Chest Pain, Exercise Electrocardiography and Coronary Arteriography

Over the last 6 or 7 years Dr. Richard Ross and I in the department of medicine at Johns Hopkins Medical School have had a continuing interest in objective methods which might be used in assessing the individual who comes to the physician complaining of chest pain. Angina pectoris is many things; it is a metabolic defect with lactate excess, it is a certain pathological picture, it is a group of individuals who are disposed to have certain things happen to them, but most of all angina pectoris is pain in the chest. It is pain in the chest as far as the patient is concerned, and this is the symptom on which the physician has to base important decisions concerning diagnosis, prognosis and treatment. The problem with chest pain is that it is a very subjective complaint, and a discussion with the patient is certainly the most satisfactory way to establish its cause

Development of high temperature superconducting current feeders for a large-scale superconducting experimental fusion system

The National Institute for Fusion Science (NIFS), in collaboration with universities and laboratories in Japan, the Forschungszentrum Karlsruhe (FZK) and the Max-Planck Institut fur Plasma Physik (IPP) in Germany, is planning to develop high temperature superconducting (HTS) current feeders for large-scale superconducting coils. Two programs are being progressed: one is a current feedthrough for superfluid helium (He II) cooled superconducting coils; the other is current leads for experimental fusion system. The paper describes the present status of the two programs, including joint experiments of a 20 kA Bi-2223 current lead developed by FZK and development of a prototype YBCO bulk current feedthrough for He II cooled superconducting coils. In addition, the test results of Bi-2212 tubes fabricated by diffusion process, applicable to HTS current leads, are described Bi_2Sr_2 CaCu_2O_

Phosphorus Is Associated with Coronary Artery Disease in Patients with Preserved Renal Function

High serum phosphorus levels have been associated with mortality and cardiovascular events in patients with chronic kidney disease and in the general population. In addition, high phosphorus levels have been shown to induce vascular calcification and endothelial dysfunction in vitro. The aim of this study was to evaluate the relation of phosphorus and coronary calcification and atherosclerosis in the setting of normal renal function. This was a cross-sectional study involving 290 patients with suspected coronary artery disease and undergoing elective coronary angiography, with a creatinine clearance >60 ml/min/1.73 m2. Coronary artery obstruction was assessed by the Friesinger score and coronary artery calcification by multislice computed tomography. Serum phosphorus was higher in patients with an Agatston score >10 than in those with an Agatston score ≤10 (3.63±0.55 versus 3.49±0.52 mg/dl; p = 0.02). In the patients with Friesinger scores >4, serum phosphorus was higher (3.6±0.5 versus 3.5±0.6 mg/dl, p = 0.04) and median intact fibroblast growth factor 23 was lower (40.3 pg/ml versus 45.7 pg/ml, p = 0.01). Each 0.1-mg/dl higher serum phosphate was associated with a 7.4% higher odds of having a Friesinger score >4 (p = 0.03) and a 6.1% greater risk of having an Agatston score >10 (p = 0.01). Fibroblast growth factor 23 was a negative predictor of Friesinger score (p = 0.002). In conclusion, phosphorus is positively associated with coronary artery calcification and obstruction in patients with suspected coronary artery disease and preserved renal function