Symptomatic relief precedes improvement of myocardial blood flow in patients under spinal cord stimulation

BACKGROUND: Spinal cord electrical stimulation (SCS) has shown to be a treatment option for patients suffering from angina pectoris CCS III-IV although being on optimal medication and not suitable for conventional treatment strategies, e.g. CABG or PTCA. Although many studies demonstrated a clear symptomatic relief under SCS therapy, there are only a few short-term studies that investigated alterations in cardiac ischemia. Therefore doubts remain whether SCS has a direct effect on myocardial perfusion. METHODS: A prospective study to investigate the short- and long-term effect of spinal cord stimulation (SCS) on myocardial ischemia in patients with refractory angina pectoris and coronary multivessel disease was designed. Myocardial ischemia was measured by MIBI-SPECT scintigraphy 3 months and 12 months after the beginning of neurostimulation. To further examine the relation between cardiac perfusion and functional status of the patients we measured exercise capacity (bicycle ergometry and 6-minute walk test), symptoms and quality of life (Seattle Angina Questionnaire [SAQ]), as well. RESULTS: 31 patients (65 ± 11 SEM years; 25 male, 6 female) were included into the study. The average consumption of short acting nitrates (SAN) decreased rapidly from 12 ± 1.6 times to 3 ± 1 times per week. The walking distance and the maximum workload increased from 143 ± 22 to 225 ± 24 meters and 68 ± 7 to 96 ± 12 watt after 3 months. Quality of life increased (SAQ) significantly after 3 month compared to baseline, as well. No further improvement was observed after one year of treament. Despite the symptomatic relief and the improvement in maximal workload computer based analysis (Emory Cardiac Toolbox) of the MIBI-SPECT studies after 3 months of treatment did not show significant alterations of myocardial ischemia compared to baseline (16 patients idem, 7 with increase and 6 with decrease of ischemia, 2 patients dropped out during initial test phase). Interestingly, in the long-term follow up after one year 16 patients (of 27 who completed the one year follow up) showed a clear decrease of myocardial ischemia and only one patient still had an increase of ischemia compared to baseline. CONCLUSION: Thus, spinal cord stimulation not only relieves symptoms, but reduces myocardial ischemia as well. However, since improvement in symptoms and exercise capacity starts much earlier, decreased myocardial ischemia might not be a direct effect of neurostimulation but rather be due to a better coronary collateralisation because of an enhanced physical activity of the patients

Selected issues of coal-fired power generation in terms of maintaining its high share in the future structure of electricity generation in Poland

The Polish economy is one of the most dynamically developing economies in Europe. However, this development over the next 30 years is threatened by the lack of adequate supply of cheap and reliable energy. This is due to an array of negligence and delays in the expansion and reconstruction of the energy system. Due to the increasingly urgent need to solve this problem, many concepts about the direction in which the development of the Polish power system should go have emerged. This article presents arguments emphasising the advisability of maintaining the maximum high share of coal-fired power plants in the future structure of power generation. There is proven that raw materials in Poland may ensure stable development of the economy for next 100 years. Also, thanks to new technologies, CO2emissions may by reduced by half

Default Reasoning System DeReS

In this paper, we describe an automated reasoning system, called DeReS. DeReS implements default logic of Reiter by supporting several basic reasoning tasks such as testing whether extensions exist, finding one or all extensions (if at least one exists) and querying if a formula belongs to one or all extensions. If an input theory is a logic program, DeReS computes stable models of this program and supports queries on membership of an atom in some or all stable models. The paper contains an account of our preliminary experiments with DeReS and a discussion of the results. We show that a choice of a propositional prover is critical for the efficiency of DeReS. We also present a general technique that eliminates the need for some global consistency checks and results in substantial speedups. We experimentally demonstrate the potential of the concept of relaxed stratification for making automated reasoning systems practical. 1 INTRODUCTION The area of nonmonotonic l..

Computing With Default Logic

Default logic was proposed by Reiter as a knowledge representation tool. In this paper, we present our work on the Default Reasoning System, DeReS, the first comprehensive and optimized implementation of default logic. While knowledge representation remains the main application area for default logic, as a source of large-scale problems needed for experimentation and as a source of intuitions needed for a systematic methodology of encoding problems as default theories we use here the domain of combinatorial problems. To experimentally study the performance of DeReS we developed a benchmarking system, the TheoryBase. The TheoryBase is designed to support experimental investigations of nonmonotonic reasoning systems based on the language of default logic or logic programming. It allows the user to create parameterized collections of default theories having similar properties and growing sizes and, consequently, to study the asymptotic performance of nonmonotonic systems under i..

Zastosowanie superabsorbentow w uprawie papryki pod oslonami

Celem badań była ocena wpływu trzech superabsorbentów (Ekosorb sodowy, Ekosorb potasowy, Aqua Gel) jako komponentów podłoża na plon oraz zawartość suchej masy i witaminy C w owocach papryki odmian Lamuyo i Sirono. Dodatek superabsorbentów do podłoża z substratu torfowego miał niewielki wpływ na wielkość plonu papryki ogółem, ale zwiększył plon handlowy. Zastosowanie Ekosorbu potasowego powodowało niewielki wzrost zawartości suchej masy i witaminy C w owocach papryki. Plon odmiany Lamuyo był nieco mniejszy niż odmiany Sirono, ale owoce tej odmiany zawierały więcej witaminy C.The studies aimed at evaluating the effect of three superabsorbents (sodium Ekosorb, potassium Ekosorb, Aqua Gel) as the substrate components on yielding and contents of dry matter and vitamin C in red pepper (Lamuyo, Sirono cvs.) fruits. The addition of superabsorbents to peat substrate didn’t significantly affect the total yield but increased the marketable yield. The addition of potassium Ekosorb slightly increased the dry matter and vitamin C contents in red papper fruits. The yield of Sirono variety was higher than that of Lamuyo variety, but the fruits of Lamuyo variety contained more vitamin C

Rovibrational structure and potential energy function of the X 0 þ ground electronic state of ArXe

a b s t r a c t Rotationally resolved (1 + 1 0 ) resonance-enhanced two-photon ionization spectra of the D 0 þ ; C 1 X 0 þ band systems of several isotopomers of ArXe were recorded at high resolution in the wave-number range from 77000 cm À1 to 77300 cm À1 using a near-Fourier-transform-limited vacuum-ultraviolet laser sys