Extracorporeal Cardiac Shock Wave Therapy Ameliorates Clinical Symptoms and Improves Regional Myocardial Blood Flow in a Patient with Severe Coronary Artery Disease and Refractory Angina

Different therapeutic options are being used for chronic coronary artery disease (CAD). We report about a 51-year-old female with CAD and refractory angina pectoris despite maximally tolerated medical therapy and after both percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). The patient received cardiac shock wave therapy (CSWT) over a period of 6 month. There was no arrhythmia during or after treatment; enzyme levels were normal at all times. PET imaging showed a substantial improvement of myocardial stress perfusion. Since the patient reported that she now was fully capable to deal with her everyday life, further treatment options were postponed. Our case report suggests that ultrasound-guided CSWT is able to improve symptoms and perfusion in ischemic myocardium

Приготовление суспензий нанопорошка ZnO в растворе глицина

The focus of the work was to make an attempt to prepare an aggregative-stable suspension of ZnO nanopowder with average particle size of 20-40 nm, which was prepared by plasma method in aminoacetic acid. The infrared spectrums of the solution before and after exposure to nanopowder in 2 M glycine solution was used to check the effectiveness of glycine sorption on the particle surface. It was experimentally revealed that the centrifugate, separated from the nanoparticles after incubation in 2M nanopowder surfactant solution with a particle concentration of 2, 10 and 20 wt.% during a week, had a peak height decrease from 11.1 (initial 2M glycine solution) to 9.45 ... 5.3 ... 4.5 units on the IR spectrum at a wavelength of 1250 cm{-1}, and the percentage of adsorbed glycine 15, 52 and 59.4 %, respectively. Selected surfactant has been efficiently adsorbed on the surface of ZnO particles and can be used to stabilize the nanoparticles in aqueous aggregative-stable suspensions

Sefalet

Emine Semiye'nin Mütalaa'da tefrika edilen Sefalet adlı romanıArşivdeki eksikler nedeniyle tefrika yarım kalmıştır. Ancak tefrikanın tamamlandığı bilinmektedir

Effect of ABCG2, OCT1, and ABCB1(MDR1) Gene Expression on Treatment-Free Remission in a EURO-SKI Subtrial

Introduction Tyrosine kinase inhibitors (TKIs) can safely be discontinued in chronic myeloid leukemia (CML) patients with sustained deep molecular response. ABCG2 (breast cancer resistance protein), OCT1 (organic cation transporter 1), and ABCB1 (multidrug resistance protein 1) gene products are known to play a crucial role in acquired pharmacogenetic TKI resistance. Their influence on treatment-free remission (TFR) has not yet been investigated. Materials and Methods RNA was isolated on the last day of TKI intake from peripheral blood leukocytes of 132 chronic phase CML patients who discontinued TKI treatment within the European Stop Tyrosine Kinase Inhibitor Study trial. Plasmid standards were designed including subgenic inserts of OCT1, ABCG2, and ABCB1 together with GUSB as reference gene. For expression analyses, quantitative real-time polymerase chain reaction was used. Multiple Cox regression analysis was performed. In addition, gene expression cutoffs for patient risk stratification were investigated. Results The TFR rate of 132 patients, 12 months after TKI discontinuation, was 54% (95% confidence interval [CI], 46%-62%). ABCG2 expression (‰) was retained as the only significant variable (P = .02; hazard ratio, 1.04; 95% CI, 1.01-1.07) in multiple Cox regression analysis. Only for the ABCG2 efflux transporter, a significant cutoff was found (P = .04). Patients with an ABCG2/GUSB transcript level >4.5‰ (n = 93) showed a 12-month TFR rate of 47% (95% CI, 37%-57%), whereas patients with low ABCG2 expression (≤4.5‰; n = 39) had a 12-month TFR rate of 72% (95% CI, 55%-82%). Conclusion In this study, we investigated the effect of pharmacogenetics in the context of a CML treatment discontinuation trial. The transcript levels of the efflux transporter ABCG2 predicted TFR after TKI discontinuation

Myocardial Perfusion SPECT 2018 in Germany: Results of the 8th Survey

AIM This paper presents the results of the 8$^{th}$ survey of myocardial perfusion SPECT (MPS) from the reporting year 2018. METHODS 291 questionnaires (184 practices (PR), 77 hospitals (HO), 30 university hospitals (UH)) were evaluated. Results of the last survey from 2015 are set in squared brackets. RESULTS MPS of 145 930 [121 939] patients were reported (+ 19.6 %). 76 % [78 %] of all patients were studied in PR, 16 % [14 %] in HO, and 8 % [8 %] in UH, mostly with a 2-day-protocol 48 % [50 %]. 99.96 % [98 %] of all MPS were performed with Tc-99 m radiopharmaceuticals and in 0.04 % with Tl-201.A pharmacological stress test was applied in 49 % [43 %] (23 % [22 %] adenosine, 26 % [20 %] regadenoson, dipyridamole or dobutamine together < 1 % [1 %]). Attenuation correction was performed in 26 % [25 %] of all MPS, gated SPECT in 86 % [80 %] of stress MPS, in 87 % [78 %] of rest and in 83 % [76 %] of all stress and rest MPS. 67 % [53 %] of the departments performed MPS scoring by default, whereas 16 % [24 %] did not apply this feature at all.69 % [60 %] reported an increase or no changes in their MPS patient numbers. One hundred twenty-six departments which participated in the surveys from 2009 to 2018 reported an increase in MPS by 44 %. 69 % [70 %] of the MPS were requested by ambulatory care cardiologists. CONCLUSION The 2018 MPS survey reveals a high-grade adherence of routine MPS practice to current guidelines. The positive development in MPS performance and MPS numbers observed since 2012 remains ongoing

Deep learning approximation of attenuation maps for myocardial perfusion SPECT with an IQ⋅SPECT collimator

Huxohl T, Patel G, Zabel R, Burchert W. Deep learning approximation of attenuation maps for myocardial perfusion SPECT with an IQ⋅SPECT collimator. EJNMMI Physics. 2023;10(1): 49.**Background** The use of CT images for attenuation correction of myocardial perfusion imaging with single photon emission computer tomography (SPECT) increases diagnostic confidence. However, acquiring a CT image registered to a SPECT image is often not possible because most scanners are SPECT-only. It is possible to approximate attenuation maps using deep learning, but this has not yet been shown to work for a SPECT scanner with an IQ⋅SPECT collimator. This study investigates whether it is possible to approximate attenuation maps from non-attenuation-corrected (nAC) reconstructions acquired with a SPECT scanner equipped with an IQ⋅SPECT collimator. **Methods** Attenuation maps and reconstructions were acquired retrospectively for 150 studies. A U–Net was trained to predict attenuation maps from nAC reconstructions using the conditional generative adversarial network framework. Predicted attenuation maps are compared to real attenuation maps using the normalized mean absolute error (NMAE). Attenuation-corrected reconstructions were computed, and the resulting polar maps were compared by pixel and by average perfusion per segment using the absolute percent error (APE). The training and evaluation code is available at https://gitlab.ub.uni-bielefeld.de/thuxohl/mu-map. **Results** Predicted attenuation maps are similar to real attenuation maps, achieving an NMAE of 0.020±0.007. The same is true for polar maps generated from reconstructions with predicted attenuation maps compared to CT-based attenuation maps. Their pixel-wise absolute distance is 3.095±3.199, and the segment-wise APE is 1.155±0.769. **Conclusions** It is feasible to approximate attenuation maps from nAC reconstructions acquired by a scanner with an IQ⋅SPECT collimator using deep learning