Diagnostic capability of feature-tracking cardiovascular magnetic resonance to detect infarcted segments: a comparison with tagged magnetic resonance and wall thickening analysis.

AIM: To examine the diagnostic capabilities of feature-tracking cardiovascular magnetic resonance (FT-CMR), tagged cine magnetic resonance (MR), and wall thickening (WT) analyses to detect infarcted segments in patients with established myocardial infarction (MI). MATERIALS AND METHODS: Twenty patients with established MI were selected retrospectively and the peak endocardial circumferential strain (CS) was quantified based on the 16-segment model. According to CMR with late gadolinium enhancement, segments were categorised as transmural MI, subendocardial MI, and no MI. RESULTS: A total of 320 segments (62 transmural MI, 50 subendocardial MI, and 208 no MI) were analysed. Peak endocardial CS was significantly lower for transmural MI compared with subendocardial MI (p<0.05) and no MI (p<0.001). Cut-off values of -11.2% for CS by FTCMR, -10.9% for CS by tagged MR, and 23.8% for %WT, differentiated between infarcted and non-infarcted segments with a sensitivity of 72%, 71%, and 56%; specificity of 71%, 75%, and 67%; accuracy of 72%, 73%, and 63%; positive predictive value of 57%, 60%, and 48%; negative predictive value of 83%, 83%, and 74%; and an area-under-the-curve of 0.77, 0.79, and 0.64, respectively. CONCLUSIONS: FT-CMR was diagnostically superior to %WT, and could differentiate between subendocardial and transmural MI. Unlike tagged MR, FT-CMR did not require the acquisition of additional sequences.

Chiral Surface Twists and Skyrmion Stability in Nanolayers of Cubic Helimagnets.

Theoretical analysis and Lorentz transmission electron microscopy (LTEM) investigations in an FeGe wedge demonstrate that chiral twists arising near the surfaces of noncentrosymmetric ferromagnets [Meynell et al., Phys. Rev. B 90, 014406 (2014)] provide a stabilization mechanism for magnetic Skyrmion lattices and helicoids in cubic helimagnet nanolayers. The magnetic phase diagram obtained for freestanding cubic helimagnet nanolayers shows that magnetization processes differ fundamentally from those in bulk cubic helimagnets and are characterized by the first-order transitions between modulated phases. LTEM investigations exhibit a series of hysteretic transformation processes among the modulated phases, which results in the formation of the multidomain patterns.

Antifungal effects of palmitic acid salt and ultrapure soft water on Scedosporium apiospermum.

AIMS: Scedosporium apiospermum sometimes causes serious infectious diseases on the skin of immunodeficient subjects. Antifungal effects of fatty acid salts in soap against S. apiospermum were investigated under different water conditions. METHODS AND RESULTS: Ultrapure soft water (UPSW) was generated by the water softener with cation-exchange resin. The calcium and magnesium ions were replaced with sodium ions in UPSW. Scedosporium apiospermum was incubated with different fatty acid salts that constituted soap in distilled water (DW), tap water (TW) and UPSW. After incubation, the number of fungi was counted. Among the fatty acids, palmitic acid salt (C16) reduced the number of S. apiospermum. UPSW enhanced the antifungal effect of C16 on S. apiospermum. The absence of both calcium and magnesium ions and the existence of sodium chloride in UPSW were responsible for its antifungal effect. In addition, repeated short-term treatment with UPSW and C16 decreased the number of S. apiospermum. CONCLUSIONS: Antifungal effects of C16 on S. apiospermum were demonstrated. Moreover, the use of UPSW promoted the antifungal effect of C16. SIGNIFICANCE AND IMPACT OF STUDY: This study provides the preventive method for diseases associated with S. apiospermum infection using novel palmitic acid soap in UPSW.

Using Convolutional Neural Networks for Classification of Bifurcation Regions in IVOCT Images.

Optical Coherence Tomography (OCT) technology enabled the experts to analyze coronary lesions from high-resolution intravascular images. Studies have shown the relationship between bifurcation regions and a higher occurrence of wall thickening and lesions in these areas. Some level of automation could benefit experts, since examining pullback frames is a laborious and time-consuming task. Although Convolutional Neural Networks (CNN) have shown promising results in classification tasks of medical images, we did not identify the use of CNN's in IVOCT images to classify bifurcation regions in the literature. In this work, we evaluated a CNN architecture in the bifurcation classification task trained with IVOCT images from 9 pullbacks from 9 different patients. We used data augmentation to balance the dataset, due to the low amount of bifurcation-labeled frames. Our classification results are comparable to other works in the literature, presenting better result in AUC (99.70%).

Lumen Segmentation in Optical Coherence Tomography Images using Convolutional Neural Network.

Lumen segmentation in Optical Coherence Tomography (OCT) images is a very important step to analyze points of interest that may help on atherosclerosis diagnostic and treatment. Past studies use many different methods to segment the lumen in IVOCT images, like level set, morphological reconstruction, Markov random fields, and Otsu binarization. Despite Convolutional Neural Networks (CNN) have shown promising results in the image processing area, we did not identify, in the literature, works applying CNN in IVOCT images. In this paper, we present the lumen segmentation using CNN. We evaluated three different CNN architectures. The CNNs were evaluated using three versions from the image dataset, differing from each other by image size (768x768 pixels and 192x192 pixels), and by coordinate system representation (Cartesian and polar). The best results, Accuracy, Dice index and Jaccard index of over 99%, 98% and 97%, respectively, were obtained with the smallest size images represented by polar coordinate system.

Thallium-201 myocardial tomography with intravenous infusion of adenosine triphosphate in diagnosis of coronary artery disease.

OBJECTIVES: The purpose of this study was to evaluate the feasibility, safety and diagnostic accuracy of thallium-201 myocardial tomography with intravenous adenosine triphosphate (ATP) infusion in patients with suspected coronary artery disease. BACKGROUND: Both ATP and adenosine are potent coronary vasodilators with a very short half-life. Several studies have confirmed that the diagnostic accuracy of adenosine thallium-201 scintigraphy is comparable to that with exercise. However, a high incidence of side effects, including atrioventricular (AV) block, has also been reported. Because the appropriate infusion rate for ATP has not yet been determined, this agent has not been tested in combination with myocardial scintigraphy. METHODS: The study group included 253 consecutive patients who underwent thallium-201 myocardial tomography with ATP infusion (0.16 mg/kg body weight per min for 5 min). The occurrence of adverse effects was carefully monitored. Of the 120 patients with coronary angiography, 76 had significant coronary artery disease. Tomographic images were assessed visually and by computer-quantified polar maps, and they were compared with the results of coronary angiography. RESULTS: Although 56% of the patients had some adverse effects, they were transient and mild. In all patients, the ATP infusion protocol could be completed, and no patient required aminophylline; AV block occurred in only 2% of the patients. The sensitivity and specificity were 88% and 80%, respectively, by visual analysis and 91% and 86%, respectively, by computer quantification. CONCLUSIONS: Thallium tomography with ATP is feasible and has a diagnostic value similar to that with adenosine for detecting coronary artery disease. In addition, it may have fewer side effects than adenosine myocardial tomography.

Structural details of ribonuclease H from Escherichia coli as refined to an atomic resolution.

The crystal structure of RNase H from Escherichia coli has been determined by the multiple isomorphous replacement method, and refined by the stereochemically restrained least-squares procedure to a crystallographic R-factor of 0.196 at 1.48 A resolution. In the final structure, the root-mean-square (r.m.s.) deviation for bond lengths is 0.017 A, and for angle distances 0.036 A. The structure is composed of a five-stranded beta-sheet and five alpha-helices, and reveals the details of hydrogen bonding, electrostatic and hydrophobic interactions between intra- and intermolecular residues. The refined structure allows an explanation of the particular interactions between the basic protrusion, consisting of helix alpha III and the following loop, and the remaining major domain. The beta-sheet, alpha II, alpha III and alpha IV form a central hydrophobic cleft that contains all six tryptophan residues, and presumably serves to fix the orientation of the basic protrusion. Two parallel adjacent helices, alpha I and alpha IV, are associated with a few triads of hydrophobic interactions, including many leucine residues, that are similar to the repeated leucine motif. The well-defined electron density map allows detailed discussion of amino acid residues likely to be involved in binding a DNA/RNA hybrid, and construction of a putative model of the enzyme complexed with a DNA/RNA hybrid oligomer. In this model, a protein region, from the Mg(2+)-binding site to the basic protrusion, covers roughly two turns of a DNA/RNA hybrid double helix. A segment (11-23) containing six glycine residues forms a long loop between the beta A and beta B strands. This loop, which protrudes into the solvent region, lies on the interface between the enzyme and a DNA/RNA hybrid in the model of the complex. The mean temperature factors of main-chain atoms show remarkably high values in helix alpha III that constitutes the basic protrusion, suggesting some correlation between its flexibility and the nucleic acid binding function. The Mg(2+)-binding site, surrounded by four invariant acidic residues, can now be described more precisely in conjunction with the catalytic activity. The arrangement of molecules within the crystal appears to be dominated by the cancelling out of a remarkably biased charge distribution on the molecular surface, which is derived in particular from the separation between the acidic Mg(2+)-binding site and the basic protrusion.

Relationship between insulin resistance and cardiac sympathetic nervous function in essential hypertension.

BACKGROUND: It has been suggested that hyperinsulinemia and insulin resistance participate in the pathogenesis of hypertension, in part by activating sympathetic activity. OBJECTIVE: We aimed to examine the relationship between insulin resistance and cardiac sympathetic nervous function in patients with essential hypertension using 123I-metaiodobenzylguanidine (MIBG) cardiac scintigraphy. METHODS AND RESULTS: Twenty-eight patients (18 men) with essential hypertension and 11 (seven men) control individuals with a mean age of 55.8+/-3.3 years were recruited. Patients with diabetes mellitus, congestive heart failure or coronary artery disease were excluded from this study. To evaluate insulin resistance, we used steady-state plasma glucose (SSPG; mg/dl) levels measured by the SSPG method. To evaluate cardiac sympathetic nervous function, we calculated the heart-to-mediastinum ratio from the delayed MIBG image (H:M-D) and the mean washout rate (WOR, %). There were significant differences (P<0.01) in SSPG, H:M-D and WOR between the essential hypertension and control individual groups (125 versus 103 mg/dl, 2.2 versus 2.4, and 32 versus 23%, respectively). Stepwise regression analysis showed that SSPG and plasma norepinephrine level are independent predictors for the cardiac sympathetic nervous function obtained from MIBG scintigraphy. CONCLUSIONS: These findings indicate that insulin resistance is significantly related to activation of the cardiac sympathetic nervous function associated with left ventricular hypertrophy in patients with essential hypertension.

Comparison of adenosine triphosphate and dipyridamole in diagnosis by thallium-201 myocardial scintigraphy.

UNLABELLED: We examined whether 201Tl myocardial scintigraphy with intravenous infusion of adenosine triphosphate (ATP) can be substituted for dipyridamole (DIP) in the diagnosis of coronary artery disease CAD). METHODS: The coronary flow reserve (CFR) during intravenous infusion of ATP (0.10-0.20 mg/kg/min) was compared with that during intravenous infusion of DIP (0.56 mg/kg) using a Doppler flow wire in 19 subjects with normal coronary arteries. The highest CFR level was found in the ATP dose range of 0.16-0.20 mg/kg/min. The CFR at the ATP dose of 0.16 mg/kg/min was significantly higher than that during DIP infusion (4.2 versus 3.6) (p < 0.01), for which reason we adopted this dose of ATP. According, 201Tl SPECT in 140 patients with suspected CAD was performed after infusion of 0.16 mg/kg/min of ATP in 70 of them and 0.56 mg/kg of DIP in the 70 others. RESULTS: ATP stress 201Tl SPECT showed no significant difference in sensitivity and accuracy from DIP stress 201Tl SPECT (87.0% versus 82.9, and 87.1% versus 78.6, respectively). Adverse effects occurred at higher frequency when ATP was used, but they were mild and disappeared rapidly after administration was stopped. CONCLUSION: ATP stress 201Tl SPECT is accurate and safe. The optimal ATP regimen for this purpose is considered to be a 5-min infusion at 0.16 mg/kg/min. However, our data in CAD patients suggest that ATP stress 201Tl SPECT is equivalent to DIP stress 201Tl SPECT in the detection of CAD.

Effects of probucol and cilostazol alone and in combination on frequency of poststenting restenosis.

The present study was conducted to assess the preventive effect of combined treatment with probucol, an antioxidant, and cilostazol, a phosphodiesterase inhibitor, against poststenting restenosis. Study patients were randomized to 4 modality groups 1 week before stenting: control, probucol (500 mg/day), cilostazol (200 mg/day), and probucol plus cilostazol. Treatment on these modalities was conducted from 5 prestent days until the poststenting follow-up evaluation (6 poststenting months). All patients received aspirin (81 mg/day). The efficacy of each modality against restenosis was evaluated in a total 126 patients with 165 coronary arterial lesions, using a quantitative method. The decrease in luminal diameter at the poststenting follow-up was 1.04 +/- 0.57 mm for controls, 0.88 +/- 0.82 mm for those taking probucol, 0.61 +/- 0.59 mm for those taking cilostazol (p <0.05 vs control), and 0.40 +/- 0.52 mm (p <0.01 vs control) for the combined treatment group. Restenosis rate per segment was 31.7% for controls, 16.7% for the probucol group, 12.5% for the cilostazol group (p <0.05 vs control), and 9.5% for the combined treatment group (p <0.05 vs the control). Neither mortality, myocardial infarction, stent thrombosis, or coronary bypass surgery, nor any serious complications were observed in the combined treatment group. Combined treatment with probucol and cilostazol has thus proved safe and effective in preventing acute poststenting complications and suppressing chronic restenosis.

The influence of left ventricular geometry on coronary vasomotion in patients with essential hypertension.

The objective of this study was to assess the influence of left ventricular (LV) geometric pattern on coronary vasomotion in patients with essential hypertension. We studied 34 hypertensive patients, who had never been treated, with angiographically normal coronary arteries. Patients were classified into four LV geometric patterns by echocardiography: normal, concentric remodeling, eccentric hypertrophy, and concentric hypertrophy. The responses of coronary vasomotion in left anterior descending artery to vasoactive agents (acetylcholine, isosorbide dinitrate, adenosine triphosphate) were examined using a Doppler guidewire and quantitative coronary angiography. The percent increase in coronary blood flow evoked with acetylcholine (endothelium-dependent vasomotion) showed lowest in concentric hypertrophy, followed by eccentric hypertrophy, concentric remodeling, and normal geometry. The significant linear relationship between acetylcholine-induced coronary blood flow and LV mass was noted. There was no difference in the percent increase in coronary blood flow evoked with isosorbide dinitrate (endothelium-independent vasomotion of conduit vessel) among the four groups. The percent increase in coronary blood flow evoked with adenosine triphosphate (endothelium-independent vasomotion of resistant vessel) was significantly lower in patients with concentric hypertrophy than in the other three groups. The results in this study suggest that coronary vasomotion may be associated with LV geometry in patients with hypertension. The endothelium-dependent vasodilation is impaired progressively as LV hypertrophy advances. The endothelium-independent vasodilation of microvessels is impaired only in concentric hypertrophy. This advanced abnormality of coronary vasomotion may contribute to the high cardiovascular morbidity and mortality in patients with concentric hypertrophy.

Crystallization and preliminary crystallographic data of the alpha-amylase inhibitors, Haim I and Paim I.

Two proteins that act as alpha-amylase inhibitors, Haim I and Paim I, were crystallized and preliminary X-ray diffraction studies on them were carried out. We also sequenced Haim I prepared from Streptomyces griseosporeus YM-25 and confirmed that it is composed of 78 amino acid residues. Crystals of Haim I were grown from ammonium sulfate solution mixed with ethanol by the vapor diffusion technique. The crystals grew as hexagonal bipyramids and diffracted X-rays beyond 2.0 A resolution. They belong to the space group P6(1)22 (or P6(5)22) with unit cell dimensions of a = b = 36.7 A, c = 192.4 A, and contain one molecule per asymmetric unit. Paim I, a protein of 39 amino acid residues produced by Streptomyces corchorusii, was crystallized under similar conditions to Haim I. The crystals diffracted X-rays beyond 2.5 A. They belong to the space group P4(1)2(1)2 (or P4(3)2(1)2) with unit cell dimensions of a = b = 65.4 A, c = 96.1 A, and contain three molecules per asymmetric unit.

Endogenous opioid peptide effects on the guinea-pig biliary tract.

The effects of the endogenous opioid peptides, dynorphin (1-13), Met-enkephalin and beta-endorphin, on contraction induced by transmural stimulation of terminal bile duct preparations (terminal cavity and ampulla) and gallbladder were investigated in vitro. These peptides inhibited ampulla contraction, dose dependently. The potency order, indicated by ID50, was the same as in the guinea-pig ileum, but the absolute ID50 values in the ampulla were lower than in the ileum. In the terminal cavity, the dynorphin (1-13) ID50 was still less than in the ampulla, and beta-endorphin and Met-enkephalin did not reduce contraction by as much as 50%. In the gallbladder, the effects of these opioid peptides on contraction induced by transmural stimulation were not significant. The results suggest differences in the receptor populations of the ampulla and terminal cavity, and lack of opiate receptors (at least micro and k receptors) in the gallbladder.

Identification of gK systems activated by [Ca2+].

Rhythmic caffeine hyperpolarizations generated in bullfrog sympathetic ganglion cells are assumed to be caused by periodic increase in gK due to rise in [Ca2+]i7--9,13. Caffeine-induced outward currents seem to be composed of two different components, which show different pharmacological natures and also different dependencies on membrane potential changes. These two components may be generated by activation of two voltage-dependent K+ currents, namely IK1 (the delayed rectifier K+ current) and IK2 (IM) of ganglion cells. These results suggested that at least two different gK systems were activated by [Ca2+]i in sympathetic ganglion cells.

Antidromic inhibition of acetylcholine release from presynaptic nerve terminals in bullfrog's sympathetic ganglia.

In isolated bullfrog's sympathetic ganglia it was examined if the release of acetylcholine (ACh) from presynaptic nerve terminals was changed when postsynaptic ganglion cells were activated antidromically. The fast excitatory postsynaptic potential (fast EPSP) of ganglion cells was found to be depressed, whereas the nicotinic ACh potential of these cells was not depressed, immediately after these ganglion cells were activated by antidromic axonal or direct intracellular stimulations. This indicates that activation of ganglion cells results in inhibiton of the release of ACh from their presynaptic nerve terminals. Such an antidromic inhibition of ACh release could not be clearly observed when preparations were perfused with Ca2+-deficient solution or when adrenaline (10(-5) M) was added to the superfusion solution. Frequency of the spontaneous miniature EPSP was also found to be decreased after antidromic activation of ganglion cells. On the basis of these results it was concluded that some kind of transmitter was released from activated ganglion cells which inhibited ACh release by acting on preganglionic nerve terminals. This putative neurotransmitter was suggested to be adrenaline.

Biogenic antagonists of the nicotinic receptor: their interactions with erabutoxin.

The hypothesis that the sensitivity of the nicotinic ACh-receptor is reduced by some neurotransmitters was evaluated by studying the interaction between these neurotransmitters and erabutoxin-b (ETX-b), known to bind irreversibly with the specific ACh-receptor site. It was found that the blocking action of ETX-b was apparently prevented by previous application of 5-HT, whereas it was not prevented by application of catecholamine (CA). These results indicate that 5-HT blocks the nicotinic ACh-receptor by interacting with the specific ACh binding site, whereas CA blocks it by interacting with an allosteric site of the ACh-receptor ionic channel complex.

Effects of chemical stimulation and lesion of the rostral ventrolateral medulla in spontaneously hypertensive rats.

We investigated whether or not the rostral ventrolateral medulla (RVL) participates in maintaining a higher arterial pressure of spontaneously hypertensive rats (SHR). SHR and Wistar-Kyoto rats (WKY) were anesthetized with chloralose, paralyzed with tubocurarine, and artificially ventilated. Chemical excitation of the RVL neurons by microinjection of excitatory amino acids (L-glutamate) elicited a dose-dependent pressor response in both the SHR and WKY groups. The magnitude of increase in the arterial pressure (AP) was similar in both groups, but the present increase of AP was higher in WKY than in SHR. Chemical lesions of the bilateral RVL produced by the microinjection of tetrodotoxin decreased the AP to the spinal level, which was similar in both groups. The results indicate that the RVL functions as the sole sympathetic output of the brain in SHR, and suggest that the RVL neurons may be tonically overactive to maintain hypertension in SHR.

Validity of microsphere model in cerebral blood flow measurement using N-isopropyl-p-(I-123) iodoamphetamine.

A microsphere model is sometimes used when calculating cerebral blood flow (CBF) using N-isopropyl-p-[I-123]iodoamphetamine (IMP), and is based on the assumption that there is essentially no washout of IMP. The validity of a microsphere model was investigated by comparison with the values of CBF obtained by means of a model which takes into consideration the diffusion of IMP from brain tissue to blood (nonmicrosphere model). When calculating CBF by the latter model, the look-up table method was used with expression of the double integral in the model equation by the recursion relations, a method which is useful for obtaining pixel-by-pixel values. The average rate constants for diffusion from brain to blood of gray and white matter were 0.021 and 0.0016 min-1, respectively. The values of CBF obtained by applying a microsphere model to the data acquired from 0 to 3.2 min after IMP injection were overestimated by approximately 23% compared with those values obtained using a nonmicrosphere model. This is considered to be due to the effect of the IMP activity in the vascular space. Values obtained using the data acquired from 3.2 to 6.4 min were underestimated by approximately 15%. When the values of CBF obtained by a microsphere model were interpolated, they became nearly equal to those obtained using a nonmicrosphere model at about 4 to 5 min after injection. This is suggested to be the reason why the underestimation due to diffusion from brain to blood is cancelled out by the overestimation due to the IMP in the vascular space. Our preliminary results suggest that it is necessary to take the diffusion of IMP from brain tissue to blood into account for the quantification of CBF using IMP.

Conditioned taste aversion induced by inhalation exposure to methyl bromide in rats.

The toxic effect of methyl bromide vapor was assessed by a conditioned taste aversion regime. Rats kept under a water deprivation schedule for 7 days, were permitted access to 0.3% (w/v) sodium saccharin, and were exposed to methyl bromide at 0, 25, 50, and 100 ppm for 4 h. 3 days after the exposure, saccharin preference tests were carried out, revealing dose-dependent saccharin aversion in the exposure group. This result suggests that the conditioned taste aversion method is effective for assessing the toxicity of gaseous substances such as methyl bromide.

Changes in free amino acid contents of rat brain induced by exposure to methyl bromide.

Rats were exposed to methyl bromide (MB) for 24 h at 10-120 ppm or for 3 weeks at 1-10 ppm. Changes in free amino acid contents of rat midbrain were measured by high-performance liquid chromatography (HPLC). MB increased glutamine and aspartic acid contents dose-dependently by short-and long-term exposure. Alanine content was markedly increased by long-term exposure to 10 ppm MB. Glycine was dose-dependently increased, except at 120 ppm. The harmful effect of MB on the central nervous system is discussed in relation to the changes in amino acid metabolism.