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Yutaka Goryo, Teruyoshi Kume, Yusuke Kobayashi, Hiroshi Okamoto, Ai Kawamura, Kenzo Fukuhara, Terumasa Koyama, Ryotaro Yamada, Koichiro Imai, Yoji Neishi, Shiro Uemura
A 68-year-old female with acute coronary syndrome was transferred to our hospital. Emergency coronary angiography showed 90% stenosis with severe calcification in the proximal right coronary artery (RCA). Intravascular ultrasound (IVUS) images were obtained and showed circumferential heavy calcification without any evidence of plaque rupture. Optical frequency domain imaging (OFDI) images were obtained in the RCA lesion 3 days after the initial coronary angiography. A cavity of plaque rupture in the calcified plaque by using OFDI was observed in the lesion, which could not be recognized by IVUS...
January 11, 2017: International Heart Journal
Malte Kühnemund, Iván Hernández-Neuta, Mohd Istiaq Sharif, Matteo Cornaglia, Martin A M Gijs, Mats Nilsson
Single molecule quantification assays provide the ultimate sensitivity and precision for molecular analysis. However, most digital analysis techniques, i.e. droplet PCR, require sophisticated and expensive instrumentation for molecule compartmentalization, amplification and analysis. Rolling circle amplification (RCA) provides a simpler means for digital analysis. Nevertheless, the sensitivity of RCA assays has until now been limited by inefficient detection methods. We have developed a simple microfluidic strategy for enrichment of RCA products into a single field of view of a low magnification fluorescent sensor, enabling ultra-sensitive digital quantification of nucleic acids over a dynamic range from 1...
January 10, 2017: Nucleic Acids Research
Kambis Mashayekhi, Zivile Valuckiene, Hans Neuser, Marlon Walter, Wolfgang Gappmaier, Thomas Kaiser, Franz-Josef Neumann, Ibrahim Akin, Michael Behnes
This case report describes a successful percutaneous coronary intervention (PCI) of a severely calcified aorto-ostial chronic total occlusion (CTO) of the right coronary artery (RCA). The lesion was treated by a retrograde approach implementing long spiral subintimal wire tracking and final coronary stenting creating a subintimal neo-luminal helix around the natively occluded RCA. After 6 months of follow-up valuable angiographic results were proven.
November 2016: Journal of Thoracic Disease
Juan Huang, Xiao-Yu Li, Yi-Chen Du, Li-Na Zhang, Ke-Ke Liu, Li-Na Zhu, De-Ming Kong
Sensitive and reliable detection of DNA methyltransferase (MTase) is of great significance for both early tumor diagnosis and therapy. In this study, a simple, label-free and sensitive DNA MTase-sensing method was developed on the basis of a nicking endonuclease-mediated multiple primers-like rolling circle amplification (RCA) strategy. In this method, a dumbbell RCA template was prepared by blunt-end ligation of two molecules of hairpin DNA. In addition to the primer-binding sequence, the dumbbell template contained another three important parts: 5'-CCGG-3' sequences in double-stranded stems, nicking endonuclease recognition sites and C-rich sequences in single-stranded loops...
December 30, 2016: Biosensors & Bioelectronics
L Hubbard, B Ziemer, S Malkasian, J Lipinski, B Sadeghi, H Javan, B Dertli, E Groves, S Molloi
PURPOSE: To evaluate the accuracy of a patient-specific coronary perfusion territory assignment algorithm that uses CT angiography (CTA) and a minimum-cost-path approach to assign coronary perfusion territories on a voxel-by-voxel basis for determination of myocardial mass at risk. METHODS: Intravenous (IV) contrast (370 mg/mL iodine, 25 mL, 7 mL/s) was injected centrally into five swine (35-45 kg) and CTA was performed using a 320-slice CT scanner at 100 kVp and 200 mA...
June 2016: Medical Physics
S Mossahebi, K Langen, M Guerrero, B Yi, W Lu, C Kalavagunta, K Prado, S Chen
PURPOSE: Calculation-based patient-specific IMRT/VMAT QA, as a DICOM-RT-based plan verification system, has been commissioned and is currently being used at our institution. We report our investigation of IMRT/VMAT plan verification failures/warnings out of more than 1,000 plans verified over an 18-month period. METHODS: Seven patients with QA failures/warnings from our calculation-based IMRT/VMAT QA were selected. Dose to 95% of PTV volume (D95%) and mean PTV dose with a difference of greater than 3%, a global gamma passing rate of less than 95%, and a mean dose difference to organ at risk (OAR) larger than 5% were set as the failure/warning criteria...
June 2016: Medical Physics
M Spraker, M Nyflot, E Ford, G Kane, J Zeng, K Hendrickson
PURPOSE: Safety and quality has garnered increased attention in radiation oncology, and physicians and physicists are ideal leaders of clinical patient safety programs. However, it is not clear whether residency programs incorporate formal patient safety training and adequately equip residents to assume this leadership role. A national survey was conducted to evaluate medical and physics residents' exposure to safety topics and their confidence with the skills required to lead clinical safety programs...
June 2016: Medical Physics
Yusuke Watanabe, Kensuke Takagi, Toru Naganuma, Sunao Nakamura
BACKGROUND: Percutaneous coronary intervention (PCI) with early generation drug-eluting stent (eDES) implantation for ostial right coronary artery (RCA) lesions is challenging because of the frequent need for repeat revascularization. We compared mid-term clinical outcomes following eDES or new generation DES (nDES) implantation for ostial RCA lesions. METHODS: The study included 150 patients with ostial RCA lesions, 76 treated with eDES and 74 with nDES between January 2005 and September 2013...
December 31, 2016: Cardiovascular Therapeutics
Richárd Nagymihály, Zoltán Veréb, Réka Albert, Laura Sidney, Harminder Dua, Andrew Hopkinson, Goran Petrovski
BACKGROUND: To characterise human corneal endothelial cell (HCEnC) cultures generated by the peel-and-digest method based on their surface protein/carbohydrate expression pattern. METHODS: QPCR was used to compare expression of Vimentin, CD90, Cytokeratin-19, ZO-1, Claudin 14 in cultured HCEnC and cell line B4G12 versus stromal cells. Fluorescence-activated cell sorting (FACS) was used to assess surface protein distribution of cultured and uncultured HCEnC. Distribution of surface proteins/ carbohydrates was visualised by immunofluorescent and lectin staining...
December 29, 2016: Clinical & Experimental Ophthalmology
Jakob Gubensek, Alesa Orsag, Rafael Ponikvar, Jadranka Buturovic-Ponikvar
BACKGROUND: Regional citrate anticoagulation (RCA) during hemodialysis interferes with calcium homeostasis. Optimal ionized calcium (iCa) target range during RCA and consequent calcium balance are unknown. METHODS: In a randomized controlled trial (ACTRN12613001029785) 30 chronic hemodialysis patients were assigned to normal (1.1-1.2 mmol/) or low (0.95-1.05 mmol/l) iCa target range during a single hemodialysis with RCA. The primary outcome was calcium mass balance during the procedure, using a partial spent dialysate collection method; magnesium mass balance was also measured...
2016: PloS One
Ernesto Forte, Marco Aiello, Marianna Inglese, Teresa Infante, Andrea Soricelli, Carlo Tedeschi, Marco Salvatore, Carlo Cavaliere
AIMS: Coronary artery aneurysms (CAAs) are incidentally revealed by coronary angiography and consist in a localized dilation of a coronary artery. Although invasive coronary angiography (ICA) is the gold standard imaging technique, it can lead to the underestimation of CAAs diameter in presence of parietal thrombi. Computed tomography coronary angiography (CTCA) is a very sensitive tool in CAAs detection and provides a clear visualization of coronary lumen highlighting intraluminal thrombi...
December 26, 2016: European Heart Journal Cardiovascular Imaging
Sofoklis Mitsos, Saina Attaran, Anthony C De Souza
Coronary artery stenosis is a potentially life-threatening complication after heart valve surgery. The details are presented of a patient with unobstructed coronary arteries, who underwent routine aortic valve replacement and developed dissection of the right coronary artery (RCA) on the third postoperative day, and occlusion of the left anterior descending (LAD) artery one month after surgery. This complication required prompt clinical recognition and diagnosis by repeat coronary angiography, and a rapid intervention with coronary artery bypass grafting or with angioplasty and stenting...
July 2016: Journal of Heart Valve Disease
Yuichi Saito, Hideki Kitahara, Toshihiro Shoji, Satoshi Tokimasa, Takashi Nakayama, Kazumasa Sugimoto, Yoshihide Fujimoto, Yoshio Kobayashi
Intracoronary acetylcholine (ACh) provocation test is useful to diagnose vasospastic angina. However, paroxysmal atrial fibrillation (AF) often occurs during intracoronary ACh provocation test, leading to disabling symptoms. The aim of this study was to investigate the incidence and predictors of paroxysmal AF during the test. A total of 377 patients without persistent AF who underwent intracoronary ACh provocation test were included. Paroxysmal AF during ACh provocation test was defined as documented AF on electrocardiogram during the procedure...
December 22, 2016: Heart and Vessels
Heike A Hildebrandt, Polykarpos C Patsalis, Fadi Al-Rashid, Markus Neuhäuser, Tienush Rassaf, Gerd Heusch, Philipp Kahlert, Petra Kleinbongard
AIMS: We aimed to compare intravascular ultrasound with virtual histology (VH-IVUS), optical coherence tomography (OCT) and near-infrared spectroscopy (NIRS) for their ability to quantify the true amount and characterise the nature of released plaque material during bioresorbable vascular scaffold (BVS) implantation into right coronary artery (RCA) lesions using a distal occlusion and aspiration device. METHODS AND RESULTS: Seventeen patients underwent BVS implantation into the right coronary artery under distal protection with intracoronary imaging using VH-IVUS, OCT and NIRS...
December 20, 2016: EuroIntervention
Keiichi Tsuchida, Kota Nishida, Hirotaka Oda, Yukio Hosaka, Kazuyoshi Takahashi, Satoshi Nakazawa
A 70-year-old man with severe symptomatic functional mitral valve regurgitation underwent successful mitral valve repair combined with tricuspid valve ring annuloplasty. Pre-operative coronary angiography (CAG) showed no significant stenosis. One-and-a-half years later, the patient presented with an acute exacerbation of heart failure. Repeat CAG demonstrated tight stenosis in the right coronary artery (RCA) with arterial kinking that corresponded to the same point as the stenosis where the RCA is the closest to the tricuspid valve ring...
December 17, 2016: Cardiovascular Intervention and Therapeutics
Eduard E Vasilevskis, Joseph G Ouslander, Amanda S Mixon, Susan P Bell, J Mary Lou Jacobsen, Avantika A Saraf, Daniel Markley, Kelly C Sponsler, Jill Shutes, Emily A Long, Sunil Kripalani, Sandra F Simmons, John F Schnelle
BACKGROUND: Hospital readmissions from skilled nursing facilities (SNFs) are common. Previous research has not examined how assessments of avoidable readmissions differ between hospital and SNF perspectives. OBJECTIVES: To determine the percentage of readmissions from post-acute care that are considered potentially avoidable from hospital and SNF perspectives. DESIGN: Prospective cohort study. SETTING: One academic medical center and 23 SNFs...
December 16, 2016: Journal of the American Geriatrics Society
Yusuke Watanabe, Yusuke Fujino, Hisaaki Ishiguro, Sunao Nakamura
A 70-year-old man with a medical history of hypertension, dyslipidemia, and diabetes was referred to our hospital for effort angina. Coronary angiography revealed chronic total occlusion (CTO) of the proximal right coronary artery (RCA) that had been collateralized by septal branches from the left anterior descending coronary artery, left circumflex coronary artery, and an antegrade bridge. Three everolimus-eluting stents (Xience-Alpine: 3.0 × 38 mm, 2.75 × 38 mm, and 2.5 × 38 mm; Abbott-Vascular Co...
October 30, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Arash Gholoobi
The anomalous origin of the right coronary artery (RCA) as a branch from the left anterior descending artery (LAD) is a very rare variation of the single coronary artery anomaly. The anomalous vessel arises from the proximal or midportion of the LAD and courses anterior to the pulmonary artery trunk in most instances. In this case report, a 61-year-old woman is introduced who underwent coronary angiography following inferoposterior myocardial infarction, in which an anomalous RCA was seen originating from the midportion of the LAD...
July 6, 2016: Journal of Tehran Heart Center
Kathryn M Kellogg, Zach Hettinger, Manish Shah, Robert L Wears, Craig R Sellers, Melissa Squires, Rollin J Fairbanks
BACKGROUND: Despite over a decade of efforts to reduce the adverse event rate in healthcare, the rate has remained relatively unchanged. Root cause analysis (RCA) is a process used by hospitals in an attempt to reduce adverse event rates; however, the outputs of this process have not been well studied in healthcare. This study aimed to examine the types of solutions proposed in RCAs over an 8-year period at a major academic medical institution. METHODS: All state-reportable adverse events were gathered, and those for which an RCA was performed were analysed...
December 9, 2016: BMJ Quality & Safety
Jing Shen, Hongyang Wang, Chunxiang Li, Yanyan Zhao, Xijuan Yu, Xiliang Luo
In this work, a simple and highly sensitive label-free electrochemical aptasensor for adenosine detection was developed based on target-aptamer binding triggered nicking endonuclease-assisted strand-replacement DNA polymerization and rolling circle amplification (RCA) strategy. The magnetic beads (MB) probe, which was attached the aptamer of adenosine and mDNA, was firstly fabricated. In the presence of adenosine, mDNA was released from MB upon recognition of the aptamer to target adenosine. The released mDNA as the primer activated autonomous DNA polymerization/nicking process and accompanied by the continuous release of replicated DNA fragments...
April 15, 2017: Biosensors & Bioelectronics
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