Gated blood-pool SPECT evaluation of changes after radiofrequency catheter ablation of accessory pathways Evidence for persistent ventricular preexcitation despite successful therapy

AbstractOBJECTIVESThis study was designed to prospectively evaluate the effects of radiofrequency ablation in Wolff-Parkinson-White (WPW) syndrome by scintigraphic analysis.BACKGROUNDThe functional changes triggered by radiofrequency current ablation of atrioventricular accessory pathways are not fully known.METHODSForty-four patients with WPW syndrome were consecutively investigated before and 48 h after radiofrequency therapy. Fourteen patients had right sided atrioventricular pathways and 30 patients had left sided bypass-tracts. Planar gated imaging and gated blood pool tomography were performed in all of these patients.RESULTSA significant increase in the left ventricular ejection fraction (LVEF) was demonstrated in patients with left preexcitation (62.2 ± 7.9% before ablation against 64.4 ± 6.3% after ablation, p = 0.02) but not for those with right sided anomalous pathway. Phase analysis only gave significant differences following ablation of right sided pathways (left-to-right phase difference = 14.4 ± 13.8° before ablation versus 7.5 ± 7.2° after ablation, p < 0.05). Early abnormal ventricular contraction persisted in 12 patients with right accessory pathways and in 8 patients with left accessory pathways despite the complete disappearance of any abnormal conduction as proven electrophysiologically.CONCLUSIONSFollowing catheter ablation of atrioventricular accessory pathways: 1) an improvement of left ventricular function may be seen, particularly in patients with left sided accessory pathways, and 2) unexpected persistence of local ventricular preexcitation at the site of successful ablation may be detected

18F-FDOPA PET/CT Uptake Parameters Correlate with Catecholamine Secretion in Human Pheochromocytomas

International audienceBackground: 18 F-FDOPA positron emission tomography/ computed tomography (PET/CT) is a sensitive nuclear imaging technology for the diagnosis of pheochromocytomas (PHEO). However, its utility in determining predictive factors for the secretion of catecholamines remains poorly studied. Methods: Thirty-nine histologically confirmed PHEO were included in this retrospective single-center study. Patients underwent 18 F-FDOPA PET/CT before surgery, with an evaluation of several uptake parameters (standardized uptake values [SUV max and SUV mean ] and the metabolic burden [MB] calculated as follows: MB = SUV mean × tumor volume) and measurement of plasma and/or urinary metanephrine (MN), normetanephrine (NM), and chromogranin A. Thirty-five patients were screened for germline mutations in the RET, SDHx, and VHL genes. Once resected, primary cultures of 5 PHEO were used for real-time measurement of catechol-amine release by carbon fiber amperometry. Results: The MB of the PHEO positively correlated with 24-h urinary excre-tion of NM (r = 0.64, p < 0.0001), MN (r = 0.49, p = 0.002), combined MN and NM (r = 0.75, p < 0.0001), and eventually plasma free levels of NM (r = 0.55, p = 0.006). In the mutated patients (3 SDHD, 2 SDHB, 3 NF1, 1 VHL, and 3 RET), a similar correlation was observed between MB and 24-h urinary combined MN and NM (r = 0.86, p = 0.0012). For the first time, we demonstrate a positive correlation between the PHEO-to-liver SUV max ratio and the mean number of secretory granule fusion events of the corresponding PHEO cells revealed by amperometric spikes (p = 0.01). Conclusion: While the 18 F-FDOPA PET/CT MB of PHEO strongly correlates with the concentration of MN, amperometric recordings suggest that 18 F-FDOPA uptake could be enhanced by overactivity of cat-echolamine exocytosis

X-Ray Flares and Oscillations from the Black Hole Candidate X-Ray Transient XTE J1650-500 at Low Luminosity

We report on X-ray observations made with the Rossi X-ray Timing Explorer of the black hole candidate (BHC) transient XTE J1650-500 at the end of its first, and currently only, outburst. By monitoring the source at low luminosities over several months, we found 6 bright ~100 second X-ray flares and long time scale oscillations of the X-ray flux. The oscillations are aperiodic with a characteristic time scale of 14.2 days and an order of magnitude variation in the 2.8-20 keV flux. The oscillations may be related to optical "mini-outbursts" that have been observed at the ends of outbursts for other short orbital period BHC transients. The X-ray flares have durations between 62 and 215 seconds and peak fluxes that are 5-24 times higher than the persistent flux. The flares have non-thermal energy spectra and occur when the persistent luminosity is near 3E34 (d/4 kpc)^2 erg/s (2.8-20 keV). The rise time for the brightest flare demonstrates that physical models for BHC systems must be able to account for the situation where the X-ray flux increases by a factor of up to 24 on a time scale of seconds. We discuss the flares in the context of observations and theory of Galactic BHCs and compare the flares to those detected from Sgr A*, the super-massive black hole at the Galactic center. We also compare the flares to X-ray bursts that are seen in neutron star systems. While some of the flare light curves are similar to those of neutron star bursts, the flares have non-thermal energy spectra in contrast to the blackbody spectra exhibited in bursts. This indicates that X-ray bursts should not be taken as evidence that a given system contains a neutron star unless the presence of a blackbody component in the burst spectrum can be demonstrated.Comment: 9 pages, accepted by Ap

Multiscale aspects of the response of a temperature field to a pulsed laser or a periodic laser spot: some applications for IR thermography for non destructive evaluation, terahertz tomography, super-resolution, and microscale heat transfer

The study of the response of a temperature field (recorded from IR cameras) to a laser spot heating is increasingly used for NDE (Non Destructive Evaluation) applications. The most classical type of application is to use the flying spot in order to detect vertical cracks and/or to measure the in plane thermal diffusivity in relation to the observation plane of opaque materials. But several other ways of applications are presented here related to tomography and also super resolution. Instead of opaque materials applications, the tomography is using the principles of the flying spot. It consists in an indirect detection on an intermediate layer (the thermoconverter) that can convert a wide range of radiation from the spot. The objective of super-resolution can also be implemented with flying spot in order to circumvent the low spatial resolution of IR imaging systems. Such methods consider spots whose diameter is small compared to the size of the pixel. Some applications of our team will be shown with multiscale considerations

The periodic pulse photothermal radiometry technique within the front face configuration

The front face photothermal radiometry technique has been improved in order to estimate the thermal conductivity of thin films with better accuracy compared to existing techniques. The experimental pro- cedure is based on the front face response to a nanoseconds laser pulse repeated periodically at high fre- quency, i. e., a Dirac comb waveform. Averaging the thermal response by considering thousands successive pulses allows improving largely the signal noise ratio. The unknown thermal properties and related experimental parameters are identified by minimizing the gap between the measured signal and the theoretical response that accounts with the pulse waveform, the repetition frequency and the detector transfer function. Minimization is first achieved by implementing first a simplex technique that gives an initial set of values to start the Metropolis–Hastings algorithm in a second step. Application of the proposed methodology is done considering amorphous GeTe film deposited on a Si wafer. It is shown that this experimental method as well as the implementation of the Bayes minimization technique allows to identify the thin film intrinsic thermal conductivity with high accuracy considering some uncertainty on the other parameters assumed to be known

Resuming Training in High-Level Athletes After Mild COVID-19 Infection: A Multicenter Prospective Study (ASCCOVID-19)

BACKGROUND: There is a paucity of data on cardiovascular sequelae of asymptomatic/mildly symptomatic SARS-Cov-2 infections (COVID). OBJECTIVES: The aim of this prospective study was to characterize the cardiovascular sequelae of asymptomatic/mildly symptomatic COVID-19 among high/elite-level athletes. METHODS: 950 athletes (779 professional French National Rugby League (F-NRL) players; 171 student athletes) were included. SARS-Cov-2 testing was performed at inclusion, and F-NRL athletes were intensely followed-up for incident COVID-19. Athletes underwent ECG and biomarker profiling (D-Dimer, troponin, C-reactive protein). COVID(+) athletes underwent additional exercise testing, echocardiography and cardiac magnetic resonance imaging (CMR). RESULTS: 285/950 athletes (30.0%) had mild/asymptomatic COVID-19 [79 (8.3%) at inclusion (COVID(+)(prevalent)); 206 (28.3%) during follow-up (COVID(+)(incident))]. 2.6% COVID(+) athletes had abnormal ECGs, while 0.4% had an abnormal echocardiogram. During stress testing (following 7-day rest), COVID(+) athletes had a functional capacity of 12.8 ± 2.7 METS with only stress-induced premature ventricular ectopy in 10 (4.3%). Prevalence of CMR scar was comparable between COVID(+) athletes and controls [COVID(+) vs. COVID(-); 1/102 (1.0%) vs 1/28 (3.6%)]. During 289 ± 56 days follow-up, one athlete had ventricular tachycardia, with no obvious link with a SARS-CoV-2 infection. The proportion with troponin I and CRP values above the upper-limit threshold was comparable between pre- and post-infection (5.9% vs 5.9%, and 5.6% vs 8.7%, respectively). The proportion with D-Dimer values above the upper-limit threshold increased when comparing pre- and post-infection (7.9% vs 17.3%, P = 0.01). CONCLUSION: The absence of cardiac sequelae in pauci/asymptomatic COVID(+) athletes is reassuring and argues against the need for systematic cardiac assessment prior to resumption of training (clinicaltrials.gov; NCT04936503).L'Institut de Rythmologie et modélisation Cardiaqu

Catching Element Formation In The Act

Gamma-ray astronomy explores the most energetic photons in nature to address some of the most pressing puzzles in contemporary astrophysics. It encompasses a wide range of objects and phenomena: stars, supernovae, novae, neutron stars, stellar-mass black holes, nucleosynthesis, the interstellar medium, cosmic rays and relativistic-particle acceleration, and the evolution of galaxies. MeV gamma-rays provide a unique probe of nuclear processes in astronomy, directly measuring radioactive decay, nuclear de-excitation, and positron annihilation. The substantial information carried by gamma-ray photons allows us to see deeper into these objects, the bulk of the power is often emitted at gamma-ray energies, and radioactivity provides a natural physical clock that adds unique information. New science will be driven by time-domain population studies at gamma-ray energies. This science is enabled by next-generation gamma-ray instruments with one to two orders of magnitude better sensitivity, larger sky coverage, and faster cadence than all previous gamma-ray instruments. This transformative capability permits: (a) the accurate identification of the gamma-ray emitting objects and correlations with observations taken at other wavelengths and with other messengers; (b) construction of new gamma-ray maps of the Milky Way and other nearby galaxies where extended regions are distinguished from point sources; and (c) considerable serendipitous science of scarce events -- nearby neutron star mergers, for example. Advances in technology push the performance of new gamma-ray instruments to address a wide set of astrophysical questions.Comment: 14 pages including 3 figure

Catching Element Formation In The Act

Gamma-ray astronomy explores the most energetic photons in nature to address some of the most pressing puzzles in contemporary astrophysics. It encompasses a wide range of objects and phenomena: stars, supernovae, novae, neutron stars, stellar-mass black holes, nucleosynthesis, the interstellar medium, cosmic rays and relativistic-particle acceleration, and the evolution of galaxies. MeV gamma-rays provide a unique probe of nuclear processes in astronomy, directly measuring radioactive decay, nuclear de-excitation, and positron annihilation. The substantial information carried by gamma-ray photons allows us to see deeper into these objects, the bulk of the power is often emitted at gamma-ray energies, and radioactivity provides a natural physical clock that adds unique information. New science will be driven by time-domain population studies at gamma-ray energies. This science is enabled by next-generation gamma-ray instruments with one to two orders of magnitude better sensitivity, larger sky coverage, and faster cadence than all previous gamma-ray instruments. This transformative capability permits: (a) the accurate identification of the gamma-ray emitting objects and correlations with observations taken at other wavelengths and with other messengers; (b) construction of new gamma-ray maps of the Milky Way and other nearby galaxies where extended regions are distinguished from point sources; and (c) considerable serendipitous science of scarce events -- nearby neutron star mergers, for example. Advances in technology push the performance of new gamma-ray instruments to address a wide set of astrophysical questions

Catching element formation in the act

Gamma-ray astronomy explores the most energetic photons in nature to address some of the most pressing puzzles in contemporary astrophysics. It encompasses a wide range of objects and phenomena: stars, supernovae, novae, neutron stars, stellar-mass black holes, nucleosynthesis, the interstellar medium, cosmic rays and relativistic-particle acceleration, and the evolution of galaxies. MeV gamma-rays provide a unique probe of nuclear processes in astronomy, directly measuring radioactive decay, nuclear de-excitation, and positron annihilation. The substantial information carried by gamma-ray photons allows us to see deeper into these objects, the bulk of the power is often emitted at gamma-ray energies, and radioactivity provides a natural physical clock that adds unique information. New science will be driven by time-domain population studies at gamma-ray energies. This science is enabled by next-generation gamma-ray instruments with one to two orders of magnitude better sensitivity, larger sky coverage, and faster cadence than all previous gamma-ray instruments. This transformative capability permits: (a) the accurate identification of the gamma-ray emitting objects and correlations with observations taken at other wavelengths and with other messengers; (b) construction of new gamma-ray maps of the Milky Way and other nearby galaxies where extended regions are distinguished from point sources; and (c) considerable serendipitous science of scarce events -- nearby neutron star mergers, for example. Advances in technology push the performance of new gamma-ray instruments to address a wide set of astrophysical questions

Goal-directed and habitual control in the basal ganglia: implications for Parkinson's disease

Progressive loss of the ascending dopaminergic projection in the basal ganglia is a fundamental pathological feature of Parkinson's disease. Studies in animals and humans have identified spatially segregated functional territories in the basal ganglia for the control of goal-directed and habitual actions. In patients with Parkinson's disease the loss of dopamine is predominantly in the posterior putamen, a region of the basal ganglia associated with the control of habitual behaviour. These patients may therefore be forced into a progressive reliance on the goal-directed mode of action control that is mediated by comparatively preserved processing in the rostromedial striatum. Thus, many of their behavioural difficulties may reflect a loss of normal automatic control owing to distorting output signals from habitual control circuits, which impede the expression of goal-directed action. © 2010 Macmillan Publishers Limited. All rights reserved