to estimate how the zero coronary artery calcium (CAC) score in symptomatic patients with intermediate probability of coronary artery disease predicts the absence of obstructive non-calcified coronary plaques (NCAPs). CAC scoring and coronary arteries were evaluated by means of 64-multislice CT coronary angiography (CCTA). In 166 subject with CAC=0, Non-obstructive NCAPs (less than 50%) were found in 17 patients (10.2%), while significant stenosis were diagnosed in 3 (2%). In the female insignificant stenoses were more frequent (12%) than in men (6%), however, all 3 cases with significant stenosis were male. In our study, where CCTA has been used as diagnostic method for CAD diagnosing, the prevalence of non-calcified plaques in CAC=0 subjects is relatively high. Our study confirms a relatively low incidence of significant coronary stenosis in this subset of CAD-suspected subjects.

  1. Clinical signs of androgen excess as risk factors for coronary artery disease.

    PubMed

    Wild, R A; Grubb, B; Hartz, A; Van Nort, J J; Bachman, W; Bartholomew, M

    1990-08-01

    Women with androgen excess have been found to have higher triglycerides and lower high-density lipoprotein cholesterol concentrations than nonhirsute women and are presumed to be at increased risk of coronary artery disease. However, definitive data linking androgen excess with coronary artery disease is lacking. We evaluated 102 women coming to coronary artery catheterization for signs and symptoms of androgen excess. Hirsutism was found more commonly in those women with confirmed coronary artery disease (chi 2 = 10.11). Waist:hip ratio (an index of android fat distribution) was associated with hirsutism (by ANOVA, F-test) and with coronary artery disease (t-test). The strongest associations were found in older women (aged greater than or equal to 60). Androgen excess in women may signal risk for coronary artery disease.

  2. Tbx18 Regulates Development of the Epicardium and Coronary Vessels

    PubMed Central

    Wu, San-Pin; Dong, Xiu-Rong; Regan, Jenna N.; Su, Chang; Majesky, Mark W.

    2013-01-01

    The epicardium and coronary vessels originate from progenitor cells in the proepicardium. Here we show that Tbx18, a T-box family member highly expressed in the proepicardium, controls critical early steps in coronary development. In Tbx18-/- mouse embryos, both the epicardium and coronary vessels exhibit structural and functional defects. At E12.5, the Tbx18-deficient epicardium contains protrusions and cyst-like structures overlying a disorganized coronary vascular plexus that contains ectopic structures resembling blood islands. At E13.5, the left and right coronary stems form correctly in mutant hearts. However, analysis of PECAM-1 whole mount immunostaining, distribution of SM22αlacZ/+ activity, and analysis of coronary vascular casts suggest that defective vascular plexus remodeling produces a compromised arterial network at birth consisting of fewer distributing conduit arteries with smaller lumens and a reduced capacity to conduct blood flow. Gene expression profiles of Tbx18-/- hearts at E12.5 reveal altered expression in 79 genes that are associated with development of vascular system including sonic hedgehog signaling components patched and smoothened, VEGF-A, angiopoietin-1, endoglin, and Wnt factors compared to wild type hearts. Thus, formation of coronary vasculature is responsive to Tbx18-dependent gene targets in the epicardium, and a poorly structured network of coronary conduit vessels is formed in Tbx18 null hearts due to defects in epicardial cell signaling and fate during heart development. Lastly, we demonstrate that Tbx18 possesses a SRF/CArG box dependent repressor activity capable of repressing progenitor cell differentiation into smooth muscle cells, suggesting a potential function of Tbx18 in maintaining the progenitor status of epicardial-derived cells. PMID:24016759

  3. Circulating humanin levels are associated with preserved coronary endothelial function

    PubMed Central

    Widmer, R. J.; Flammer, A. J.; Herrmann, J.; Rodriguez-Porcel, M.; Wan, J.; Cohen, P.; Lerman, L. O.

    2013-01-01

    Humanin is a small endogenous antiapoptotic peptide, originally identified as protective against Alzheimer's disease, but subsequently also found on human endothelium as well as carotid artery plaques. Endothelial dysfunction is a precursor to the development of atherosclerotic plaques, which are characterized by a highly proinflammatory, reactive oxygen species, and apoptotic milieu. Previous animal studies demonstrated that humanin administration may improve endothelial function. Thus the aim of this study was to test the hypothesis that patients with coronary endothelial dysfunction have reduced systemic levels of humanin. Forty patients undergoing coronary angiography and endothelial function testing were included and subsequently divided into two groups based on coronary blood flow (CBF) response to intracoronary acetylcholine (normal ≥ 50% increase from baseline, n = 20 each). Aortic plasma samples were obtained at the time of catheterization for the analysis of humanin levels and traditional biomarkers of atherosclerosis including C-reactive protein, Lp-Pla2, and homocysteine. Baseline characteristics were similar in both groups. Patients with coronary endothelial dysfunction (change in CBF = −33 ± 25%) had significantly lower humanin levels (1.3 ± 1.1 vs. 2.2 ± 1.5 ng/ml, P = 0.03) compared with those with normal coronary endothelial function (change in CBF = 194 ± 157%). There was a significant and positive correlation between improved CBF and humanin levels (P = 0.0091) not seen with changes in coronary flow reserve (P = 0.76). C-reactive protein, Lp-Pla2, and homocysteine were not associated with humanin levels. Thus we observed that preserved human coronary endothelial function is uniquely associated with higher systemic humanin levels, introducing a potential diagnostic and/or therapeutic target for patients with coronary endothelial function. PMID:23220334

  4. Bio-Inspired Stretchable Absolute Pressure Sensor Network

    PubMed Central

    Guo, Yue; Li, Yu-Hung; Guo, Zhiqiang; Kim, Kyunglok; Chang, Fu-Kuo; Wang, Shan X.

    2016-01-01

    A bio-inspired absolute pressure sensor network has been developed. Absolute pressure sensors, distributed on multiple silicon islands, are connected as a network by stretchable polyimide wires. This sensor network, made on a 4’’ wafer, has 77 nodes and can be mounted on various curved surfaces to cover an area up to 0.64 m × 0.64 m, which is 100 times larger than its original size. Due to Micro Electro-Mechanical system (MEMS) surface micromachining technology, ultrathin sensing nodes can be realized with thicknesses of less than 100 µm. Additionally, good linearity and high sensitivity (~14 mV/V/bar) have been achieved. Since the MEMS sensor process has also been well integrated with a flexible polymer substrate process, the entire sensor network can be fabricated in a time-efficient and cost-effective manner. Moreover, an accurate pressure contour can be obtained from the sensor network. Therefore, this absolute pressure sensor network holds significant promise for smart vehicle applications, especially for unmanned aerial vehicles. PMID:26729134

  5. Absolute gravity acceleration measurement in atomic sensor laboratories

    NASA Astrophysics Data System (ADS)

    de Angelis, M.; Greco, F.; Pistorio, A.; Poli, N.; Prevedelli, M.; Saccorotti, G.; Sorrentino, F.; Tino, G. M.

    2012-03-01

    This paper reports the results from the accurate measurement of the acceleration of gravity g taken at two separate premises in the Polo Scientifico of the Florence University (Italy). In these laboratories, two separate experiments aiming at measuring the Newtonian constant and testing the measurement of forces with high spatial resolution are in progress. Both experiments require an independent knowledge on the local value of g. Gravity measurements were conducted using an FG5 absolute gravimeter, and accompanied by seismic recordings for evaluating the noise condition at the site. The absolute accelerations of gravity at the two laboratories are ( 980 492 160.6 ± 4.0) μGal and ( 980 492 048.3 ± 3.0) μGal for the European Laboratory for Non-Linear Spectroscopy (LENS) and Dipartimento di Fisica e Astronomia, respectively. Other than for the two referenced experiments, the data here presented will serve as a benchmark for any future study requiring an accurate knowledge of the absolute value of the acceleration of gravity in the study region.

  6. Bio-Inspired Stretchable Absolute Pressure Sensor Network.

    PubMed

    Guo, Yue; Li, Yu-Hung; Guo, Zhiqiang; Kim, Kyunglok; Chang, Fu-Kuo; Wang, Shan X

    2016-01-02

    A bio-inspired absolute pressure sensor network has been developed. Absolute pressure sensors, distributed on multiple silicon islands, are connected as a network by stretchable polyimide wires. This sensor network, made on a 4'' wafer, has 77 nodes and can be mounted on various curved surfaces to cover an area up to 0.64 m × 0.64 m, which is 100 times larger than its original size. Due to Micro Electro-Mechanical system (MEMS) surface micromachining technology, ultrathin sensing nodes can be realized with thicknesses of less than 100 µm. Additionally, good linearity and high sensitivity (~14 mV/V/bar) have been achieved. Since the MEMS sensor process has also been well integrated with a flexible polymer substrate process, the entire sensor network can be fabricated in a time-efficient and cost-effective manner. Moreover, an accurate pressure contour can be obtained from the sensor network. Therefore, this absolute pressure sensor network holds significant promise for smart vehicle applications, especially for unmanned aerial vehicles.

  7. Computational study of the risk of restenosis in coronary bypasses.

    PubMed

    Guerciotti, Bruno; Vergara, Christian; Ippolito, Sonia; Quarteroni, Alfio; Antona, Carlo; Scrofani, Roberto

    2017-02-01

    Coronary artery disease, caused by the buildup of atherosclerotic plaques in the coronary vessel wall, is one of the leading causes of death in the world. For high-risk patients, coronary artery bypass graft is the preferred treatment. Despite overall excellent patency rates, bypasses may fail due to restenosis. In this context, the purpose of this work was to perform a parametric computational study of the fluid dynamics in patient-specific geometries with the aim of investigating a possible relationship between coronary stenosis degree and risk of graft failure. Firstly, we propose a strategy to prescribe realistic boundary conditions in the absence of measured data, based on an extension of Murray's law to provide the flow division at bifurcations in case of stenotic vessels and non-Newtonian blood rheology. Then, we carry out numerical simulations in three patients affected by severe coronary stenosis and treated with a graft, in which the stenosis degree is virtually varied in order to compare the resulting fluid dynamics in terms of hemodynamic indices potentially involved in restenosis development. Our findings suggest that low degrees of coronary stenosis produce a more disturbed fluid dynamics in the graft, resulting in hemodynamic conditions that may promote a higher risk of graft failure.

  8. From Hubble's NGSL to Absolute Fluxes

    NASA Technical Reports Server (NTRS)

    Heap, Sara R.; Lindler, Don

    2012-01-01

    Hubble's Next Generation Spectral Library (NGSL) consists of R-l000 spectra of 374 stars of assorted temperature, gravity, and metallicity. Each spectrum covers the wavelength range, 0.18-1.00 microns. The library can be viewed and/or downloaded from the website, http://archive.stsci.edu/prepds/stisngsll. Stars in the NGSL are now being used as absolute flux standards at ground-based observatories. However, the uncertainty in the absolute flux is about 2%, which does not meet the requirements of dark-energy surveys. We are therefore developing an observing procedure that should yield fluxes with uncertainties less than 1 % and will take part in an HST proposal to observe up to 15 stars using this new procedure.

  9. Consistent thermostatistics forbids negative absolute temperatures

    NASA Astrophysics Data System (ADS)

    Dunkel, Jörn; Hilbert, Stefan

    2014-01-01

    Over the past 60 years, a considerable number of theories and experiments have claimed the existence of negative absolute temperature in spin systems and ultracold quantum gases. This has led to speculation that ultracold gases may be dark-energy analogues and also suggests the feasibility of heat engines with efficiencies larger than one. Here, we prove that all previous negative temperature claims and their implications are invalid as they arise from the use of an entropy definition that is inconsistent both mathematically and thermodynamically. We show that the underlying conceptual deficiencies can be overcome if one adopts a microcanonical entropy functional originally derived by Gibbs. The resulting thermodynamic framework is self-consistent and implies that absolute temperature remains positive even for systems with a bounded spectrum. In addition, we propose a minimal quantum thermometer that can be implemented with available experimental techniques.

  10. Absolute measurement of length with nanometric resolution

    NASA Astrophysics Data System (ADS)

    Apostol, D.; Garoi, F.; Timcu, A.; Damian, V.; Logofatu, P. C.; Nascov, V.

    2005-08-01

    Laser interferometer displacement measuring transducers have a well-defined traceability route to the definition of the meter. The laser interferometer is de-facto length scale for applications in micro and nano technologies. However their physical unit -half lambda is too large for nanometric resolution. Fringe interpolation-usual technique to improve the resolution-lack of reproducibility could be avoided using the principles of absolute distance measurement. Absolute distance refers to the use of interferometric techniques for determining the position of an object without the necessity of measuring continuous displacements between points. The interference pattern as produced by the interference of two point-like coherent sources is fitted to a geometric model so as to determine the longitudinal location of the target by minimizing least square errors. The longitudinal coordinate of the target was measured with accuracy better than 1 nm, for a target position range of 0.4μm.

  11. Computer processing of spectrograms for absolute intensities.

    PubMed

    Guttman, A; Golden, J; Galbraith, H J

    1967-09-01

    A computer program was developed to process photographically recorded spectra for absolute intensity. Test and calibration films are subjected to densitometric scans that provide digitally recorded densities on magnetic tapes. The nonlinear calibration data are fitted by least-squares cubic polynomials to yield a good approximation to the monochromatic H&D curves for commonly used emulsions (2475 recording film, Royal-X, Tri-X, 4-X). Several test cases were made. Results of these cases show that the machine processed absolute intensities are accurate to within 15%o. Arbitrarily raising the sensitivity threshold by 0.1 density units above gross fog yields cubic polynomial fits to the H&D curves that are radiometrically accurate within 10%. In addition, curves of gamma vs wavelength for 2475, Tri-X, and 4-X emulsions were made. These data show slight evidence of the photographic Purkinje effect in the 2475 emulsion.

  12. An absolute measure for a key currency

    NASA Astrophysics Data System (ADS)

    Oya, Shunsuke; Aihara, Kazuyuki; Hirata, Yoshito

    It is generally considered that the US dollar and the euro are the key currencies in the world and in Europe, respectively. However, there is no absolute general measure for a key currency. Here, we investigate the 24-hour periodicity of foreign exchange markets using a recurrence plot, and define an absolute measure for a key currency based on the strength of the periodicity. Moreover, we analyze the time evolution of this measure. The results show that the credibility of the US dollar has not decreased significantly since the Lehman shock, when the Lehman Brothers bankrupted and influenced the economic markets, and has increased even relatively better than that of the euro and that of the Japanese yen.

  13. Probing absolute spin polarization at the nanoscale.

    PubMed

    Eltschka, Matthias; Jäck, Berthold; Assig, Maximilian; Kondrashov, Oleg V; Skvortsov, Mikhail A; Etzkorn, Markus; Ast, Christian R; Kern, Klaus

    2014-12-10

    Probing absolute values of spin polarization at the nanoscale offers insight into the fundamental mechanisms of spin-dependent transport. Employing the Zeeman splitting in superconducting tips (Meservey-Tedrow-Fulde effect), we introduce a novel spin-polarized scanning tunneling microscopy that combines the probing capability of the absolute values of spin polarization with precise control at the atomic scale. We utilize our novel approach to measure the locally resolved spin polarization of magnetic Co nanoislands on Cu(111). We find that the spin polarization is enhanced by 65% when increasing the width of the tunnel barrier by only 2.3 Å due to the different decay of the electron orbitals into vacuum.

  14. Absolute and relative dosimetry for ELIMED

    NASA Astrophysics Data System (ADS)

    Cirrone, G. A. P.; Cuttone, G.; Candiano, G.; Carpinelli, M.; Leonora, E.; Lo Presti, D.; Musumarra, A.; Pisciotta, P.; Raffaele, L.; Randazzo, N.; Romano, F.; Schillaci, F.; Scuderi, V.; Tramontana, A.; Cirio, R.; Marchetto, F.; Sacchi, R.; Giordanengo, S.; Monaco, V.

    2013-07-01

    The definition of detectors, methods and procedures for the absolute and relative dosimetry of laser-driven proton beams is a crucial step toward the clinical use of this new kind of beams. Hence, one of the ELIMED task, will be the definition of procedures aiming to obtain an absolute dose measure at the end of the transport beamline with an accuracy as close as possible to the one required for clinical applications (i.e. of the order of 5% or less). Relative dosimetry procedures must be established, as well: they are necessary in order to determine and verify the beam dose distributions and to monitor the beam fluence and the energetic spectra during irradiations. Radiochromic films, CR39, Faraday Cup, Secondary Emission Monitor (SEM) and transmission ionization chamber will be considered, designed and studied in order to perform a fully dosimetric characterization of the ELIMED proton beam.

  15. [The Fabry's Disease Cardiomyopathy as Differential Diagnosis of Acute Coronary Syndrome].

    PubMed

    Oder, Daniel; Störk, Stefan; Wanner, Christoph; Ertl, Georg; Weidemann, Frank; Nordbeck, Peter

    2017-03-01

    The progressive cardiomyopathy in patients with Fabry disease is often accompanied by angina pectoris and elevated levels of high-sensitive troponin T (hs-TnT), potentially mimicking acute coronary syndrome. Here, we present to representative cases with focus on clinical, diagnostic and therapeutic settings. An overview on the cardiomyopathy associated with Fabry disease and its role as differential diagnosis of acute coronary syndrome is provided. Fabry cardiomyopathy might exhibit similar clinical and biochemical constellations as seen in acute coronary syndrome. Thus, Fabry cardiomyopathy should be considered a differential diagnosis in acute coronary syndrome, particularly in patients demonstrating left ventricular hypertrophy of unknown origin.

  16. Acute coronary syndromes in patients with HIV

    PubMed Central

    Seecheran, Valmiki K.; Giddings, Stanley L.

    2017-01-01

    Highly active antiretroviral treatment (HAART) has considerably increased the life expectancy of patients infected with HIV. Coronary artery disease is a leading cause of mortality in patients infected with HIV. This is primarily attributed to their increased survival, HAART-induced metabolic derangements, and to HIV itself. The pathophysiology of atherosclerosis in HIV is both multifactorial and complex – involving direct endothelial injury and dysfunction, hypercoagulability, and a significant contribution from traditional cardiac risk factors. The advent of HAART has since heralded a remarkable improvement in outcomes, but at the expense of other unforeseen issues. It is thus of paramount importance to swiftly recognize and manage acute coronary syndromes in HIV-infected patients to attenuate adverse complications, which should translate into improved clinical outcomes. PMID:27845996

  17. Cutaneous markers of coronary artery disease

    PubMed Central

    Dwivedi, Shridhar; Jhamb, Rajat

    2010-01-01

    Coronary artery disease (CAD) is rapidly increasing in prevalence across the world and particularly in south Asians at a relatively younger age. As atherosclerosis starts in early childhood, the process of risk evaluation must start quite early. The present review addresses the issue of cutaneous markers associated with atherosclerosis, and the strengths and weaknesses of the markers in identifying early coronary atherosclerosis. A diligent search for such clinical markers, namely xanthelasma, xanthoma, arcus juvenilis, acanthosis nigricans, skin tags, ear lobe crease, nicotine stains, premature graying in smokers, hyperpigmented hands in betel quid sellers, central obesity, and signs of peripheral vascular disease may prove to be a rewarding exercise in identifying asymptomatic CAD in high risk individuals. PMID:21160602

  18. Contemporary Review on Spontaneous Coronary Artery Dissection.

    PubMed

    Saw, Jacqueline; Mancini, G B John; Humphries, Karin H

    2016-07-19

    Spontaneous coronary artery dissection (SCAD) is gaining recognition as an important cause of myocardial infarction, especially in young women. There has been a surge in the diagnosis of SCAD in recent years, presumably due to an increased use of coronary angiography, and the clinical availability and application of high-resolution intracoronary imaging. The improved recognition and diagnosis, together with increased publications and attention through social media, have considerably raised awareness of this condition, which was once believed to be very rare. Recent publications of moderate to large contemporary case series have helped elucidate the early natural history, presenting characteristics (clinical and angiographic), underlying etiology, management, and cardiovascular outcomes with this condition, thus providing observations and important clinical insights of value to clinicians managing this challenging and perplexing patient cohort. The aim of our review is to provide a comprehensive contemporary update of SCAD to aid health care professionals in managing these patients in both the acute and chronic settings.

  19. Silicon Absolute X-Ray Detectors

    SciTech Connect

    Seely, John F.; Korde, Raj; Sprunck, Jacob; Medjoubi, Kadda; Hustache, Stephanie

    2010-06-23

    The responsivity of silicon photodiodes having no loss in the entrance window, measured using synchrotron radiation in the 1.75 to 60 keV range, was compared to the responsivity calculated using the silicon thickness measured using near-infrared light. The measured and calculated responsivities agree with an average difference of 1.3%. This enables their use as absolute x-ray detectors.

  20. Diagnostic Performance of Resting CT Myocardial Perfusion in Patients With Possible Acute Coronary Syndrome

    PubMed Central

    Branch, Kelley R.; Busey, Janet; Mitsumori, Lee M.; Strote, Jared; Caldwell, James H.; Busch, Joshua H.; Shuman, William P.

    2014-01-01

    OBJECTIVE Coronary CT angiography has high sensitivity, but modest specificity, to detect acute coronary syndrome. We studied whether adding resting CT myocardial perfusion imaging improved the detection of acute coronary syndrome. SUBJECTS AND METHODS Patients with low-to-intermediate cardiac risk presenting with possible acute coronary syndrome received both the standard of care evaluation and a research thoracic 64-MDCT examination. Patients with an obstructive (> 50%) stenosis or a nonevaluable coronary segment on CT were diagnosed with possible acute coronary syndrome. CT perfusion was determined by applying gray and color Hounsfield unit maps to resting CT angiography images. Adjudicated patient diagnoses were based on the standard of care and 3-month follow-up. Patient-level diagnostic performance for acute coronary syndrome was calculated for coronary CT, CT perfusion, and combined techniques. RESULTS A total of 105 patients were enrolled. Of the nine (9%) patients with acute coronary syndrome, all had obstructive CT stenoses but only three had abnormal CT perfusion. CT perfusion was normal in all other patients. To detect acute coronary syndrome, CT angiography had 100% sensitivity, 89% specificity, and a positive predictive value of 45%. For CT perfusion, specificity and positive predictive value were each 100%, and sensitivity was 33%. Combined cardiac CT and CT perfusion had similar specificity but a higher positive predictive value (100%) than did CT angiography. CONCLUSION Resting CT perfusion using CT angiographic images may have high specificity and may improve CT positive predictive value for acute coronary syndrome without added radiation and contrast. However, normal resting CT perfusion cannot exclude acute coronary syndrome. PMID:23617513

  1. Negative absolute temperature for mobile particles

    NASA Astrophysics Data System (ADS)

    Braun, Simon; Ronzheimer, Philipp; Schreiber, Michael; Hodgman, Sean; Bloch, Immanuel; Schneider, Ulrich

    2013-05-01

    Absolute temperature is usually bound to be strictly positive. However, negative absolute temperature states, where the occupation probability of states increases with their energy, are possible in systems with an upper energy bound. So far, such states have only been demonstrated in localized spin systems with finite, discrete spectra. We realized a negative absolute temperature state for motional degrees of freedom with ultracold bosonic 39K atoms in an optical lattice, by implementing the attractive Bose-Hubbard Hamiltonian. This new state strikingly revealed itself by a quasimomentum distribution that is peaked at maximum kinetic energy. The measured kinetic energy distribution and the extracted negative temperature indicate that the ensemble is close to degeneracy, with coherence over several lattice sites. The state is as stable as a corresponding positive temperature state: The negative temperature stabilizes the system against mean-field collapse driven by negative pressure. Negative temperatures open up new parameter regimes for cold atoms, enabling fundamentally new many-body states. Additionally, they give rise to several counterintuitive effects such as heat engines with above unity efficiency.

  2. Measurement of absolute gravity acceleration in Firenze

    NASA Astrophysics Data System (ADS)

    de Angelis, M.; Greco, F.; Pistorio, A.; Poli, N.; Prevedelli, M.; Saccorotti, G.; Sorrentino, F.; Tino, G. M.

    2011-01-01

    This paper reports the results from the accurate measurement of the acceleration of gravity g taken at two separate premises in the Polo Scientifico of the University of Firenze (Italy). In these laboratories, two separate experiments aiming at measuring the Newtonian constant and testing the Newtonian law at short distances are in progress. Both experiments require an independent knowledge on the local value of g. The only available datum, pertaining to the italian zero-order gravity network, was taken more than 20 years ago at a distance of more than 60 km from the study site. Gravity measurements were conducted using an FG5 absolute gravimeter, and accompanied by seismic recordings for evaluating the noise condition at the site. The absolute accelerations of gravity at the two laboratories are (980 492 160.6 ± 4.0) μGal and (980 492 048.3 ± 3.0) μGal for the European Laboratory for Non-Linear Spectroscopy (LENS) and Dipartimento di Fisica e Astronomia, respectively. Other than for the two referenced experiments, the data here presented will serve as a benchmark for any future study requiring an accurate knowledge of the absolute value of the acceleration of gravity in the study region.

  3. System for absolute measurements by interferometric sensors

    NASA Astrophysics Data System (ADS)

    Norton, Douglas A.

    1993-03-01

    The most common problem of interferometric sensors is their inability to measure absolute path imbalance. Presented in this paper is a signal processing system that gives absolute, unambiguous reading of optical path difference for almost any style of interferometric sensor. Key components are a wide band (incoherent) optical source, a polychromator, and FFT electronics. Advantages include no moving parts in the signal processor, no active components at the sensor location, and the use of standard single mode fiber for sensor illumination and signal transmission. Actual absolute path imbalance of the interferometer is determined without using fringe counting or other inferential techniques. The polychromator extracts the interference information that occurs at each discrete wavelength within the spectral band of the optical source. The signal processing consists of analog and digital filtering, Fast Fourier analysis, and a peak detection and interpolation algorithm. This system was originally designed for use in a remote pressure sensing application that employed a totally passive fiber optic interferometer. A performance qualification was made using a Fabry-Perot interferometer and a commercially available laser interferometer to measure the reference displacement.

  4. Chemical composition of French mimosa absolute oil.

    PubMed

    Perriot, Rodolphe; Breme, Katharina; Meierhenrich, Uwe J; Carenini, Elise; Ferrando, Georges; Baldovini, Nicolas

    2010-02-10

    Since decades mimosa (Acacia dealbata) absolute oil has been used in the flavor and perfume industry. Today, it finds an application in over 80 perfumes, and its worldwide industrial production is estimated five tons per year. Here we report on the chemical composition of French mimosa absolute oil. Straight-chain analogues from C6 to C26 with different functional groups (hydrocarbons, esters, aldehydes, diethyl acetals, alcohols, and ketones) were identified in the volatile fraction. Most of them are long-chain molecules: (Z)-heptadec-8-ene, heptadecane, nonadecane, and palmitic acid are the most abundant, and constituents such as 2-phenethyl alcohol, methyl anisate, and ethyl palmitate are present in smaller amounts. The heavier constituents were mainly triterpenoids such as lupenone and lupeol, which were identified as two of the main components. (Z)-Heptadec-8-ene, lupenone, and lupeol were quantified by GC-MS in SIM mode using external standards and represents 6%, 20%, and 7.8% (w/w) of the absolute oil. Moreover, odorant compounds were extracted by SPME and analyzed by GC-sniffing leading to the perception of 57 odorant zones, of which 37 compounds were identified by their odorant description, mass spectrum, retention index, and injection of the reference compound.

  5. Constrained Least Absolute Deviation Neural Networks

    PubMed Central

    Wang, Zhishun; Peterson, Bradley S.

    2008-01-01

    It is well known that least absolute deviation (LAD) criterion or L1-norm used for estimation of parameters is characterized by robustness, i.e., the estimated parameters are totally resistant (insensitive) to large changes in the sampled data. This is an extremely useful feature, especially, when the sampled data are known to be contaminated by occasionally occurring outliers or by spiky noise. In our previous works, we have proposed the least absolute deviation neural network (LADNN) to solve unconstrained LAD problems. The theoretical proofs and numerical simulations have shown that the LADNN is Lyapunov-stable and it can globally converge to the exact solution to a given unconstrained LAD problem. We have also demonstrated its excellent application value in time-delay estimation. More generally, a practical LAD application problem may contain some linear constraints, such as a set of equalities and/or inequalities, which is called constrained LAD problem, whereas the unconstrained LAD can be considered as a special form of the constrained LAD. In this paper, we present a new neural network called constrained least absolute deviation neural network (CLADNN) to solve general constrained LAD problems. Theoretical proofs and numerical simulations demonstrate that the proposed CLADNN is Lyapunov stable and globally converges to the exact solution to a given constrained LAD problem, independent of initial values. The numerical simulations have also illustrated that the proposed CLADNN can be used to robustly estimate parameters for nonlinear curve fitting, which is extensively used in signal and image processing. PMID:18269958

  6. Long-term survival after coronary bypass surgery and percutaneous coronary intervention

    PubMed Central

    Mølstad, Per; Moer, Rasmus; Rødevand, Olaf

    2016-01-01

    Objectives To assess whether there exists a long-term difference in survival after treatment with coronary bypass surgery or percutaneous coronary intervention in patients with coronary disease as judged by all-cause mortality. Methods Retrospective study from the Feiring Heart Clinic database of survival in 22 880 patients—15 078 treated with percutaneous coronary intervention and 7802 with bypass surgery followed up to 16 years. Results Cox regression and propensity score analysis showed no difference in survival for one-vessel and two-vessel disease during the whole study period. In three-vessel disease, however, the analysis revealed a consistent and highly significant survival benefit in the first 8 years with an HR of 0.76 (95% CI 0.69 to 0.84, p<0.001) in favour of bypass surgery with similar survival rates in the two treatment strategies after that time period. Conclusions Treatment strategy did not affect survival in one-vessel and two-vessel disease, but bypass surgery offered an improved survival in the first 8 years in patients with three-vessel disease. These results are consistent with most previous reports and the survival benefit should be taken into account when selecting a strategy for this patient group. PMID:27843567

  7. Computerized analysis of coronary artery disease: Performance evaluation of segmentation and tracking of coronary arteries in CT angiograms

    SciTech Connect

    Zhou, Chuan Chan, Heang-Ping; Chughtai, Aamer; Kuriakose, Jean; Agarwal, Prachi; Kazerooni, Ella A.; Hadjiiski, Lubomir M.; Patel, Smita; Wei, Jun

    2014-08-15

    .2% and 53.4%, respectively. For the 62 test cases, a total of 55 FPs were identified by radiologist in 23 of the cases. Conclusions: The authors’ MSCAR-RBG method achieved high sensitivity for coronary artery segmentation and tracking. Studies are underway to further improve the accuracy for the arterial segments affected by motion artifacts, severe calcified and noncalcified soft plaques, and to reduce the false tracking of the veins and other noisy structures. Methods are also being developed to detect coronary artery disease along the tracked vessels.

  8. Percutaneous Coronary Intervention Enhances Accelerative Wave Intensity in Coronary Arteries

    PubMed Central

    Narayan, Om; Leung, Michael C. H.; Wong, Dennis T. L.; Meredith, Ian T.; Cameron, James D.

    2015-01-01

    Background The systolic forward travelling compression wave (sFCW) and diastolic backward travelling decompression waves (dBEW) predominantly accelerate coronary blood flow. The effect of a coronary stenosis on the intensity of these waves in the distal vessel is unknown. We investigated the relationship between established physiological indices of hyperemic coronary flow and the intensity of the two major accelerative coronary waves identified by Coronary Wave Intensity analysis (CWIA). Methodology / Principal Findings Simultaneous intracoronary pressure and velocity measurement was performed during adenosine induced hyperemia in 17 patients with pressure / Doppler flow wires positioned distal to the target lesion. CWI profiles were generated from this data. Fractional Flow Reserve (FFR) and Coronary Flow Velocity Reserve (CFVR) were calculated concurrently. The intensity of the dBEW was significantly correlated with FFR (R = -0.70, P = 0.003) and CFVR (R = -0.73, P = 0.001). The intensity of the sFCW was also significantly correlated with baseline FFR (R = 0.71, p = 0.002) and CFVR (R = 0.59, P = 0.01). Stenting of the target lesion resulted in a median 178% (interquartile range 55–280%) (P<0.0001) increase in sFCW intensity and a median 117% (interquartile range 27–509%) (P = 0.001) increase in dBEW intensity. The increase in accelerative wave intensity following PCI was proportionate to the baseline FFR and CFVR, such that stenting of lesions associated with the greatest flow limitation (lowest FFR and CFVR) resulted in the largest increases in wave intensity. Conclusions Increasing ischemia severity is associated with proportionate reductions in cumulative intensity of both major accelerative coronary waves. Impaired diastolic microvascular decompression may represent a novel, important pathophysiologic mechanism driving the reduction in coronary blood flow in the setting of an epicardial stenosis. PMID:26658896

  9. Exercise thallium-201 myocardial imaging in left main coronary artery disease: sensitive but not specific

    SciTech Connect

    Rehn, T.; Griffith, L.S.; Achuff, S.C.; Bailey, I.K.; Bulkley, B.H.; Burow, R.; Pitt, B.; Becker, L.C.

    1981-08-01

    To determine the usefulness of thallium-201 scintigraphy for identifying left main coronary artery disease, the results of scintigraphy at rest and during exercise were compared in 24 patients with 50 percent or greater narrowing of the left main coronary artery and 80 patients with 50 percent or greater narrowing of one or more of the major coronary arteries but without left main coronary involvement. By segmental analysis of the scintigrams, perfusion defects were assigned to the left anterior descending, left circumflex or right coronary artery, singly or in combination, and the pattern of simultaneous left anterior descending and circumflex arterial defects was used to identify left main coronary artery disease. Of the 24 patients with left main coronary artery disease, 22 (92 percent) had abnormal exercise scintigrams. Despite this high sensitivity, the pattern of perfusion defects was not specific; the ''left main pattern'' was found in 3 patients (13 percent) with left main coronary artery disease but also in 3 (33 percent) of 9 patients with combined left anterior descending and left circumflex arterial disease, 4 (19 percent) of 21 patients with three vessel disease and 3 (6 percent) of 50 patients with one or two vessel disease but excluding the group with left anterior descending plus left circumflex arterial disease. The pattern of perfusion defects in the patients with left main coronary artery disease was determined by the location and severity of narrowings in the coronary arteries downstream from the left main arterial lesion. Concomitant lesions in other arteries were found in all patients with left main coronary disease (one vessel in 1 patient, two vessels in 7 patients and three vessels in 16). For this reason, it is unlikely that even with improvements in radiopharmaceutical agents and imaging techniques, myocardial perfusion scintigraphy will be sufficiently specific for definitive identification of left main coronary artery disease.

  10. Origin and course of the coronary arteries in normal mice and in iv/iv mice

    PubMed Central

    ICARDO, JOSÉ M.; COLVEE, ELVIRA

    2001-01-01

    This paper reports on the origin and distribution of the coronary arteries in normal mice and in mice of the iv/iv strain, which show situs inversus and heterotaxia. The coronary arteries were studied by direct observation of the aortic sinuses with the scanning electron microscope, and by examination of vascular corrosion casts. In the normal mouse, the left and right coronaries (LC, RC) arise from the respective Valsalva sinus and course along the ventricular borders to reach the heart apex. Along this course the coronary arteries give off small branches at perpendicular or acute angles to supply the ventricles. The ventricular septum is supplied by the septal artery, which arises as a main branch from the right coronary. Conus arteries arise from the main coronary trunks, from the septal artery and/or directly from the Valsalva sinus. The vascular casts demonstrate the presence of intercoronary anastomoses. The origin of the coronary arteries was found to be abnormal in 84% of the iv/iv mice. These anomalies included double origin, high take-off, slit-like openings and the presence of a single coronary orifice. These anomalies occurred singly or in any combination, and were independent of heart situs. The septal artery originated from RC in most cases of situs solitus but originated predominantly from LC in situs inversus hearts. Except for this anomalous origin no statistical correlation was found between the coronary anomalies and heart situs or a particular mode of heterotaxia. The coronary anomalies observed in the iv/iv mice are similar to those found in human hearts. Most coronary anomalies appear to be due to defective connections between the aortic root and the developing coronaries. iv/iv mice may therefore constitute a good model to study the development of similar anomalies in the human heart. PMID:11693308

  11. Diagnostic accuracy of noninvasive coronary angiography with 320-detector row computed tomography.

    PubMed

    Nasis, Arthur; Leung, Michael C; Antonis, Paul R; Cameron, James D; Lehman, Sam J; Hope, Sarah A; Crossett, Marcus P; Troupis, John M; Meredith, Ian T; Seneviratne, Sujith K

    2010-11-15

    We sought to evaluate the diagnostic accuracy of noninvasive coronary angiography using 320-detector row computed tomography, which provides 16-cm craniocaudal coverage in 350 ms and can image the entire coronary tree in a single heartbeat, representing a significant advance from previous-generation scanners. We evaluated 63 consecutive patients who underwent 320-detector row computed tomography and invasive coronary angiography for the investigation of suspected coronary artery disease. Patients with known coronary artery disease were excluded. Computed tomographic (CT) studies were assessed by 2 independent observers blinded to results of invasive coronary angiography. A single observer unaware of CT results assessed invasive coronary angiographic images quantitatively. All available coronary segments were included in the analysis, regardless of size or image quality. Lesions with >50% diameter stenoses were considered significant. Mean heart rate was 63 ± 7 beats/min, with 6 patients (10%) in atrial fibrillation during image acquisition. Thirty-three patients (52%) and 70 of 973 segments (7%) had significant coronary stenoses on invasive coronary angiogram. Seventeen segments (2%) were nondiagnostic on computed tomogram and were assumed to contain significant stenoses on an "intention-to-diagnose" analysis. Sensitivity, specificity, and positive and negative predictive values of computed tomography for detecting significant stenoses were 94%, 87%, 88%, and 93%, respectively, by patient (n = 63), 89%, 95%, 82%, and 97%, respectively, by artery (n = 260), and 87%, 97%, 73%, and 99%, respectively, by segment (n = 973). In conclusion, noninvasive 320-detector row CT coronary angiography provides high diagnostic accuracy across all coronary segments, regardless of size, cardiac rhythm, or image quality.

  12. Coronary Artery Disease Risk Factors, Coronary Artery Calcification and Coronary Bypass Surgery

    PubMed Central

    Ulusoy, Fatih Rifat; Ipek, Emrah; Korkmaz, Ali Fuat; Gurler, Mehmet Yavuz; Gulbaran, Murat

    2015-01-01

    Introduction Atherosclerosis is an intimal disease which affects large and medium size arteries including aorta and carotid, coronary, cerebral and radial arteries. Calcium accumulated in the coronary arterial plaques have substantial contribution to the plaque volume. The aim of our study is to investigate the relationship between coronary artery disease (CAD) risk factors and coronary arterial calcification, and to delineate the importance of CACS in coronary artery bypass surgery. Materials and Methods The current study is retrospective and 410 patients admitted to our clinic with atypical chest pain and without known CAD were included. These individuals were evaluated by 16 slice electron beam computed tomography with suspicion of CAD and their calcium scores were calculated. Detailed demographic and medical history were obtained from all of the patients. Results In our study, we employed five different analyses using different coronary arterial calcification score (CACS) thresold levels reported in previous studies. All of the analyses, performed according to the previously defined thresold levels, showed that risk factors had strong positive relationship with CACS as mentioned in previous studies. Conclusion Coronary arterial calcification is part of the athero-sclerotic process and although it can be detected in atherosclerotic vessel, it is absent in a normal vessel. It can be concluded that the clinical scores, even they are helpful, have some limitations in a significant part of the population for cardiovascular risk determination. It is important for an anastomosis region to be noncalcified in coronary bypass surgery. In a coronary artery, it will be helpness for showing of calcific field and anostomosis spot. PMID:26155507

  13. Assessment of coronary vasomotion by intracoronary ultrasound

    NASA Astrophysics Data System (ADS)

    Dupouy, Patrick J.; Dubois-Rande, Jean Luc; Pelle, Gabriel; Gallot, Dominique; Geschwind, Herbert J.

    1993-06-01

    Recently, new intravascular ultrasound devices for intracoronary use became available. The aim of the study was to evaluate the accuracy of intravascular ultrasound for the assessment of coronary artery vasomotion and endothelial function in patients with atherosclerosis. Twenty patients with luminal irregularities on coronary angiogram and a high cholesterol level (287 +/- 19 mg/dl) (group 1) and 6 patients with angiographically smooth arteries and a minimally elevated cholesterol level (197 +/- 12 mg/dl) (group 2) were studied. A mechanical intravascular ultrasound probe (4.3 French, 30 MHz, Cardiovascular Imaging Systems) was placed into the proximal segment of the coronary artery. Off-line measurements of the lumen area and calculation of mean intimal thickness indice was performed using digitized ultrasound images. Endothelial function was studied during a sympathetic stimulation by a cold pressor test and after intracoronary administration of papaverine and linsidomine. Mean intimal thickness was higher in group 1 than in group 2 (1.52 +/- 0.64 mm vs. 0.18 +/- 0.08 mm, p < 0.001). Linsidomine infusion induced a significant vasodilating effect in both groups (p < 0.001).

  14. Anomalous left main coronary artery: case series of different courses and literature review.

    PubMed

    Marler, Adam T; Malik, Jamil A; Slim, Ahmad M

    2013-01-01

    Background. Congenital anomalies of the coronary arteries are a cause of sudden cardiac death. Of the known anatomic variants, anomalous origination of a coronary artery from an opposite sinus of Valsalva (ACAOS) remains the main focus of debate. Case Series. We present three cases, all presenting to our facility within one week's time, of patients with newly discovered anomalous origination of the left coronary artery from the right sinus of Valsalva (L-ACAOS). All patients underwent cardiac computed tomography for evaluation of coronary anatomy along with other forms of functional testing. Despite the high risk nature of two of the anomalies, the patients are being treated medically without recurrence of symptoms. Summary. After review of the literature, we have found that the risk of sudden cardiac death in patients with congenital coronary anomalies, even among variants considered the highest risk, may be overestimated. In addition, the exact prevalence of coronary anomalies in the general population is currently underestimated. A national coronary artery anomaly registry based on cardiac computed tomography and invasive coronary angiography data would be helpful in advancing our understanding of these cardiac peculiarities. The true prevalence of congenital coronary anomalies and overall risk of sudden cardiac death in this population are not well known. Surgical intervention remains the mainstay of therapy in certain patients though recent investigations into the pathophysiology of these abnormalities have shown that the risk of surgery may outweigh the minimal reduction in risk of sudden cardiac death.

  15. Reconstruction of coronary arteries from X-ray angiography: A review.

    PubMed

    Çimen, Serkan; Gooya, Ali; Grass, Michael; Frangi, Alejandro F

    2016-08-01

    Despite continuous progress in X-ray angiography systems, X-ray coronary angiography is fundamentally limited by its 2D representation of moving coronary arterial trees, which can negatively impact assessment of coronary artery disease and guidance of percutaneous coronary intervention. To provide clinicians with 3D/3D+time information of coronary arteries, methods computing reconstructions of coronary arteries from X-ray angiography are required. Because of several aspects (e.g. cardiac and respiratory motion, type of X-ray system), reconstruction from X-ray coronary angiography has led to vast amount of research and it still remains as a challenging and dynamic research area. In this paper, we review the state-of-the-art approaches on reconstruction of high-contrast coronary arteries from X-ray angiography. We mainly focus on the theoretical features in model-based (modelling) and tomographic reconstruction of coronary arteries, and discuss the evaluation strategies. We also discuss the potential role of reconstructions in clinical decision making and interventional guidance, and highlight areas for future research.

  16. ST Elevation Infarction after Heart Transplantation Induced by Coronary Spasms and Mural Thrombus Detected by Optical Coherence Tomography

    PubMed Central

    Holm, Niels Ramsing; Eiskjær, Hans; Poulsen, Steen Hvitfeldt; Maeng, Michael; Terkelsen, Christian Juhl; Christiansen, Evald Høj

    2016-01-01

    The case illustrates the possible link between coronary spasms, intraluminal thrombus formation, and widespread organized and layered thrombi in HTx patients. Furthermore, the case underlines the clinical value of OCT as a novel method for high-resolution vessel imaging in heart-transplanted (HTx) patients with coronary spasms and suspected coronary artery disease. Coronary spasms and sudden death are frequent complications after HTx. The underlying mechanisms leading to these complications are unknown. The present case displays the clinical course of a 19-year-old HTx patient who was hospitalized due to acute myocardial infarction induced by severe coronary spasms. The patients remained unstable on conservative therapy. Therefore, an optical coherence tomography (OCT) was performed and revealed massive, organized thrombi in the left main coronary artery, the circumflex coronary artery, and the left anterior descending coronary artery. The patient was stabilized after percutaneous coronary intervention. As a mural thrombus often goes undetected by coronary angiography, OCT may prove benefit in HTx patients with myocardial infarction or suspected coronary spasms. PMID:27980873

  17. Exercise testing in suspected coronary artery disease.

    PubMed

    Sox, H C

    1985-12-01

    The interpretation and selection of exercise tests depends on the pretest probability of CAD. Imperfect tests (like exercise tests) provide probability estimates, not definite statements (such as "the patient has CAD" or "the patient does not have CAD"). In patients with a low pretest probability of CAD (asymptomatic persons or men and women with nonanginal chest pain), abnormal exercise test results provide probability estimates that are much too low to conclude that the patient has CAD. In patients with anginal pain and normal exercise tests, the probability of CAD is too high to conclude that the patient has a normal coronary circulation. Exercise tests are not useful for trying to rule out CAD in patients with anginal pain. In patients with an intermediate pretest probability of CAD (men and women with atypical angina and women with typical angina), abnormal exercise tests (particularly the myocardial scintiscan) provide probability estimates that are high enough to justify starting treatment for CAD. Exercise tests are most useful in this group, a conclusion that has been reached by other methods of analysis. The myocardial scintiscan is much more useful than the exercise ECG in women. When CAD is strongly suspected, exercise tests have relatively little diagnostic value but may be useful for prognosis. However, clinical evidence of poor ventricular function may alone suffice to select patients with angina pectoris for coronary arteriography. Conversely, when clinical indicators of congestive heart failure are absent, the prognosis in chronic stable angina is so favorable that any further testing may be unnecessary. Screening asymptomatic persons for CAD is a very low yield practice. Patients who have no cardiac risk factors (hypercholesterolemia, family history of CAD, cigarette smoking, and hypertension) are at especially low risk of a primary cardiac event. Older men with stable typical angina are particularly likely to have left main coronary artery

  18. Coronary collateral circulation: its relevance.

    PubMed

    Karrowni, Wassef; El Accaoui, Ramzi N; Chatterjee, Kanu

    2013-11-15

    The interest in coronary collateral circulation (CCC) as "natural bypasses" is growing, especially in patients in whom the extent of coronary atherosclerosis is too severe to allow for conventional revascularization. The anatomic foundation of CCC has been recognized for long time. Recently, reliable methods have become available for the assessment of the adequacy of collateral flow. However, the debate regarding the importance of CCC in the different clinical settings continues. In this article, we present the recent progress in the understanding of anatomy and physiology of the CCC and focus on the studies addressing their functional significance in acute, subacute, and chronic coronary artery disease. In addition, we provide a focused update on the essential role of collateral circulation in the management of coronary chronic total occlusions.

  19. The Effects of Diabetes Mellitus on the Relationship Between Myocardial Adenosine Production and Coronary Vascular Resistance

    DTIC Science & Technology

    1987-03-13

    responsible for the vasodilation. 10 Coronary vasoconstriction has been observed with breathing 100% oxygen and with exposure to hypobaric oxygen...depending on the presence of diabetes related and non - diabetes related coronary artery disease risk factors (Fuller, 1980) The high levels of...circulating glucose, triglycerides, and cholesterol observed in diabetics are risk factors in the development of atherosclerosis. Diabetes related

  20. Marital Discord and Coronary Artery Disease: A Comparison of Behaviorally Defined Discrete Groups

    ERIC Educational Resources Information Center

    Smith, Timothy W.; Uchino, Bert N.; Berg, Cynthia A.; Florsheim, Paul

    2012-01-01

    Objective: Marital difficulties can confer risk of coronary heart disease, as in a study of outwardly healthy couples (T. W. Smith et al., 2011) where behavioral ratings of low affiliation and high control during marital disagreements were associated with asymptomatic coronary artery disease (CAD). However, taxometric studies suggest that marital…

  1. A One-Sided Affair: Unoriginal Origin of the Left Coronary Artery, a Case Report

    PubMed Central

    Ali, Omair; Rehman, Saifur; Jbara, Yaser; White, Bryan

    2014-01-01

    Coronary artery anomalies constitute a group of congenital malformations that have a multitude of clinical manifestations and highly variable pathophysiology. We report a 56-year-old male with angina due to an anomalous origin of the left main coronary artery; approach and management.

  2. Psychosocial risk factors for coronary heart disease.

    PubMed

    Glozier, Nick; Tofler, Geoffrey H; Colquhoun, David M; Bunker, Stephen J; Clarke, David M; Hare, David L; Hickie, Ian B; Tatoulis, James; Thompson, David R; Wilson, Alison; Branagan, Maree G

    2013-08-05

    In 2003, the National Heart Foundation of Australia published a position statement on psychosocial risk factors and coronary heart disease (CHD). This consensus statement provides an updated review of the literature on psychosocial stressors, including chronic stressors (in particular, work stress), acute individual stressors and acute population stressors, to guide health professionals based on current evidence. It complements a separate updated statement on depression and CHD. Perceived chronic job strain and shift work are associated with a small absolute increased risk of developing CHD, but there is limited evidence regarding their effect on the prognosis of CHD. Evidence regarding a relationship between CHD and job (in)security, job satisfaction, working hours, effort-reward imbalance and job loss is inconclusive. Expert consensus is that workplace programs aimed at weight loss, exercise and other standard cardiovascular risk factors may have positive outcomes for these risk factors, but no evidence is available regarding the effect of such programs on the development of CHD. Social isolation after myocardial infarction (MI) is associated with an adverse prognosis. Expert consensus is that although measures to reduce social isolation are likely to produce positive psychosocial effects, it is unclear whether this would also improve CHD outcomes. Acute emotional stress may trigger MI or takotsubo ("stress") cardiomyopathy, but the absolute increase in transient risk from an individual stressor is low. Psychosocial stressors have an impact on CHD, but clinical significance and prevention require further study. Awareness of the potential for increased cardiovascular risk among populations exposed to natural disasters and other conditions of extreme stress may be useful for emergency services response planning. Wider public access to defibrillators should be available where large populations gather, such as sporting venues and airports, and as part of the response

  3. Acute coronary syndrome in Behcet’s disease caused by a coronary artery aneurysm and thrombosis

    PubMed Central

    Tekin, Bahar; Özen, Gülsen; Tekayev, Nazar; Gerçek, Şeyma; Direskeneli, Haner

    2014-01-01

    Behcet’s disease (BD) is a multisystemic vasculitis that can involve vessels of all sizes and is characterized by recurrent oral and genital ulcers with variable manifestations affecting the skin, eyes, and central nervous and musculoskeletal systems. Vascular involvement in BD is reported to be up to 40% in different series. The abdominal and thoracic aorta and pulmonary and femoral arteries are the most commonly involved arteries. However coronary arteries are rarely affected. Herein, we present a 29-year-old man who was consulted with progressive severe chest pain of 3 days in duration to our clinic. The patient was diagnosed with BD with mucocutaneous symptoms and a positive pathergy test 1 year ago and was in clinical remission for the last 6 months. At the first evaluation in the emergency department, the patient’s vital signs were stable, whereas he had elevated troponin T levels with a normal electrocardiogram and hypokinetic areas in the apex of the heart in the echocardiography. Conventional and computed tomography coronary angiography revealed aneurysms and intramural thrombosis in the left anterior descending and right coronary arteries. Although ischemic symptoms and signs improved with anticoagulant and antiaggregant therapies, coronary aneurysms were observed to increase in size. Immunosuppressive (IS) treatment was started with pulse intravenous corticosteroids and cyclophosphamide. Because of the high re-stenosis risk, stents were not applied to the affected vessels during the acute thrombosis period. During routine investigations, an in situ pulmonary thrombosis was also detected bilaterally in the peripheral pulmonary arteries. In conclusion, coronary artery aneurysm is a rare and poor prognostic manifestation of BD. The treatment protocol for these aneurysms is not well clarified. IS therapies are definitely indicated, but the role of anticoagulants and invasive vascular interventions is controversial. PMID:27708903

  4. Physiologic assessment of coronary artery fistula

    SciTech Connect

    Gupta, N.C.; Beauvais, J. )

    1991-01-01

    Coronary artery fistula is an uncommon clinical entity. The most common coronary artery fistula is from the right coronary artery to the right side of the heart, and it is less frequent to the pulmonary artery. The effect of a coronary artery fistula may be physiologically significant because of the steal phenomenon resulting in coronary ischemia. Based on published reports, it is recommended that patients with congenital coronary artery fistulas be considered candidates for elective surgical correction to prevent complications including development of congestive heart failure, angina, subacute bacterial endocarditis, myocardial infarction, and coronary aneurysm formation with rupture or embolization. A patient is presented in whom treadmill-exercise thallium imaging was effective in determining the degree of coronary steal from a coronary artery fistula, leading to successful corrective surgery.

  5. Clock time is absolute and universal

    NASA Astrophysics Data System (ADS)

    Shen, Xinhang

    2015-09-01

    A critical error is found in the Special Theory of Relativity (STR): mixing up the concepts of the STR abstract time of a reference frame and the displayed time of a physical clock, which leads to use the properties of the abstract time to predict time dilation on physical clocks and all other physical processes. Actually, a clock can never directly measure the abstract time, but can only record the result of a physical process during a period of the abstract time such as the number of cycles of oscillation which is the multiplication of the abstract time and the frequency of oscillation. After Lorentz Transformation, the abstract time of a reference frame expands by a factor gamma, but the frequency of a clock decreases by the same factor gamma, and the resulting multiplication i.e. the displayed time of a moving clock remains unchanged. That is, the displayed time of any physical clock is an invariant of Lorentz Transformation. The Lorentz invariance of the displayed times of clocks can further prove within the framework of STR our earth based standard physical time is absolute, universal and independent of inertial reference frames as confirmed by both the physical fact of the universal synchronization of clocks on the GPS satellites and clocks on the earth, and the theoretical existence of the absolute and universal Galilean time in STR which has proved that time dilation and space contraction are pure illusions of STR. The existence of the absolute and universal time in STR has directly denied that the reference frame dependent abstract time of STR is the physical time, and therefore, STR is wrong and all its predictions can never happen in the physical world.

  6. Method of differential-phase/absolute-amplitude QAM

    DOEpatents

    Dimsdle, Jeffrey William

    2008-10-21

    A method of quadrature amplitude modulation involving encoding phase differentially and amplitude absolutely, allowing for a high data rate and spectral efficiency in data transmission and other communication applications, and allowing for amplitude scaling to facilitate data recovery; amplitude scale tracking to track-out rapid and severe scale variations and facilitate successful demodulation and data retrieval; 2.sup.N power carrier recovery; incoherent demodulation where coherent carrier recovery is not possible or practical due to signal degradation; coherent demodulation; multipath equalization to equalize frequency dependent multipath; and demodulation filtering.

  7. Method of differential-phase/absolute-amplitude QAM

    DOEpatents

    Dimsdle, Jeffrey William

    2007-07-03

    A method of quadrature amplitude modulation involving encoding phase differentially and amplitude absolutely, allowing for a high data rate and spectral efficiency in data transmission and other communication applications, and allowing for amplitude scaling to facilitate data recovery; amplitude scale tracking to track-out rapid and severe scale variations and facilitate successful demodulation and data retrieval; 2.sup.N power carrier recovery; incoherent demodulation where coherent carrier recovery is not possible or practical due to signal degradation; coherent demodulation; multipath equalization to equalize frequency dependent multipath; and demodulation filtering.

  8. Method of differential-phase/absolute-amplitude QAM

    DOEpatents

    Dimsdle, Jeffrey William

    2007-10-02

    A method of quadrature amplitude modulation involving encoding phase differentially and amplitude absolutely, allowing for a high data rate and spectral efficiency in data transmission and other communication applications, and allowing for amplitude scaling to facilitate data recovery; amplitude scale tracking to track-out rapid and severe scale variations and facilitate successful demodulation and data retrieval; 2.sup.N power carrier recovery; incoherent demodulation where coherent carrier recovery is not possible or practical due to signal degradation; coherent demodulation; multipath equalization to equalize frequency dependent multipath; and demodulation filtering.

  9. Method of differential-phase/absolute-amplitude QAM

    SciTech Connect

    Dimsdle, Jeffrey William

    2009-09-01

    A method of quadrature amplitude modulation involving encoding phase differentially and amplitude absolutely, allowing for a high data rate and spectral efficiency in data transmission and other communication applications, and allowing for amplitude scaling to facilitate data recovery; amplitude scale tracking to track-out rapid and severe scale variations and facilitate successful demodulation and data retrieval; 2.sup.N power carrier recovery; incoherent demodulation where coherent carrier recovery is not possible or practical due to signal degradation; coherent demodulation; multipath equalization to equalize frequency dependent multipath; and demodulation filtering.

  10. Method of differential-phase/absolute-amplitude QAM

    DOEpatents

    Dimsdle, Jeffrey William

    2007-07-17

    A method of quadrature amplitude modulation involving encoding phase differentially and amplitude absolutely, allowing for a high data rate and spectral efficiency in data transmission and other communication applications, and allowing for amplitude scaling to facilitate data recovery; amplitude scale tracking to track-out rapid and severe scale variations and facilitate successful demodulation and data retrieval; 2.sup.N power carrier recovery; incoherent demodulation where coherent carrier recovery is not possible or practical due to signal degradation; coherent demodulation; multipath equalization to equalize frequency dependent multipath; and demodulation filtering.

  11. Brownian motion: Absolute negative particle mobility

    NASA Astrophysics Data System (ADS)

    Ros, Alexandra; Eichhorn, Ralf; Regtmeier, Jan; Duong, Thanh Tu; Reimann, Peter; Anselmetti, Dario

    2005-08-01

    Noise effects in technological applications, far from being a nuisance, can be exploited with advantage - for example, unavoidable thermal fluctuations have found application in the transport and sorting of colloidal particles and biomolecules. Here we use a microfluidic system to demonstrate a paradoxical migration mechanism in which particles always move in a direction opposite to the net acting force (`absolute negative mobility') as a result of an interplay between thermal noise, a periodic and symmetric microstructure, and a biased alternating-current electric field. This counterintuitive phenomenon could be used for bioanalytical purposes, for example in the separation and fractionation of colloids, biological molecules and cells.

  12. Arbitrary segments of absolute negative mobility

    NASA Astrophysics Data System (ADS)

    Chen, Ruyin; Nie, Linru; Chen, Chongyang; Wang, Chaojie

    2017-01-01

    In previous research work, investigators have reported only one or two segments of absolute negative mobility (ANM) in a periodic potential. In fact, many segments of ANM also occur in the system considered here. We investigate transport of an inertial particle in a gating ratchet periodic potential subjected to a constant bias force. Our numerical results show that its mean velocity can decrease with the bias force increasing, i.e. ANM phenomenon. Furthermore, the ANM can take place arbitrary segments, even up to more than thirty. Intrinsic physical mechanism and conditions for arbitrary segments of ANM to occur are discussed in detail.

  13. Absolute quantification of myocardial blood flow.

    PubMed

    Yoshinaga, Keiichiro; Manabe, Osamu; Tamaki, Nagara

    2016-07-21

    With the increasing availability of positron emission tomography (PET) myocardial perfusion imaging, the absolute quantification of myocardial blood flow (MBF) has become popular in clinical settings. Quantitative MBF provides an important additional diagnostic or prognostic information over conventional visual assessment. The success of MBF quantification using PET/computed tomography (CT) has increased the demand for this quantitative diagnostic approach to be more accessible. In this regard, MBF quantification approaches have been developed using several other diagnostic imaging modalities including single-photon emission computed tomography, CT, and cardiac magnetic resonance. This review will address the clinical aspects of PET MBF quantification and the new approaches to MBF quantification.

  14. An absolute radius scale for Saturn's rings

    NASA Technical Reports Server (NTRS)

    Nicholson, Philip D.; Cooke, Maren L.; Pelton, Emily

    1990-01-01

    Radio and stellar occultation observations of Saturn's rings made by the Voyager spacecraft are discussed. The data reveal systematic discrepancies of almost 10 km in some parts of the rings, limiting some of the investigations. A revised solution for Saturn's rotation pole has been proposed which removes the discrepancies between the stellar and radio occultation profiles. Corrections to previously published radii vary from -2 to -10 km for the radio occultation, and +5 to -6 km for the stellar occultation. An examination of spiral density waves in the outer A Ring supports that the revised absolute radii are in error by no more than 2 km.

  15. Absolute Rate Theories of Epigenetic Stability

    NASA Astrophysics Data System (ADS)

    Walczak, Aleksandra M.; Onuchic, Jose N.; Wolynes, Peter G.

    2006-03-01

    Spontaneous switching events in most characterized genetic switches are rare, resulting in extremely stable epigenetic properties. We show how simple arguments lead to theories of the rate of such events much like the absolute rate theory of chemical reactions corrected by a transmission factor. Both the probability of the rare cellular states that allow epigenetic escape, and the transmission factor, depend on the rates of DNA binding and unbinding events and on the rates of protein synthesis and degradation. Different mechanisms of escape from the stable attractors occur in the nonadiabatic, weakly adiabatic and strictly adiabatic regimes, characterized by the relative values of those input rates.

  16. Absolute rate theories of epigenetic stability

    NASA Astrophysics Data System (ADS)

    Walczak, Aleksandra M.; Onuchic, José N.; Wolynes, Peter G.

    2005-12-01

    Spontaneous switching events in most characterized genetic switches are rare, resulting in extremely stable epigenetic properties. We show how simple arguments lead to theories of the rate of such events much like the absolute rate theory of chemical reactions corrected by a transmission factor. Both the probability of the rare cellular states that allow epigenetic escape and the transmission factor depend on the rates of DNA binding and unbinding events and on the rates of protein synthesis and degradation. Different mechanisms of escape from the stable attractors occur in the nonadiabatic, weakly adiabatic, and strictly adiabatic regimes, characterized by the relative values of those input rates. rate theory | stochastic gene expression | gene switches

  17. Absolute method of measuring magnetic susceptibility

    USGS Publications Warehouse

    Thorpe, A.; Senftle, F.E.

    1959-01-01

    An absolute method of standardization and measurement of the magnetic susceptibility of small samples is presented which can be applied to most techniques based on the Faraday method. The fact that the susceptibility is a function of the area under the curve of sample displacement versus distance of the magnet from the sample, offers a simple method of measuring the susceptibility without recourse to a standard sample. Typical results on a few substances are compared with reported values, and an error of less than 2% can be achieved. ?? 1959 The American Institute of Physics.

  18. Absolute Priority for a Vehicle in VANET

    NASA Astrophysics Data System (ADS)

    Shirani, Rostam; Hendessi, Faramarz; Montazeri, Mohammad Ali; Sheikh Zefreh, Mohammad

    In today's world, traffic jams waste hundreds of hours of our life. This causes many researchers try to resolve the problem with the idea of Intelligent Transportation System. For some applications like a travelling ambulance, it is important to reduce delay even for a second. In this paper, we propose a completely infrastructure-less approach for finding shortest path and controlling traffic light to provide absolute priority for an emergency vehicle. We use the idea of vehicular ad-hoc networking to reduce the imposed travelling time. Then, we simulate our proposed protocol and compare it with a centrally controlled traffic light system.

  19. Effects of incomplete stent apposition on the changes in hemodynamics inside a curved and calcified coronary artery

    NASA Astrophysics Data System (ADS)

    Poon, Eric; Ooi, Andrew; Barlis, Peter; Hayat, Umair; Moore, Stephen

    2014-11-01

    Percutaneous coronary intervention (PCI) is the modern gold standard for treatment of coronary artery disease. Stenting (a common PCI procedure) of simple lesion inside a relatively straight segment of coronary artery has proven to be highly successful. However, incomplete stent apposition (ISA) where there is a lack of contact between the stent struts and lumen wall is not uncommon in curved and calcified coronary arteries. Computational fluid dynamics simulations are carried out to study the changes in hemodynamics as a result of ISA inside a curved and calcified coronary artery. For a 3 mm coronary artery, we simulate a resting condition at 80 mL/min and a range of hyperemic conditions with coronary flow reserve in between 1 and 2. The heartbeat is fixed at 75 BPM. Five different curvatures of the coronary artery are considered. Negative effects on hemodynamic variables, such as low wall shear stress (<0.5 Pa); high wall shear stress gradient (>5,000 Pa/m) and oscillation shear index (0 <= OSI <= 0.5), are employed to identify locations with high possibilities of adverse clinical events. This study will lead to better understandings of ISA in curved and calcified coronary arteries and help improve future coronary stent deployment. Supported by the Australian Research Council (LP120100233) and Victorian Life Sciences Computation Initiative (VR0210).

  20. 64 slice-coronary computed tomography sensitivity and specificity in the evaluation of coronary artery bypass graft stenosis: A meta-analysis.

    PubMed

    Barbero, Umberto; Iannaccone, Mario; d'Ascenzo, Fabrizio; Barbero, Cristina; Mohamed, Abdirashid; Annone, Umberto; Benedetto, Sara; Celentani, Dario; Gagliardi, Marco; Moretti, Claudio; Gaita, Fiorenzo

    2016-08-01

    A non-invasive approach to define grafts patency and stenosis in the follow-up of coronary artery bypass graft (CABG) patients may be an interesting alternative to coronary angiography. 64-slice-coronary computed tomography is nowadays a diffused non-invasive method that permits an accurate evaluation of coronary stenosis, due to a high temporal and spatial resolution. However, its sensitivity and specificity in CABG evaluation has to be clearly defined, since published studies used different protocols and scanners. We collected all studies investigating patients with stable symptoms and previous CABG and reporting the comparison between diagnostic performances of invasive coronary angiography and 64-slice-coronary computed tomography. As a result, sensitivity and specificity of 64-slice-coronary computed tomography for CABG occlusion were 0.99 (95% CI 0.97-1.00) and 0.99 (95% CI: 0.99-1.00) with an area under the curve (AUC) of 0.99. 64-slice-coronary computed tomography sensitivity and specificity for the presence of any CABG stenosis >50% were 0.98 (95% CI: 0.97-0.99) and 0.98 (95% CI: 0.96-0.98), while AUC was 0.99. At meta-regression, neither the age nor the time from graft implantation had effect on sensitivity and specificity of 64-slice-coronary computed tomography detection of significant CABG stenosis or occlusion. In conclusion 64-slice-coronary computed tomography confirmed its high sensitivity and specificity in CABG stenosis or occlusion evaluation.

  1. Evaluation of troponin T criteria for periprocedural myocardial infarction in patients with acute coronary syndromes.

    PubMed

    Shugman, Ibrahim Meloud; Diu, Patrick; Gohil, Jayesh; Kadappu, Krishna Kishor; Leung, Melissa; Lo, Sidney; Leung, Dominic Y; Hopkins, Andrew P; Juergens, Craig P; French, John K

    2011-03-15

    In patients with acute coronary syndromes undergoing percutaneous coronary intervention (PCI), the diagnosis of periprocedural myocardial infarction is often problematic when the pre-PCI levels of cardiac troponin T (TnT) are elevated. Thus, we examined different TnT criteria for periprocedural myocardial infarction when the pre-PCI TnT levels were elevated and also the associations between the post-PCI cardiac marker levels and outcomes. We established the relation between the post-PCI creatine kinase-MB (CKMB) and TnT levels in 582 patients (315 with acute coronary syndromes and 272 with stable coronary heart disease). A post-PCI increase in the CKMB levels to 14.7 μg/L (3 × the upper reference limit [URL] in men) corresponded to a TnT of 0.23 μg/L. In the 85 patients with acute coronary syndromes and normal CKMB, but elevated post peak TnT levels before PCI (performed at a median of 5 days, interquartile range 3 to 7), the post-PCI cardiac marker increases were as follows: 21 (24.7%) with a ≥ 20% increase in TnT, 10 (11.8%) with an CKMB level >3 × URL, and 12 (14%) with an absolute TnT increase of >0.09 μg/L (p <0.005 for both). In the patients with stable coronary heart disease and post-PCI cardiac markers > 3× URL compared to those without markers elevations, the rate of freedom from death or nonfatal myocardial infarction was 88% for those with TnT elevations versus 99% (p <0.001, log-rank) and 84% for those with CKMB elevations versus 98% (p <0.001, log-rank). Of the patients with acute coronary syndromes, the post-PCI marker levels did not influence the outcomes. In conclusion, in patients with acute coronary syndromes and elevated TnT levels undergoing PCI several days later, ≥20% increases in TnT were more common than absolute increments in the TnT or CKMB levels of >3× URL. Also, periprocedural cardiac marker elevations in patients with acute coronary syndromes did not have prognostic significance.

  2. Noninvasive Imaging in Coronary Artery Disease

    PubMed Central

    Heo, Ran; Nakazato, Ryo; Kalra, Dan; Min, James K.

    2014-01-01

    Noninvasive cardiac imaging is widely used to evaluate the presence of coronary artery disease. Recently, with improvements in imaging technology, noninvasive imaging has also been used for evaluation of the presence, severity, and prognosis of coronary artery disease. Coronary CT angiography and MRI of coronary arteries provide an anatomical assessment of coronary stenosis, whereas the hemodynamic significance of a coronary artery stenosis can be assessed by stress myocardial perfusion imaging, such as SPECT/PET and stress MRI. For appropriate use of multiple imaging modalities, the strengths and limitations of each modality are discussed in this review. PMID:25234083

  3. Risk assessment by myocardial perfusion imaging for coronary revascularization, medical therapy, and noncardiac surgery.

    PubMed

    Papaioannou, Georgios I; Heller, Gary V

    2003-01-01

    Stress myocardial perfusion imaging (MPI) has become an important tool in risk stratification of patients with known coronary artery disease. A normal myocardial perfusion scan has a high negative predictive value and is associated with low annual mortality rate (< 1%). Patients with extensive ischemia (> 20% of the left ventricle), defects in more than 1 coronary vascular territory, transient or persistent left ventricular cavity dilation, and ejection fraction less than 45% have a high annual mortality rate (> 3%). Those patients should undergo coronary revascularization whenever feasible, as the cardiac event rate increases in proportion to the magnitude of the jeopardized myocardium. Stress MPI can be used to demonstrate ischemia in patients with symptoms early after coronary artery bypass surgery (< 5 years) or in those without symptoms late (>/= 5 years) after coronary artery bypass surgery. With respect to patients who underwent percutaneous interventions, stress MPI can help detect in-stent restenosis early after the intervention (3-6 months) or assess the progression of native coronary disease afterward. Since preliminary data suggest that a reduction in the perfusion defect size may translate to a reduction of coronary events, stress MPI can help assess the efficacy of medical management of coronary disease. Finally, stress MPI is indicated for perioperative cardiac risk stratification for noncardiac surgery in patients with intermediate risk predictors (mild angina, prior myocardial infarction or heart failure symptoms, diabetes mellitus, renal insufficiency) and poor functional capacity or in those who undergo high-risk surgery with significant implications in further preoperative management.

  4. Absolute Spectrophotometry of 237 Open Cluster Stars

    NASA Astrophysics Data System (ADS)

    Clampitt, L.; Burstein, D.

    1994-12-01

    We present absolute spectrophotometry of 237 stars in 7 nearby open clusters: Hyades, Pleiades, Alpha Persei, Praesepe, Coma Berenices, IC 4665, and M 39. The observations were taken using the Wampler single-channel scanner (Wampler 1966) on the Crossley 0.9m telescope at Lick Observatory from July 1973 through December 1974. 21 bandpasses spanning the spectral range 3500 Angstroms to 7780 Angstroms were observed for each star, with bandwiths ranging from 32Angstroms to 64 Angstroms. Data are standardized to the Hayes--Latham (1975) system. Our measurements are compared to filter colors on the Johnson BV, Stromgren ubvy, and Geneva U V B_1 B_2 V_1 G systems, as well as to spectrophotometry of a few stars published by Gunn, Stryker & Tinsley and in the Spectrophotometric Standards Catalog (Adelman; as distributed by the NSSDC). Both internal and external comparisons to the filter systems indicate a formal statistical accuracy per bandpass of 0.01 to 0.02 mag, with apparent larger ( ~ 0.03 mag) differences in absolute calibration between this data set and existing spectrophotometry. These data will comprise part of the spectrophotometry that will be used to calibrate the Beijing-Arizona-Taipei-Connecticut Color Survey of the Sky (see separate paper by Burstein et al. at this meeting).

  5. Why to compare absolute numbers of mitochondria.

    PubMed

    Schmitt, Sabine; Schulz, Sabine; Schropp, Eva-Maria; Eberhagen, Carola; Simmons, Alisha; Beisker, Wolfgang; Aichler, Michaela; Zischka, Hans

    2014-11-01

    Prompted by pronounced structural differences between rat liver and rat hepatocellular carcinoma mitochondria, we suspected these mitochondrial populations to differ massively in their molecular composition. Aiming to reveal these mitochondrial differences, we came across the issue on how to normalize such comparisons and decided to focus on the absolute number of mitochondria. To this end, fluorescently stained mitochondria were quantified by flow cytometry. For rat liver mitochondria, this approach resulted in mitochondrial protein contents comparable to earlier reports using alternative methods. We determined similar protein contents for rat liver, heart and kidney mitochondria. In contrast, however, lower protein contents were determined for rat brain mitochondria and for mitochondria from the rat hepatocellular carcinoma cell line McA 7777. This result challenges mitochondrial comparisons that rely on equal protein amounts as a typical normalization method. Exemplarily, we therefore compared the activity and susceptibility toward inhibition of complex II of rat liver and hepatocellular carcinoma mitochondria and obtained significant discrepancies by either normalizing to protein amount or to absolute mitochondrial number. Importantly, the latter normalization, in contrast to the former, demonstrated a lower complex II activity and higher susceptibility toward inhibition in hepatocellular carcinoma mitochondria compared to liver mitochondria. These findings demonstrate that solely normalizing to protein amount may obscure essential molecular differences between mitochondrial populations.

  6. The absolute threshold of cone vision

    PubMed Central

    Koeing, Darran; Hofer, Heidi

    2013-01-01

    We report measurements of the absolute threshold of cone vision, which has been previously underestimated due to sub-optimal conditions or overly strict subjective response criteria. We avoided these limitations by using optimized stimuli and experimental conditions while having subjects respond within a rating scale framework. Small (1′ fwhm), brief (34 msec), monochromatic (550 nm) stimuli were foveally presented at multiple intensities in dark-adapted retina for 5 subjects. For comparison, 4 subjects underwent similar testing with rod-optimized stimuli. Cone absolute threshold, that is, the minimum light energy for which subjects were just able to detect a visual stimulus with any response criterion, was 203 ± 38 photons at the cornea, ∼0.47 log units lower than previously reported. Two-alternative forced-choice measurements in a subset of subjects yielded consistent results. Cone thresholds were less responsive to criterion changes than rod thresholds, suggesting a limit to the stimulus information recoverable from the cone mosaic in addition to the limit imposed by Poisson noise. Results were consistent with expectations for detection in the face of stimulus uncertainty. We discuss implications of these findings for modeling the first stages of human cone vision and interpreting psychophysical data acquired with adaptive optics at the spatial scale of the receptor mosaic. PMID:21270115

  7. Absolute stereochemistry of altersolanol A and alterporriols.

    PubMed

    Kanamaru, Saki; Honma, Miho; Murakami, Takanori; Tsushima, Taro; Kudo, Shinji; Tanaka, Kazuaki; Nihei, Ken-Ichi; Nehira, Tatsuo; Hashimoto, Masaru

    2012-02-01

    The absolute stereochemistry of altersolanol A (1) was established by observing a positive exciton couplet in the circular dichroism (CD) spectrum of the C3,C4-O-bis(2-naphthoyl) derivative 10 and by chemical correlations with known compound 8. Before the discussion, the relative stereochemistry of 1 was confirmed by X-ray crystallographic analysis. The shielding effect at C7'-OMe group by C1-O-benzoylation established the relative stereochemical relationship between the C8-C8' axial bonding and the C1-C4/C1'-C4' polyol moieties of alterporriols E (3), an atropisomer of the C8-C8' dimer of 1. As 3 could be obtained by dimerization of 1 in vitro, the absolute configuration of its central chirality elements (C1-C4) must be identical to those of 1. Spectral comparison between the experimental and theoretical CD spectra supported the above conclusion. Axial stereochemistry of novel C4-O-deoxy dimeric derivatives, alterporriols F (4) and G (5), were also revealed by comparison of their CD spectra to those of 2 and 3.

  8. Absolute Electron Extraction Efficiency of Liquid Xenon

    NASA Astrophysics Data System (ADS)

    Kamdin, Katayun; Mizrachi, Eli; Morad, James; Sorensen, Peter

    2016-03-01

    Dual phase liquid/gas xenon time projection chambers (TPCs) currently set the world's most sensitive limits on weakly interacting massive particles (WIMPs), a favored dark matter candidate. These detectors rely on extracting electrons from liquid xenon into gaseous xenon, where they produce proportional scintillation. The proportional scintillation from the extracted electrons serves to internally amplify the WIMP signal; even a single extracted electron is detectable. Credible dark matter searches can proceed with electron extraction efficiency (EEE) lower than 100%. However, electrons systematically left at the liquid/gas boundary are a concern. Possible effects include spontaneous single or multi-electron proportional scintillation signals in the gas, or charging of the liquid/gas interface or detector materials. Understanding EEE is consequently a serious concern for this class of rare event search detectors. Previous EEE measurements have mostly been relative, not absolute, assuming efficiency plateaus at 100%. I will present an absolute EEE measurement with a small liquid/gas xenon TPC test bed located at Lawrence Berkeley National Laboratory.

  9. Standardization of the cumulative absolute velocity

    SciTech Connect

    O'Hara, T.F.; Jacobson, J.P. )

    1991-12-01

    EPRI NP-5930, A Criterion for Determining Exceedance of the Operating Basis Earthquake,'' was published in July 1988. As defined in that report, the Operating Basis Earthquake (OBE) is exceeded when both a response spectrum parameter and a second damage parameter, referred to as the Cumulative Absolute Velocity (CAV), are exceeded. In the review process of the above report, it was noted that the calculation of CAV could be confounded by time history records of long duration containing low (nondamaging) acceleration. Therefore, it is necessary to standardize the method of calculating CAV to account for record length. This standardized methodology allows consistent comparisons between future CAV calculations and the adjusted CAV threshold value based upon applying the standardized methodology to the data set presented in EPRI NP-5930. The recommended method to standardize the CAV calculation is to window its calculation on a second-by-second basis for a given time history. If the absolute acceleration exceeds 0.025g at any time during each one second interval, the earthquake records used in EPRI NP-5930 have been reanalyzed and the adjusted threshold of damage for CAV was found to be 0.16g-set.

  10. Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease.

    PubMed

    Khera, Amit V; Emdin, Connor A; Drake, Isabel; Natarajan, Pradeep; Bick, Alexander G; Cook, Nancy R; Chasman, Daniel I; Baber, Usman; Mehran, Roxana; Rader, Daniel J; Fuster, Valentin; Boerwinkle, Eric; Melander, Olle; Orho-Melander, Marju; Ridker, Paul M; Kathiresan, Sekar

    2016-12-15

    Background Both genetic and lifestyle factors contribute to individual-level risk of coronary artery disease. The extent to which increased genetic risk can be offset by a healthy lifestyle is unknown. Methods Using a polygenic score of DNA sequence polymorphisms, we quantified genetic risk for coronary artery disease in three prospective cohorts - 7814 participants in the Atherosclerosis Risk in Communities (ARIC) study, 21,222 in the Women's Genome Health Study (WGHS), and 22,389 in the Malmö Diet and Cancer Study (MDCS) - and in 4260 participants in the cross-sectional BioImage Study for whom genotype and covariate data were available. We also determined adherence to a healthy lifestyle among the participants using a scoring system consisting of four factors: no current smoking, no obesity, regular physical activity, and a healthy diet. Results The relative risk of incident coronary events was 91% higher among participants at high genetic risk (top quintile of polygenic scores) than among those at low genetic risk (bottom quintile of polygenic scores) (hazard ratio, 1.91; 95% confidence interval [CI], 1.75 to 2.09). A favorable lifestyle (defined as at least three of the four healthy lifestyle factors) was associated with a substantially lower risk of coronary events than an unfavorable lifestyle (defined as no or only one healthy lifestyle factor), regardless of the genetic risk category. Among participants at high genetic risk, a favorable lifestyle was associated with a 46% lower relative risk of coronary events than an unfavorable lifestyle (hazard ratio, 0.54; 95% CI, 0.47 to 0.63). This finding corresponded to a reduction in the standardized 10-year incidence of coronary events from 10.7% for an unfavorable lifestyle to 5.1% for a favorable lifestyle in ARIC, from 4.6% to 2.0% in WGHS, and from 8.2% to 5.3% in MDCS. In the BioImage Study, a favorable lifestyle was associated with significantly less coronary-artery calcification within each genetic risk

  11. Outcomes of patients with spontaneous coronary artery dissection

    PubMed Central

    McGrath-Cadell, Lucy; McKenzie, Pamela; Emmanuel, Sam; Muller, David W M; Graham, Robert M; Holloway, Cameron J

    2016-01-01

    Background Spontaneous coronary artery dissection (SCAD) is an uncommon but serious condition presenting as an acute coronary syndrome (ACS) or cardiac arrest. The pathophysiology and outcomes are poorly understood. We investigated the characteristics and outcomes of patients presenting with SCAD. Methods In a retrospective study of a large cohort of patients with SCAD, data were collected regarding clinical presentation, patient characteristics, vascular screening, coronary artery involvement and clinical outcomes. Results 40 patients with SCAD (95% women, mean age 45±10 years) were included. At least 1 traditional cardiovascular risk factor was present in 40% of patients. Migraine was reported in 43% of patients. Events preceding SCAD included parturition (8%), physical stress (13%), emotional stress (10%) and vasoconstrictor substance-use (8%). 65% of patients had a non-ST elevation ACS (NSTEACS) at presentation, 30% had an ST elevation myocardial infarction (STEMI) and 13% had a cardiac arrest. The left anterior descending artery was most frequently involved (68% of patients), and 13% had involvement of multiple coronary territories. Fibromuscular dysplasia (FMD) was identified in 7 (37%) of 19 patients screened. 68% of patients were managed medically, 30% had percutaneous coronary intervention and 5% had coronary artery bypass grafting. Over a median 16-month follow-up period, 8% of patients had at least 1 recurrent SCAD event. There were no deaths. Conclusions Patients with SCAD in this study often had multiple coronary territories involved (13%) and extracardiac vascular abnormalities, suggesting a systemic vascular process, which may explain the high incidence of migraine. All patients with SCAD should be screened for FMD and followed closely due to the possibility of recurrence. PMID:27621835

  12. Extracting infrared absolute reflectance from relative reflectance measurements.

    PubMed

    Berets, Susan L; Milosevic, Milan

    2012-06-01

    Absolute reflectance measurements are valuable to the optics industry for development of new materials and optical coatings. Yet, absolute reflectance measurements are notoriously difficult to make. In this paper, we investigate the feasibility of extracting the absolute reflectance from a relative reflectance measurement using a reference material with known refractive index.

  13. Fate of coronary collateral circulation after aorto-coronary saphenous vein bypass grafts.

    PubMed Central

    Di Luzio, V; Roy, P R; Sowton, E; Dow, J

    1975-01-01

    The pre- and postoperative patterns of coronary artery collateral circulation have been studied in 34 patients who had saphenous vein bypass grafting. When the graft remained patent homocoronary collaterals could not be visualized after operation, but new intercoronary anastomoses frequently developed to other diseased arteries. When the graft and the bypassed artery were both obstructed there was a high incidence (5 out of 11) of myocardial infarction despite good preoperative collaterals. Images PMID:1079134

  14. Percutaneous Coronary Intervention on Right Coronary Artery With All Coronary Arteries From Three Separate Ostiums in the Right Sinus of Valsalva

    PubMed Central

    Sayin, Muhammet Rasit; Aydin, Mustafa; Dogan, Sait Mesut; Karabag, Turgut

    2011-01-01

    Some of coronary artery anomalies, such as origin of all coronary arteries from three separate ostiums in the right sinus of valsalva, represent a small amount of coronary anomalies. We describe a 63-year-old female patient which coronary angiogram revealed an origin of all coronary arteries from three separate ostiums in the right sinus of valsalva, with significant atherosclerotic plaque at the midportion of the right coronary artery. The stenosis was treated through percutaneous coronary intervention.

  15. Use of Absolute and Comparative Performance Feedback in Absolute and Comparative Judgments and Decisions

    ERIC Educational Resources Information Center

    Moore, Don A.; Klein, William M. P.

    2008-01-01

    Which matters more--beliefs about absolute ability or ability relative to others? This study set out to compare the effects of such beliefs on satisfaction with performance, self-evaluations, and bets on future performance. In Experiment 1, undergraduate participants were told they had answered 20% correct, 80% correct, or were not given their…

  16. The impact of increased age on outcome from a strategy of early invasive management and revascularisation in patients with acute coronary syndromes: retrospective analysis study from the ACACIA registry

    PubMed Central

    Prakash, Roshan; Chew, Derek P

    2012-01-01

    Objective To evaluate the impact of increased age on outcome from a strategy of early invasive management and revascularisation in patients with acute coronary syndromes (ACS). Design Retrospective analysis of a national Acute Coronary Syndrome registry (ACACIA). Setting Multiple Australian (n=39) centres; 25% rural, 52% with onsite cardiac surgery. Patients Unselected consecutive patients admitted with confirmed ACS, total n=2559, median 99 per centre. Interventions Management was at the discretion of the treating physician. Analysis of outcome based on age >75 years was compared using Cox proportional hazard with a propensity model to adjust for baseline covariates. Main outcome measures Primary outcome was all-cause mortality. Secondary outcomes were bleeding and a composite of any vascular event or unplanned readmission. Results Elderly patients were more likely to present with high-risk features yet were less likely to receive evidence-based medical therapies or receive diagnostic coronary angiography (75% vs 49%, p<0.0001) and early revascularisation (50% vs 30%, p<0.0001). Multivariate analysis found early revascularisation in the elderly cohort to be associated with lower 12-month mortality hazard (0.4 (0.2–0.7)) and composite outcome (0.6 (0.5–0.8)). Propensity model suggested a greater absolute benefit in elderly patients compared to others. Conclusions Following presentation with ACS, elderly patients are less likely to receive evidence-based medical therapies, to be considered for an early invasive strategy and be revascularised. Increasing age is a significant barrier to physicians when considering early revascularisation. An early invasive strategy with revascularisation when performed was associated with substantial benefit and the absolute accrued benefit appears to be higher in elderly patients. PMID:22344538

  17. Screening for Coronary Heart Disease with Electrocardiography

    MedlinePlus

    ... Force Recommendations Screening for Coronary Heart Disease with Electrocardiography The U.S. Preventive Services Task Force (Task Force) ... recommendations on Screening for Coronary Heart Disease with Electrocardiography . These recommendations are for adult men and women ...

  18. Who Needs Coronary Artery Bypass Grafting?

    MedlinePlus

    ... from the NHLBI on Twitter. Who Needs Coronary Artery Bypass Grafting? Coronary artery bypass grafting (CABG) is used to treat people ... or after a heart attack to treat blocked arteries. Your doctor may recommend CABG if other treatments, ...

  19. Radiation-induced accelerated coronary arteriosclerosis

    SciTech Connect

    Mittal, B.; Deutsch, M.; Thompson, M.; Dameshek, H.L.

    1986-07-01

    There is a paucity of information on radiation-induced coronary heart disease. A young patient with myocardial infarction following mediastinal irradiation is described. The role of radiotherapy and chemotherapy on the subsequent development of coronary heart disease is discussed.

  20. Acute left main coronary artery thrombosis due to cocaine use.

    PubMed

    Apostolakis, Efstratios; Tsigkas, Grigorios; Baikoussis, Nikolaos G; Koniari, Ioanna; Alexopoulos, Dimitrios

    2010-08-19

    It is common knowledge that cocaine has been linked to the development of various acute and chronic cardiovascular complications including acute coronary syndromes. We present a young, male patient, drug abuser who underwent CABG due to anterolateral myocardial infarction. Our presentation is one of the very rare cases reported in literature regarding acute thrombosis of left main coronary artery related to cocaine use, in a patient with normal coronary arteries, successfully operated. Drug-abusers seem to have increased mortality and morbidity after surgery and high possibility for stent thrombosis after percutaneous coronary interventions, because of their usually terrible medical compliance and coexistent several problems of general health. There are no specific guidelines about treatment of thrombus formation in coronary arteries, as a consequence of cocaine use. So, any decision making concerning the final treatment of these patient is a unique and individualized approach. We strongly recommend that all these patients should be treated surgically, especially patients with thrombus into the left main artery.

  1. Impact of coronary bifurcation morphology on wave propagation

    PubMed Central

    Rivolo, Simone; Hadjilucas, Lucas; Sinclair, Matthew; van Horssen, Pepijn; van den Wijngaard, Jeroen; Wesolowski, Roman; Chiribiri, Amedeo; Smith, Nicolas P.

    2016-01-01

    The branching pattern of the coronary vasculature is a key determinant of its function and plays a crucial role in shaping the pressure and velocity wave forms measured for clinical diagnosis. However, although multiple scaling laws have been proposed to characterize the branching pattern, the implications they have on wave propagation remain unassessed to date. To bridge this gap, we have developed a new theoretical framework by combining the mathematical formulation of scaling laws with the wave propagation theory in the pulsatile flow regime. This framework was then validated in multiple species using high-resolution cryomicrotome images of porcine, canine, and human coronary networks. Results demonstrate that the forward well-matchedness (no reflection for pressure/flow waves traveling from the coronary stem toward the microcirculation) is a salient feature in the coronary vasculature, and this result remains robust under many scenarios of the underlying pulse wave speed distribution assumed in the network. This result also implies a significant damping of the backward traveling waves, especially for smaller vessels (radius, <0.3 mm). Furthermore, the theoretical prediction of increasing area ratios (ratio between the area of the mother and daughter vessels) in more symmetric bifurcations found in the distal circulation was confirmed by experimental measurements. No differences were observed by clustering the vessel segments in terms of transmurality (from epicardium to endocardium) or perfusion territories (left anterior descending, left circumflex, and right coronary artery). PMID:27402665

  2. Absolute nonlocality via distributed computing without communication

    NASA Astrophysics Data System (ADS)

    Czekaj, Ł.; Pawłowski, M.; Vértesi, T.; Grudka, A.; Horodecki, M.; Horodecki, R.

    2015-09-01

    Understanding the role that quantum entanglement plays as a resource in various information processing tasks is one of the crucial goals of quantum information theory. Here we propose an alternative perspective for studying quantum entanglement: distributed computation of functions without communication between nodes. To formalize this approach, we propose identity games. Surprisingly, despite no signaling, we obtain that nonlocal quantum strategies beat classical ones in terms of winning probability for identity games originating from certain bipartite and multipartite functions. Moreover we show that, for a majority of functions, access to general nonsignaling resources boosts success probability two times in comparison to classical ones for a number of large enough outputs. Because there are no constraints on the inputs and no processing of the outputs in the identity games, they detect very strong types of correlations: absolute nonlocality.

  3. In vivo absorption spectroscopy for absolute measurement.

    PubMed

    Furukawa, Hiromitsu; Fukuda, Takashi

    2012-10-01

    In in vivo spectroscopy, there are differences between individual subjects in parameters such as tissue scattering and sample concentration. We propose a method that can provide the absolute value of a particular substance concentration, independent of these individual differences. Thus, it is not necessary to use the typical statistical calibration curve, which assumes an average level of scattering and an averaged concentration over individual subjects. This method is expected to greatly reduce the difficulties encountered during in vivo measurements. As an example, for in vivo absorption spectroscopy, the method was applied to the reflectance measurement in retinal vessels to monitor their oxygen saturation levels. This method was then validated by applying it to the tissue phantom under a variety of absorbance values and scattering efficiencies.

  4. Determining Absolute Zero Using a Tuning Fork

    NASA Astrophysics Data System (ADS)

    Goldader, Jeffrey D.

    2008-04-01

    The Celsius and Kelvin temperature scales, we tell our students, are related. We explain that a change in temperature of 1°C corresponds to a change of 1 Kelvin and that atoms and molecules have zero kinetic energy at zero Kelvin, -273°C. In this paper, we will show how students can derive the relationship between the Celsius and Kelvin temperature scales using a simple, well-known physics experiment. By making multiple measurements of the speed of sound at different temperatures, using the classic physics experiment of determining the speed of sound with a tuning fork and variable-length tube, they can determine the temperature at which the speed of sound is zero—absolute zero.

  5. MAGSAT: Vector magnetometer absolute sensor alignment determination

    NASA Technical Reports Server (NTRS)

    Acuna, M. H.

    1981-01-01

    A procedure is described for accurately determining the absolute alignment of the magnetic axes of a triaxial magnetometer sensor with respect to an external, fixed, reference coordinate system. The method does not require that the magnetic field vector orientation, as generated by a triaxial calibration coil system, be known to better than a few degrees from its true position, and minimizes the number of positions through which a sensor assembly must be rotated to obtain a solution. Computer simulations show that accuracies of better than 0.4 seconds of arc can be achieved under typical test conditions associated with existing magnetic test facilities. The basic approach is similar in nature to that presented by McPherron and Snare (1978) except that only three sensor positions are required and the system of equations to be solved is considerably simplified. Applications of the method to the case of the MAGSAT Vector Magnetometer are presented and the problems encountered discussed.

  6. An estimate of global absolute dynamic topography

    NASA Technical Reports Server (NTRS)

    Tai, C.-K.; Wunsch, C.

    1984-01-01

    The absolute dynamic topography of the world ocean is estimated from the largest scales to a short-wavelength cutoff of about 6700 km for the period July through September, 1978. The data base consisted of the time-averaged sea-surface topography determined by Seasat and geoid estimates made at the Goddard Space Flight Center. The issues are those of accuracy and resolution. Use of the altimetric surface as a geoid estimate beyond the short-wavelength cutoff reduces the spectral leakage in the estimated dynamic topography from erroneous small-scale geoid estimates without contaminating the low wavenumbers. Comparison of the result with a similarly filtered version of Levitus' (1982) historical average dynamic topography shows good qualitative agreement. There is quantitative disagreement, but it is within the estimated errors of both methods of calculation.

  7. Micron Accurate Absolute Ranging System: Range Extension

    NASA Technical Reports Server (NTRS)

    Smalley, Larry L.; Smith, Kely L.

    1999-01-01

    The purpose of this research is to investigate Fresnel diffraction as a means of obtaining absolute distance measurements with micron or greater accuracy. It is believed that such a system would prove useful to the Next Generation Space Telescope (NGST) as a non-intrusive, non-contact measuring system for use with secondary concentrator station-keeping systems. The present research attempts to validate past experiments and develop ways to apply the phenomena of Fresnel diffraction to micron accurate measurement. This report discusses past research on the phenomena, and the basis of the use Fresnel diffraction distance metrology. The apparatus used in the recent investigations, experimental procedures used, preliminary results are discussed in detail. Continued research and equipment requirements on the extension of the effective range of the Fresnel diffraction systems is also described.

  8. Effectiveness of Arterial Closure Devices for Preventing Complications With Percutaneous Coronary Intervention: An Instrumental Variable Analysis

    PubMed Central

    Wimmer, Neil J.; Secemsky, Eric A; Mauri, Laura; Roe, Matthew T.; Saha-Chaudhuri, Paramita; Dai, David; McCabe, James M.; Resnic, Frederic S.; Gurm, Hitinder S.; Yeh, Robert W.

    2016-01-01

    Background Bleeding is associated with poor outcomes after percutaneous coronary intervention (PCI). While arterial closure devices (ACDs) are widely used in clinical practice, whether they are effective in reducing bleeding complications during transfemoral PCI is uncertain. The objective of this study was to evaluate the effectiveness of ACDs for the prevention of vascular access site complications in patients undergoing transfemoral PCI using an instrumental variable approach. Methods and Results We performed a retrospective analysis of CathPCI Registry from 2009-2013 at 1,470 sites across United States. Variation in the proportion of ACDs used by each individual physician operator was used as an instrumental variable to address potential confounding. A two stage instrumental variable analysis was used as the primary approach. The main outcome measure was vascular access site complications, and non-access site bleeding was used as a “falsification endpoint” (negative control) to evaluate for potential confounding. A total of 1,053,155 ACDs were used during 2,056,585 PCIs during the study period. The vascular access site complication rate was 1.5%. In the instrumental variable analysis, the use of ACDs was associated with a 0.40% absolute risk reduction in vascular access site complications (95% confidence interval (95% CI):0.31%−0.42%, number needed to treat=250). Absolute differences in non-access site bleeding were negligible (risk difference 0.04%, 95% CI:0.01%−0.07%), suggesting acceptable control of confounding in the comparison. Conclusions ACDs are associated with a modest reduction in major bleeding after PCI. The number needed to treat with ACDs to prevent one major bleeding event is high. PMID:27059685

  9. Measured and modelled absolute gravity in Greenland

    NASA Astrophysics Data System (ADS)

    Nielsen, E.; Forsberg, R.; Strykowski, G.

    2012-12-01

    Present day changes in the ice volume in glaciated areas like Greenland will change the load on the Earth and to this change the lithosphere will respond elastically. The Earth also responds to changes in the ice volume over a millennial time scale. This response is due to the viscous properties of the mantle and is known as Glaical Isostatic Adjustment (GIA). Both signals are present in GPS and absolute gravity (AG) measurements and they will give an uncertainty in mass balance estimates calculated from these data types. It is possible to separate the two signals if both gravity and Global Positioning System (GPS) time series are available. DTU Space acquired an A10 absolute gravimeter in 2008. One purpose of this instrument is to establish AG time series in Greenland and the first measurements were conducted in 2009. Since then are 18 different Greenland GPS Network (GNET) stations visited and six of these are visited more then once. The gravity signal consists of three signals; the elastic signal, the viscous signal and the direct attraction from the ice masses. All of these signals can be modelled using various techniques. The viscous signal is modelled by solving the Sea Level Equation with an appropriate ice history and Earth model. The free code SELEN is used for this. The elastic signal is modelled as a convolution of the elastic Greens function for gravity and a model of present day ice mass changes. The direct attraction is the same as the Newtonian attraction and is calculated as this. Here we will present the preliminary results of the AG measurements in Greenland. We will also present modelled estimates of the direct attraction, the elastic and the viscous signals.

  10. Absolute bioavailability of quinine formulations in Nigeria.

    PubMed

    Babalola, C P; Bolaji, O O; Ogunbona, F A; Ezeomah, E

    2004-09-01

    This study compared the absolute bioavailability of quinine sulphate as capsule and as tablet against the intravenous (i.v.) infusion of the drug in twelve male volunteers. Six of the volunteers received intravenous infusion over 4 h as well as the capsule formulation of the drug in a cross-over manner, while the other six received the tablet formulation. Blood samples were taken at predetermined time intervals and plasma analysed for quinine (QN) using reversed-phase HPLC method. QN was rapidly absorbed after the two oral formulations with average t(max) of 2.67 h for both capsule and tablet. The mean elimination half-life of QN from the i.v. and oral dosage forms varied between 10 and 13.5 hr and were not statistically different (P > 0.05). On the contrary, the maximum plasma concentration (C(max)) and area under the curve (AUC) from capsule were comparable to those from i.v. (P > 0.05), while these values were markedly higher than values from tablet formulation (P < 0.05). The therapeutic QN plasma levels were not achieved with the tablet formulation. The absolute bioavailability (F) were 73% (C.l., 53.3 - 92.4%) and 39 % (C.I., 21.7 - 56.6%) for the capsule and tablet respectively and the difference was significant (P < 0.05). The subtherapeutic levels obtained from the tablet form used in this study may cause treatment failure during malaria and caution should be taken when predictions are made from results obtained from different formulations of QN.

  11. Computer storage and retrieval of coronary trees

    NASA Technical Reports Server (NTRS)

    Starmer, C. F.; Smith, W. M.

    1975-01-01

    Coronary cineangiography is a routine procedure for evaluation of the coronary circulation. From the biplane cineangiograms a visual representation of coronary perfusion was obtained. A collection of simple ideas and procedures to aid in the collection is described. The uses to which the tree data will be put include the evaluation of myocardial function and the formation of a library sufficiently large to enable some taxonomic classification of coronary artery patterns to be made.

  12. Coronary Ostial Stenosis after Aortic Valve Replacement

    PubMed Central

    Ziakas, Antonios G.; Economou, Fotios I.; Charokopos, Nicholas A.; Pitsis, Antonios A.; Parharidou, Despina G.; Papadopoulos, Thomas I.; Parharidis, Georgios E.

    2010-01-01

    Coronary ostial stenosis is a rare but potentially serious sequela after aortic valve replacement. It occurs in the left main or right coronary artery after 1% to 5% of aortic valve replacement procedures. The clinical symptoms are usually severe and may appear from 1 to 6 months postoperatively. Although the typical treatment is coronary artery bypass grafting, patients have been successfully treated by means of percutaneous coronary intervention. Herein, we present the cases of 2 patients in whom coronary ostial stenosis developed after aortic valve replacement. In the 1st case, a 72-year-old man underwent aortic valve replacement and bypass grafting of the saphenous vein to the left anterior descending coronary artery. Six months later, he experienced a non-ST-segment-elevation myocardial infarction. Coronary angiography revealed a critical stenosis of the right coronary artery ostium. In the 2nd case, a 78-year-old woman underwent aortic valve replacement and grafting of the saphenous vein to an occluded right coronary artery. Four months later, she experienced unstable angina. Coronary angiography showed a critical left main coronary artery ostial stenosis and occlusion of the right coronary artery venous graft. In each patient, we performed percutaneous coronary intervention and deployed a drug-eluting stent. Both patients were asymptomatic on 6-to 12-month follow-up. We attribute the coronary ostial stenosis to the selective ostial administration of cardioplegic solution during surgery. We conclude that retrograde administration of cardioplegic solution through the coronary sinus may reduce the incidence of postoperative coronary ostial stenosis, and that stenting may be an efficient treatment option. PMID:20844624

  13. [Single coronary artery and right aortic arch].

    PubMed

    Martínez-Quintana, Efrén; Rodríguez-González, Fayna

    2015-01-01

    Coronary anomalies are mostly asymptomatic and diagnosed incidentally during coronary angiography or echocardiography. However, they must be taken into account in the differential diagnosis of angina, dyspnea, syncope, acute myocardial infarction or sudden death in young patients. The case is presented of two rare anomalies, single coronary artery originating from right sinus of Valsalva and right aortic arch, in a 65 year-old patient with atherosclerotic coronary artery disease treated percutaneously.

  14. Absolute magnetic helicity and the cylindrical magnetic field

    SciTech Connect

    Low, B. C.

    2011-05-15

    evolution; (iii) twist as a topological property of solenoidal fields versus the linkage properties of open and closed discrete curves treated by Gauss, Caligarneau, Berger, and Prior; and (iv) the change of absolute helicity by resistive diffusion. These are important hydromagnetic properties of twisted magnetic fields in the million-degree hot, highly conducting corona of the Sun.

  15. Percutaneous Coronary Intervention versus Coronary Artery Bypass Grafting in Patients with Diabetic Nephropathy and Left Main Coronary Artery Disease

    PubMed Central

    Li, Hsin-Ru; Hsu, Chiao-Po; Sung, Shih-Hsien; Shih, Chun-Che; Lin, Shing-Jong; Chan, Wan-Leong; Wu, Cheng-Hsueh; Lu, Tse-Min

    2017-01-01

    Background Patients with diabetic nephropathy and unprotected left main (LM) coronary artery disease suffer from high cardiovascular morbidity and mortality. Although surgical revascularization is currently recommended in this special patient population, the optimal revascularization method for this distinct patient group has remained unclear. Methods We collected 99 consecutive patients with unprotected LM disease and diabetic nephropathy, including 46 patients who had undergone percutaneous coronary intervention (PCI), and 53 who had coronary artery bypass grafting (CABG), with a mean age of 72 ± 10; with 80.8% male. Diabetic nephropathy was defined as overt proteinuria (proteinuria > 500 mg/day) and estimated glomerular filtration rate (eGFR) by the modified Modification of Diet in Renal Disease (MDRD) equation of less than 60 mL/min/1.73 m2. The baseline characteristics, angiographic results and long-term clinical outcomes were retrospectively analyzed. Results The baseline characteristic of all patients were similar except for smokers, low density lipoprotein (LDL) level and extension of coronary artery disease involvement. The median follow-up period was 3.8 years. There were 73 patients (74%) considered as high risk with additive European System for Cardiac Operative Risk Evaluation (EuroSCORE) ≥ 6. During follow-up period, the long term rate of all-cause death (PCI vs. CABG: 45.7% vs. 58.5%, p = 0.20) and all-cause death/myocardial infarction (MI)/stroke (PCI vs. CABG: 52.2% vs. 60.4%, p = 0.41) were comparable between the PCI and CABG group, whereas the repeat revascularization rate was significantly higher in the PCI group (PCI vs. CABG: 32.6% vs. 9.4%, p < 0.01). eGFR remained an independent predictor for all-cause death [hazard ratio: 0.97, 95% confidence interval: 0.96 to 0.99; p = 0.002] in multivariate logistic regression. Conclusions In the real-world practice of high-risk patients with unprotected LM disease and diabetic nephropathy, we found

  16. Preoperative levosimendan decreases mortality and the development of low cardiac output in high-risk patients with severe left ventricular dysfunction undergoing coronary artery bypass grafting with cardiopulmonary bypass

    PubMed Central

    Levin, Ricardo; Degrange, Marcela; Del Mazo, Carlos; Tanus, Eduardo; Porcile, Rafael

    2012-01-01

    BACKGROUND: The calcium sensitizer levosimendan has been used in cardiac surgery for the treatment of postoperative low cardiac output syndrome (LCOS) and difficult weaning from cardiopulmonary bypass (CPB). OBJECTIVES: To evaluate the effects of preoperative treatment with levosimendan on 30-day mortality, the risk of developing LCOS and the requirement for inotropes, vasopressors and intra-aortic balloon pumps in patients with severe left ventricular dysfunction. METHODS: Patient with severe left ventricular dysfunction and an ejection fraction <25% undergoing coronary artery bypass grafting with CPB were admitted 24 h before surgery and were randomly assigned to receive levosimendan (loading dose 10 μg/kg followed by a 23 h continuous infusion of 0.1μg/kg/min) or a placebo. RESULTS: From December 1, 2002 to June 1, 2008, a total of 252 patients were enrolled (127 in the levosimendan group and 125 in the control group). Individuals treated with levosimendan exhibited a lower incidence of complicated weaning from CPB (2.4% versus 9.6%; P<0.05), decreased mortality (3.9% versus 12.8%; P<0.05) and a lower incidence of LCOS (7.1% versus 20.8%; P<0.05) compared with the control group. The levosimendan group also had a lower requirement for inotropes (7.9% versus 58.4%; P<0.05), vasopressors (14.2% versus 45.6%; P<0.05) and intra-aortic balloon pumps (6.3% versus 30.4%; P<0.05). CONCLUSION: Patients with severe left ventricle dysfunction (ejection fraction <25%) undergoing coronary artery bypass grafting with CPB who were pretreated with levosimendan exhibited lower mortality, a decreased risk for developing LCOS and a reduced requirement for inotropes, vasopressors and intra-aortic balloon pumps. Studies with a larger number of patients are required to confirm whether these findings represent a new strategy to reduce the operative risk in this high-risk patient population. PMID:23620700

  17. Epidemiology of coronary heart disease and acute coronary syndrome

    PubMed Central

    Perez-Quilis, Carme; Leischik, Roman; Lucia, Alejandro

    2016-01-01

    The aim of this review is to summarize the incidence, prevalence, trend in mortality, and general prognosis of coronary heart disease (CHD) and a related condition, acute coronary syndrome (ACS). Although CHD mortality has gradually declined over the last decades in western countries, this condition still causes about one-third of all deaths in people older than 35 years. This evidence, along with the fact that mortality from CHD is expected to continue increasing in developing countries, illustrates the need for implementing effective primary prevention approaches worldwide and identifying risk groups and areas for possible improvement. PMID:27500157

  18. Regional variability in the myocardial clearance of thallium-201 and its importance in determining the presence or absence of coronary artery disease

    SciTech Connect

    Kaul, S.; Chesler, D.A.; Newell, J.B.; Pohost, G.M.; Okada, R.D.; Boucher, C.A.

    1986-07-01

    There are several limitations in using absolute myocardial clearance of thallium-201 for the detection of coronary artery disease. Noncardiac factors such as peak exercise heart rate and blood level of thallium can affect its absolute myocardial clearance. However, because all myocardial segments in a given heart are exposed to the same noncardiac factors, a relative difference in myocardial clearance of thallium between segments could reflect the presence of coronary artery disease. Accordingly, myocardial clearance of thallium was analyzed in 370 patients. Patients in Group I (n = 45) had less than 1% probability of having coronary artery disease, patients in Group II (n = 44) had normal coronary arteries and patients in Group III (n = 281) had coronary artery disease. Although mean myocardial clearance of thallium in 15 myocardial segments in three views in Group I subjects was 3.4 +/- 0.7 hours, the variability between the slowest and fastest clearing segments in the same subject was as much as 98%. This variability was systematic, suggesting technical reasons associated with imaging as the cause of the variability: 78% of the slowest clearing segments were basal whereas 53% of the fastest clearing segments were apical (p less than 0.01). When Group II and III patients were compared based on Group I values, the absolute myocardial clearance of thallium had a sensitivity and specificity of 92 and 16%, respectively.

  19. Malignant Course of Anomalous Left Coronary Artery Causing Sudden Cardiac Arrest: A Case Report and Review of the Literature

    PubMed Central

    Anantha Narayanan, Mahesh; DeZorzi, Christopher; Akinapelli, Abhilash; Mahfood Haddad, Toufik; Smer, Aiman; Baskaran, Janani; Biddle, William P.

    2015-01-01

    Sudden cardiac arrest has been reported to occur in patients with congenital anomalous coronary artery disease. About 80% of the anomalies are benign and incidental findings at the time of catheterization. We present a case of sudden cardiac arrest caused by anomalous left anterior descending artery. 61-year-old African American female was brought to the emergency department after sudden cardiac arrest. Initial EKG showed sinus rhythm with RBBB and LAFB with nonspecific ST-T wave changes. Coronary angiogram revealed no atherosclerotic disease. The left coronary artery was found to originate from the right coronary cusp. Cardiac CAT scan revealed similar findings with interarterial and intramural course. Patient received one-vessel arterial bypass graft to her anomalous coronary vessel along with a defibrillator for secondary prevention. Sudden cardiac arrest secondary to congenital anomalous coronary artery disease is characterized by insufficient coronary flow by the anomalous left coronary artery to meet elevated left ventricular (LV) myocardial demand. High risk defects include those involved with the proximal coronary artery or coursing of the anomalous artery between the aorta and pulmonary trunk. Per guidelines, our patient received one vessel bypass graft to her anomalous vessel. It is important for clinicians to recognize such presentations of anomalous coronary artery. PMID:26257964

  20. The ASSURE ROT Registry: Bioresorbable Vascular Scaffold Following Rotablation for Complex Coronary Lesions

    ClinicalTrials.gov

    2015-02-05

    Cardiov