bluuebunny/crossref_metadata_2025 huggingface dataset:
CT-based Assessment of Myocardial Bridging in Patients with Acute Chest Pain and No Atherosclerotic Etiology
Authors: Stănescu Alexandra , Suciu Zsuzsanna , Rat Nora , Morariu Mirabela , Chiţu Monica
Published: July 2016

Introduction: The term “myocardial bridging” is used to describe an anatomic variant where a band of cardiac muscle overlies a segment of an epicardial coronary artery. It is a highly debated topic, because it can cause conditions such as acute coronary syndrome. Myocardial bridging (MB) can be diagnosed using invasive procedures, but also non-invasive ones, such as Multislice Computed Tomography Angiography (MSCTA).

Objectives: A comparative analysis was performed on the patients who were admitted to the clinic with typical angina, ischemic ECG changes and muscular bridging shown on MSCTA, and patients with the same symptoms, but without MB. A sub-study was also undertaken in which the MB site and ischemia revealed by thickening of the myocardial muscle, using 3D Polar Mapping, were compared.

Materials and methods: A retrospective study assessed 59 patients with typical angina pectoris, shortness of breath and clinical appearance of an acute coronary syndrome, and for whom MSCTA was carried out. Patients were divided into two groups: Group 1 — patients with MB, and Group 2 — patients without MB. Thirty patients in Group 1 had 3D polar mapping to evaluate the thickness of the myocardial muscle.

Results: The mean age of our patients with muscular bridging was 55.51 ± 11.4 years, CI 51.57–59.45 years. Patients without MB had a mean age of 59.17 ± 9.6 years, CI 54.98–63.6 years, p = 0.211. 24.32% of the patients with MB were females and 60.86% from the patients without MB were males, p = 0.040. 40.54% of patients presented with MB in the first segment of the LAD and 15.62% had an MB in the second segment of LAD. In patients with an ischemic site smaller than 2 cm of the MB, the ischemic myocardial area was more pronounced compared to the patients with higher length MB (21.85 ± 6.123% vs. 17.62 ± 5.856%).

Conclusions: MSCTA is an important procedure that contributes to the clinical investigations of patients with typical angina and suspected acute coronary syndrome. There is a good positive correlation between the location of the MB and the ischemic segments as shown on 3D CT-based polar maps.
Acute Cardiac Tamponade after Left Sided Premature Ventricular Contraction Ablation
Authors: Kis Zsuzsanna , Tamás Szili Török , István Kovács
Published: July 2016

Introduction: Premature ventricular complex (PVC) is the most common cardiac arrhythmia, which in some circumstances can lead to syncope, arrhythmia-induced cardiomyopathy and sudden death. In idiopathic PVCs, the first choice of treatment is radio-frequency ablation. Identification of the substrate location makes it possible to determine the ablation site, leading to an increased success rate. Complications are related mainly to the ablation technique, peri-procedural anticoagulation therapy, and the access site. Pericardial tamponade is a rare complication. A case in which the ablation procedure of idiopathic PVCs, complicated by cardiac tamponade, is presented in this paper.

Case presentation: A 56-year-old female presented with symptomatic premature ventricular contractions. She had frequent palpitations, dyspnea, and exercise intolerance for ten years. Holter-monitoring demonstrated a total burden of 30,549 PVCs with monomorphic morphology, and with both bigeminal and trigeminal patterns. Surface ECG suggested a left-sided, left aortic cusp localization of the PVC, with a possible epicardial origin. Three-dimensional mapping was performed including the RVOT (right ventricular outflow tract) region, aorta, and coronary sinus. The ablation clinical status suggested a cardiac tamponade, which was confirmed by echocardiography. Radioscopy-controlled pericardial puncture was performed with the extraction of 300 ml of blood. Following this maneuver, the general status of the patient improved. During follow-up checks after twenty-four hours, Holter-monitoring recorded 5000 PVCs with a significant improvement in the clinical status of the patient.

Discussions: Pericardial tamponade after radio-frequency ablation is a rare complication. The risk of tamponade in a right chamber perforation is more dangerous in patients on anticoagulation therapy or with pulmonary hypertension. In order to prevent this side effect complication of the interventional procedures, certain safety maneuvers should be followed, including the use of irrigated-type catheters, or when possible, contact force catheters, ensuring invasive arterial blood pressure monitoring during intervention, and after heparin administration and the determination of ACT every twenty minutes. Transthoracic echocardiograph examination and pericardial puncture set should be readily available in the electrophysiology laboratory.
Transient Long QT Development in a Patient with Takotsubo Cardiomyopathy
Authors: Czuriga Dániel , Szegedi Andrea , Győry Ferenc , Szilágyi Attila , Sipka Sándor , Kertész Attila , Fülöp László , Czuriga István , Péter Andrea , Édes István , Bódi Annamária
Published: July 2016

QT interval prolongation on the electrocardiogram is considered a precursory sign for imminent, potentially lethal ventricular arrhythmias. Beside the inherited condition of long QT syndrome, numerous drugs, certain electrolyte disturbances and early transmural ischemia have been identified to induce reversible prolongation of the QT interval, collectively called as acquired long QT syndrome. Herein we describe a case of a patient with transient QT prolongation and Takotsubo cardiomyopathy, a rather infrequent cause of long QT development. Serial changes of the repolarization pattern were documented to demonstrate progression and resolution of the abnormal QT interval.
Non-ST-segment Elevation Myocardial Infarction Associated with Multiple Comorbidities in a Patient with a Ventriculoperitoneal Shunt for Obstructive Hydrocephalus Following Traumatic Brain Injury
Authors: Marton-Popovici Monica
Published: July 2016

Non-ST elevation myocardial infarction (NSTEMI) has the highest long-term mortality rates of all acute coronary syndromes. Usually, NSTEMI occurs in elderly patients (>75 years of age) with multiple associated diseases. The complication rate for NSTEMI, including heart failure or hemorrhages, is significantly higher than that in ST-elevation myocardial infarction patients. The case reported is of a 70 year-old male, with a history of ventriculoperitoneal shunt for obstructive hydrocephalus following a traumatic brain injury, who presented with NSTEMI.
New horizon in the treatment of sepsis: a systematic review of alternative medicine
Authors: Mousavi Sarah , Ghannadi Alireza , Meidani Mohsen
Published: July 2016

Background

Despite great advancement in treatment of sepsis, mortality of sepsis remains unacceptably high, even with the modern antibiotic and intensive care technologies. Considering the key role of immune dysfunction in sepsis pathophysiology, different treatments were evaluated, but failed to improve survival of patients. Natural remedies have been tested in various studies to overcome sepsis. In this study, we aim to review some of the evidence from clinical, in vitro and in vivo studies about the effect of alternative medicine on sepsis management.

Methods

The following databases were searched up to March 2014: PubMed, Scopus, Web of Science, Ovid and Google Scholar using combination of Mesh term. All in vitro and in vivo studies, also clinical trials, published in English, which evaluated alternative medicine in management of sepsis were included.

Results

Out of 95 relevant studies, the inclusion criteria were met for 79 cases. Among them, 18 studies were performed on humans. The most herbal medicine, including Xubijing (n=10) and then Rhubarb (n=3). Most of the reviewed botanical medicines modulate the immune system. Reduction of mortality was also reported in studies.

Conclusions

Modulation of immune system, anti-inflammatory activities and improvement of survival were the action of herbal medicine. A monovalent approach is not enough for treatment of sepsis, we recommend further studies to identify active component of herbal and use them in combination. Also an animal model of sepsis does not exactly mimic human sepsis, so more clinical studies should be performed. With no new drug on the horizon, herbal medicine will be promising for treatment of sepsis.
Character degree graphs of solvable groups with diameter three
Authors: Sass Catherine B.
Published: July 2016

Let G be a finite solvable group and

cd
⁡

(
G
)

${\operatorname{cd}(G)}$

the set of character degrees of G. The character degree graph

Δ
⁢

(
G
)

${\Delta(G)}$

is the graph whose vertices are the primes dividing the degrees in

cd
⁡

(
G
)

${\operatorname{cd}(G)}$

and there is an edge between two distinct primes p and q if their product pq divides some degree in

cd
⁡

(
G
)

${\operatorname{cd}(G)}$

. When

Δ
⁢

(
G
)

${\Delta(G)}$

has diameter three, we can partition the vertices

ρ
⁢

(
G
)

${\rho(G)}$

into four non-empty disjoint subsets

ρ
1

∪

ρ
2

∪

ρ
3

∪

ρ
4

${\rho_{1}\cup\rho_{2}\cup\rho_{3}\cup\rho_{4}}$

where no prime in

ρ
1

${\rho_{1}}$

is adjacent to any prime in

ρ
3

∪

ρ
4

${\rho_{3}\cup\rho_{4}}$

; no prime in

ρ
4

${\rho_{4}}$

is adjacent to any prime in

ρ
1

∪

ρ
2

${\rho_{1}\cup\rho_{2}}$

; every prime in

ρ
2

${\rho_{2}}$

is adjacent to some prime in

ρ
3

${\rho_{3}}$

; every prime in

ρ
3

${\rho_{3}}$

is adjacent to some prime in

ρ
2

${\rho_{2}}$

; and

|

ρ
1

∪

ρ
2

|

≤

|

ρ
3

∪

ρ
4

|

${|\rho_{1}\cup\rho_{2}|\leq|\rho_{3}\cup\rho_{4}|}$

.

We will show the following: If G is a solvable group where

Δ
⁢

(
G
)

${\Delta(G)}$

has diameter three, then

ρ
3

${\rho_{3}}$

has at least three vertices and G has a normal non-abelian Sylow p-subgroup where

p
∈

ρ
3

${p\in\rho_{3}}$

. If

ρ
1

∪

ρ
2

${\rho_{1}\cup\rho_{2}}$

has n vertices, then

ρ
3

∪

ρ
4

${\rho_{3}\cup\rho_{4}}$

must have at least

2
n

${2^{n}}$

vertices. The group G has Fitting height 3.
Infective Endocarditis in Children — New Approach in Antimicrobial Prophylaxis
Authors: Togănel Rodica
Published: July 2016

Infective endocarditis (IE) is an infection of the endocardium and/or heart valves with the formation of a thrombus and secondary damage of the involved tissue, with significant mortality and severe complications. The prevention of bacterial endocarditis is of great controversy. Antimicrobial prophylaxis is usable in the prevention of endocarditis by killing bacteria before or after their extension to the damaged endocardium. No human studies offer strong evidence to support the efficacy of antibiotic prophylaxis so far, thus it could be potentially dangerous. Therefore, the European Society of Cardiology (ESC) may need to reconsider and update the previous guidelines with the proposal of reducing the prophylactic approach of IE. The 2015 Task Force recommends prophylaxis for highest risk patients undergoing highest risk procedures, focused on prevention rather than prophylaxis of IE, especially in nosocomial endocarditis.
Inflammatory Biomarkers in Chronic Obstructive Pulmonary Disease
Authors: Comes Alexandra , Ianoşi Edith Simona , Jimborean Gabriela
Published: July 2016

Chronic obstructive lung disease (COPD) is a severe progressive disease associated with high morbidity and mortality. Early diagnosis and correct treatment improve the symptoms, quality of life and survival in COPD. Exacerbations of the disease are acute events that cause worsening of COPD symptoms (dyspnea, cough and/or sputum) and may require modification of stable COPD therapy. COPD exacerbations add inflammation, damage the quality of life, deteriorate the lung function, increase mortality and associate high socio-economic costs. Accurate early prediction of exacerbation and mortality risk facilitates patient selection upon risk, in order to provide appropriately targeted early treatment. The risk of having frequent exacerbations is clearly demonstrated by recognized studies in patients with specific criteria: previous exacerbation in the last year, decrease in FEV1s, increase in the score of St. George Questionnaire (life quality decline), high levels of several inflammatory biomarkers, such as neutrophils, C-reactive protein (CRP), fibrinogen, pro-calcitonin, eosinophils, IL-6, IL-8, chemokine ligand 18 (CCL-18/PARC), surfactant protein D (SP-D). Simultaneously elevated levels of CRP, fibrinogen and leukocyte count in COPD patients were associated with an increased risk for exacerbations. At the same time, elevated levels of the three biomarkers are associated with an increased risk of major comorbidities in COPD. Biomarker detection may be an additional tool for assessment and management of COPD comorbidities. Detection of pathologic levels of inflammatory biomarkers improves the ability to predict the risk mortality in COPD alongside with BODE index (BMI, obstruction in lung function, dyspnea scale, 6-minute walk test) and may provide a targeted treatment.
Can Erectile Dysfunction Predict Major Cardiovascular Events?
Authors: Szekeres Norbert A. , Jeremiás Zsuzsánna , Vida Árpád Olivér , Mártha Orsolya , Porav-Hodade Daniel
Published: July 2016

It is estimated that erectile dysfunction (ED) affects more than 150 million people worldwide and this number is expected to double by the year 2025. Vascular component represents the most important etiological cause of erectile dysfunction. ED shares almost all risk factors, such as hypertension, diabetes mellitus, hyperlipidaemia and smoking, with arteriosclerosis. Moderate to severe ED is associated with a considerably increased risk for coronary heart disease (CHD). This review was conducted in May 2016, when the PubMed database was searched using the combination of the terms “erectile dysfunction” and “cardiovascular diseases”, “coronary artery diseases” and “risk factors”. In this review, we analyzed the published literature, regarding the predictive role of ED in CVD and the association of ED risk factors with CVD risk factors, aiming to draw particular attention on the role of sexual inquiry of all men to prevent or decrease major cardiovascular events. In conclusion, the early detection of ED can prevent major cardiovascular events with early management of cardiovascular risk and permits to include patients in a risk stratification group. Erectile function should be evaluated using questionnaires in all male patients to prevent and decrease the rates of major cardiovascular events.
Cardioprotective Effects Induced by Preconditioning with Halogenated Anesthetics
Authors: Papurica Marius , Sandesc Dorel , Rogobete Alexandru Florin , Nartita Radu , Vernic Corina , Popovici Sonia Elena , Bedreag Ovidiu Horea
Published: July 2016

Background: Numerous studies discuss the protective effects of halogenated anesthetics on myocyte injury induced by the ischemia-reperfusion syndrome of the heart. This mechanism is known as pharmacological preconditioning.

Aim of the study: The objective of this study was to identify the effects of two volatile anesthetics frequently used in current clinical practice, Isoflurane and Sevoflurane, on the in situ heart. The study was performed on laboratory animals with induced brain death.

Material and methods: The animals were divided into 3 groups, the control group (n = 8), IZO-PRE group (n = 8) and SEVO-PRE group (n = 8), on which the experimental protocol established for this study was applied. From a molecular point of view, the expressions of protein kinase C-epsilon (PKCε) and of glycogen synthase kinase – 3 beta (GSK-3β) were investigated.

Results: Following the statistical analysis, we observed a significant reduction in the size of the infarcted area in the IZO-PRE group compared to the control group (p <0.0001). Regarding the SEVO-PRE group, no reduction was observed (p >0.05). The expression of GSK-3β is more pronounced in case of the SEVO-PRE group, at 5 minutes after reperfusion, and the effect disappears after 15 minutes. The expression of PKCε as a total form of the enzyme, occurs at 5 minutes after reperfusion in the SEVO-PRE group and late in the IZO-PRE group (after 15 minutes).

Conclusions: Both anesthetics that were applied showed a cardioprotective effect. Isoflurane provided a better structural and morphological protection, but Sevoflurane resulted in a more effective protection in terms of functionality, significantly reducing the incidence of extremely severe life-threatening arrhythmias.
Correlations Between Femoral Intima-media Thickness and Cardiovascular Risk Factors in Patients with Ischemic Heart Disease
Authors: Jeremiás Zsuzsanna , Makó Katalin , Szekeres Norbert , Rapolti Emese , Benedek Imre , Benedek Theodora
Published: July 2016

Background: Atherosclerosis has a systemic impact, producing gradual stenoses of the main vessels, and many imaging techniques have been developed in order to detect and quantify the atherosclerotic lesions. Peripheral artery disease has been shown to be associated with the presence of coronary heart disease, at the same time with carotid artery involvement. The utility of the carotid artery intima-media thickness (IMT) in predicting cardiovascular events caused by atherosclerosis, led to the idea that assessing the femoral artery IMT could have a similar impact.

Study aim: We sought to determine the correlations between the femoral IMT, the degree of left ventricular systolic dysfunction and cardiovascular risk factors in patients with established diagnosis of ischemic heart disease.

Material and methods: We prospectively included 27 patients with diagnosed ischemic heart disease. The ankle-brachial index (ABI) was assessed for the anterior and posterior tibial arteries. The left ventricular ejection fraction (LVEF) was determined by echocardiography. The femoral IMT was measured by peripheral vascular ultrasound, at the common femoral artery, 1 cm proximally from the bifurcation. The patients were divided into 2 groups: Group 1 – patients with IMT<0.9mm, and Group 2: patients with IMT >0.9 mm.

Results: The mean age of the study population was 65.52 ± 11.44 years, and 77.77% were males. The mean glycemia levels were 99.89 ± 30.34 mg/dl, total cholesterol: 176.81 ± 43.09 mg/dl and the mean triglyceride level 140 ± 65.12mg/dl. The mean LEVF was 49.98% ± 12.73%, and femoral IMT 0.75 mm ± 0.25 mm. IMT significantly correlated with cholesterol levels (R = 0.383, p = 0.048), anterior and posterior tibial artery pressures (R = 0.450, p = 0.018, R = 0.418, p = 0.029 respectively) and ABI (R = 0.623, p = 0.005). There was no significant correlation between the LVEF and the IMT (R = −0.143, p = 0.475). There was a significant difference between the 2 groups regarding the minimum anterior tibial artery pressure (95.57 mmHg vs. 63.5 mmHg, p = 0.0011) and the minimum ABI (0.85 vs. 0.5, p = 0.015), and the femoral IMT (p = 0.0001). For patients with a femoral IMT >0.9 mm, a significant correlation was found between ABI and femoral IMT (R = −0.710, p <0.0001).

Conclusion: The femoral intima-media thickness, assessed with peripheral vascular ultrasound, could be a new marker in evaluating the global cardiovascular risk in patients with ischemic heart disease. Femoral IMT could become a new marker for systemic atherosclerosis.
Association Between Severity of Peripheral Artery Disease Angio CT-derived Coronary Syntax Score in Patients with Critical Limb Ischemia
Authors: Rapolti Emese , Benedek Theodora , Kovács István , Korodi Szilamér , Suciu Zsuzsanna , Condrea Sebastian , Benedek Edvin , Mester András , Benedek Imre
Published: July 2016

Introduction: Peripheral artery disease, a frequent consequence of atherosclerosis, is usually associated with concomitant ischaemic coronary artery disease and with a high rate of cardiovascular mortality.

Material and methods: The study population consisted of 24 patients, admitted to our clinic with peripheral artery disease, 10 of them with critical limb ischaemia. In all cases, cardiovascular risk factors, left ventricular dysfunction and ejection fraction were analyzed. Peripheral Multislice Angio CT examination was used to determine the TASC class and to assess the peripheral arterial lesions. The Coronary Calcium Score and the Syntax Score were determined with angio CT of the coronary arteries.

Results: Patients were between 39 and 84 years of age, and 54% were in Fontaine class 2B, 21% in Fontaine class 3 and 25% in Fontaine class 4. 12.5% of patients presented TASC class A, 33.3% TASC class B, and 54.2% TASC class C. Coronary Calcium Scores were between 0 and 100 in 16.6% of patients, between 100 and 400 in 41.8%, and >400 in 41.6% of patients. The SYNTAX Score was <22 in 54% of patients, between 22 and 32 in 37.5%, and >32 in 8.5% of patients. A significant correlation was found between the Coronary Calcium Score and the SYNTAX Score (r = 0.82, p = 0.03). The Syntax Score was 22.43 ± 3.2 in TASC A patients, 26.2 ± 5.4 in TASC B patients, 32.1 ± 2.3 in TASC C patients (p = 0.005).

Conclusions: The severity of coronary artery disease characterized by the Syntax Score, by the presence of left main stenosis and segmental left ventricular hypokinesis presents significant correlation with the severity of peripheral artery disease, characterized by the TASC classification.
Significance of Serum Uric Acid in Children with Pulmonary Arterial Hypertension
Authors: Şuteu Carmen Corina , Benedek Theodora , Togănel Rodica
Published: July 2016

Introduction: Pulmonary arterial hypertension (PAH) is a complex disease with poor prognosis. Serum uric acid has been proposed as a potentially non-invasive and objective parameter for prognosis and response to therapy.

Objectives: To investigate the potent relationship between serum uric acid levels and functional and echocardiographic parameters in children with PAH.

Methods: Serum uric acid levels were measured in 34 children with PAH and were correlated with the functional class, 6-minute walk test, and echocardiographic parameters at baseline and at 12 months follow-up.

Results: In pediatric PAH patients serum uric acid levels were higher compared with the control subjects (p = 0.001). In the high uric acid group serum uric acid levels were correlated with 6-minute walk test (p = 0.008), and with several echocardiographic parameters, such as pulmonary vascular resistance (p = 0.04), fractional area change (p = 0.05), left ventricle eccentricity index (p = 0.04), right atrial area (p = 0.03), right ventricle myocardial index (p = 0.01), and pericardial effusion (p = 0.001), markers of right ventricular overload and dysfunction.

Conclusions: Serum uric acid levels are easy to collect and measure, and correlate with both functional and echocardiographic parameters that reflect right ventricular dysfunction.
Quality of Life after Coronary Revascularization in Patients with Acute Myocardial Infarction
Authors: Susca Mihaela , Copotoiu Monica , Popoviciu Horaţiu , Szőke Zsuzsanna , Bajka Balázs , Benedek Imre , Benedek Theodora
Published: July 2016

Background: The quality of life (QoL) in acute myocardial infarction (MI) patients can be improved using 3 therapeutic methods — surgical, pharmaceutical and physical.

Study aim: We sought to assess the QoL in patients following an acute MI, with or without percutanous coronary intervention (PCI).

Material and methods: A number of 54 patients with acute MI were included in the study. All subjects were asked to complete the EQ-SD questionnaire at baseline, and during the 12-month follow-up. The questionnaire consists of 2 parts: 1st part – assesses the mobility, self care, activities of daily life (ADL), pain, depression and anxiety; 2nd part – visual analogue scale (VAS) for the overall state. Patients were divided into 4 groups: Group 1 – all patients (n = 54); Group 2 – males (n = 40), Group 3 – female patients (n = 14), and Group 4 – patients who underwent a PCI procedure (n = 48). Blood pressure (BP) was also monitored.

Results: The mean age was 66.54 years. There were no differences between the groups at baseline, and after 1 year regarding the BP. No differences were observed regarding the VAS (baseline p = 0.990; 12-month p = 0.991). Concerning the PCI vs. non-PCI groups, no differences were found in relation to mobility, self-care, ADL, pain and depression at baseline or after 12 months. For all groups at baseline, the limited mobility was positively correlated with impaired self-care (p = 0.041) and lower ADLs (p = 0.003). After 1 year, a limited mobility was associated with defective self-care (p <0.001) and decreased ADLs (p = 0.004) and there was an improvement in mobility (p = 0.0002) and self-care (p <0.0001), compared to baseline. The PCI group associated pain with depression at baseline (p <0.001) and limited mobility with lack of ADLs (p = 0.005). At 12 months, we observed an improvement in mobility, self-care (p <0.001), and the ADLs (p <0.001). The males showed a positive association between depression and pain (p <0.001) at baseline, but not after 1 year. Mobility was the only parameter that had improved during follow-up (p = 0.043). In the female group, pain (p = 0.015) and mobility (p = 0.033) had improved after 12 months.

Conclusions: The QoL had improved in terms of mobility, self-care and new skills acquired after PCI. Both depression and pain were ameliorated in the male group, despite the lack of improvement on VAS for the overall state.
Characteristics of Coronary Lesions in Small Vessel Disease Treated with Elective Stenting in Patients with Type 2 Diabetes Mellitus
Authors: Cordunean Alina , Hodaş Roxana , Pop Sorin , Rat Nora , Jani Laura , Stănescu Alexandra , Benedek Imre , Benedek Theodora
Published: July 2016

Background: The incidence of diabetes mellitus (DM) has suffered a dramatic increase and is a serious worldwide issue. Diabetes causes microvascular and macrovascular complications including coronary artery disease (CAD) that ultimately contributes to a high rate of cardiovascular morbidity and mortality.

Study aim: The aim of this study was to assess the factors associated with the atherosclerotic involvement of small coronary arteries as compared to large vessel disease, in patients with type 2 diabetes mellitus undergoing percutaneous stent coronary angioplasty.

Material and methods: Thirty-one patients who underwent Multislice 64 CT assessment of coronary lesions and stent implantation at the level of the significant coronary lesion were included in the study. CT-based Calcium Score was determined in all patients. Group 1 included patients with coronary lesions located on a vessel with a reference diameter above 3 mm (n = 24) and Group 2 included patients with a coronary lesion located on a vessel with a reference diameter below 3 mm (n = 7).

Results: The mean age of the study population was 62.25 ± 2.59 years in Group 1 and 64.28 ± 9.18 years in Group 2. Female gender was recorded in 38% of cases in Group 1 and in 14% of cases in Group 2. The left ventricular ejection fraction was below 45% in 13% of cases in Group 1 and in 29% of patients in Group 2. Bioabsorbable stents were implanted in 57% of coronary arteries suffering from small vessel disease, compared to 4% in the rest of the coronary arteries (p = 0.005). The Calcium Score was 552.45 ± 545.79 (95% CI: 354.41–694.64) in Group 1 compared to 1387 ± 1830.3 (95% CI: 305.85–3079.9) (p = 0.014).

Conclusions: The location of the atherosclerotic process at the level of the small coronary arteries is associated with a significantly higher Calcium Score at the level of the coronary tree, and with a higher rate of bioabsorbable stent implantation.
Predictors of Left Ventricular Remodeling after Revascularized Acute Myocardial Infarction
Authors: Pop Sorin , Hodaş Roxana , Benedek Edvin , Opincariu Diana , Rat Nora , Jani Laura , Stanescu Alexandra , Chitu Monica , Benedek Imre , Benedek Theodora
Published: July 2016

Background: The acute loss of myocardium, following an acute myocardial infarction (AMI) leads to an abrupt increase in the loading conditions that induces a pattern of left ventricular remodeling (LVR). It has been shown that remodeling occurs rapidly and progressively within weeks after the AMI.

Study aim: The aim of our study was to identify predictors for LVR, and find correlations between them and the cardiovascular (CV) risk factors that lead to remodeling.

Material and methods: One hundred and five AMI patients who underwent primary PCI were included in the study. A 2-D echocardiography was performed at baseline (day 1 ± 3 post-MI) and at 6 months follow-up. The LV remodeling index (RI), was defined as the difference between the Left Ventricular End-Diastolic diameter (LVEDD) at 6 months and at baseline. The patients were divided into 2 groups, according to the RI: Group 1 – RI >15% with positive remodeling (n = 23); Group 2 – RI ≤15% with no remodeling (n = 82).

Results: The mean age was 63.26 ± 2.084 years for Group 1 and 59.72 ± 1.267 years for Group 2. The most significant predictor of LVR was the female gender (Group 1 – 52% vs. Group 2 – 18%, p <0.0001). Men younger than 50 years showed a lower rate of LVR (Group1 – 9% vs. Group 2 – 20%, p = 0.0432). In women, age over 65 years was a significant predictor for LVR (Group 1 – 26% vs. Group 2 – 9%, p = 0.0025). The CV risk factors associated with LVR were: smoking (p = 0.0008); obesity (p = 0.013); dyslipidemia (p = 0.1184). The positive remodeling group had a higher rate of LAD stenosis compared to the no-remodeling group (48% vs. 26%, p = 0.002). The presence of multi-vessel disease was shown to be higher in Group 1 (26% vs. 9%, p = 0.0025). The echocardiographic parameters that predicted LVR were: LVEF <45% (p = 0.048), mitral regurgitation (p = 0.022), and interventricular septum hypertrophy (p <0.0001).

Conclusions: The CV risk factors correlated with LVR were smoking, obesity and dyslipidemia. A >50% stenosis in the LAD and the presence of multi-vessel CAD were found to be significant predictors for LVR. The most powerful predictors of LVR following AMI were: LVEF <45%, mitral regurgitation, and interventricular septum hypertrophy.
Correlations Between Severity of Coronary Lesions and Epicardial Fat Volume in Patients with Coronary Artery Disease – a Multislice CT-based Study
Authors: Hodaş Roxana , Pop Sorin , Opincariu Diana , Rat Nora , Jani Laura , Stanescu Alexandra , Benedek Edvin , Benedek Imre , Benedek Theodora , Chitu Monica
Published: July 2016

Background: Epicardial fat has been recently identified as a major player in the development of the atherosclerotic process.

Study aim: The aim of this study was to correlate the epicardial fat volume (EFV), determined by Multisclice CT, and the severity of the coronary lesions, expressed by the Coronary Calcium Score (CCS) and Syntax Score (SxS) in patients with established coronary artery disease (CAD).

Material and methods: One-hundred-twenty-six patients underwent Multisclice 64 CT assessment of coronary lesions and epicardial fat quantification. Calculation of CCS was performed on all the three coronary vessels and was followed by determination of SxS according to guidelines. The patients were divided into 2 groups: Group 1 – patients with CCS >400 (n = 26), and Group 2 — patients with CaS <400 (n = 100).

Results: The mean age of the study population was 65.32 years for Group 1 and 54 years for Group 2 (p <0.0001). However, patients >65 years of age had a high CCS in a more significant extent than younger patients (50% in Group 1 vs. 17% in Group 2, p = 0.0115). Female gender was recorded in 48% of cases in Group 2 and in 19% of cases in Group 1 (p = 0.008). Several factors were identified in a higher extent in the group with high CCS as compared with the group with low CCS, such as the presence of significant stenosis (>50%) of the left anterior descending artery (LAD) (46% vs. 9%, p <0.0001), the presence of multi-vessel coronary disease (50% vs. 5%, p <0.0001) and a high SxS, above 23 (23% vs. 4%, p = 0.006). The epicardial fat volume was 117.81 ± 40.4 ml (95% CI: 97.98–138.2 ml) in Group 2 and 89.77 ± 37.7 ml (95% CI: 80.4–101.5 ml) in Group 1 (p = 0.0033).

Conclusions: Epicardial fat volume could represent a new imaging-derived biomarker, useful for classification of the severity of coronary artery disease, increased values of EFV being associated with other biomarkers of disease severity, such as calcium score.
Correlations Between the Contrast Density Gradient along the Coronary Stents and Functional Significance of In-stent Restenosis
Authors: Orzan Marius , Benedek Edvin , Mester András , Benedek Theodora , Chiţu Monica , Kovács István , Stănescu Alexandra , Dobra Mihaela , Benedek Imre
Published: July 2016

Introduction: Coronary artery disease (CAD) is the leading cause of death worldwide and is associated with a significant socio-economic impact. In many cases, patients are treated with implanted coronary stents that carry a significant risk for reobstruction. The aim of our study was to evaluate the importance of coronary computed tomography angiography (CCTA) in evaluating the significance of in-stent restenosis lesions and for establishing the indication for reintervention in these cases.

Materials and methods: We evaluated 25 patients who underwent CCTA examination. We determined the contrast density, expressed in Hounsfield units at two levels, proximal and distal to the stent.

Results: There were no statistically significant differences between the study groups in terms of gender (41.17% females in Group 1 vs. 37.5% in Group 2, p = 1), presence of hypertension (41.17% in Group 1 vs. 62.5% in Group 2, p = 0.31), smoking status (41.17% in Group 1 vs. 37.5% in Group 2, p = 0.31), incidence of dyslipidemia (47.05% vs. 50%, p = 1) and diabetes mellitus (35.29% vs. 0%, p = 0.31). However, the age of the study population was significantly higher in the groups with significant ISR (58.94 ± 8.35 vs. 47.25 ± 11.2, p = 0.02). Patients who showed significant angiographic in-stent stenosis (more than 70%) were found to have a higher transluminal attenuation gradient, compared with those with less severe lesions (14.5 ± 5.4 vs. 5.14 ± 2.4, p = 0.02).

Conclusions: The transluminal attenuation gradient, assessed by CCTA is a non-invasive-derived parameter that can help the clinician to determine the right time for revascularization in case of in-stent restenosis.
Perfusion Computed Tomography for the Assessment of Myocardial Viability — a Case Series
Authors: Morariu Mirabela , Opincariu Diana , Stănescu Alexandra
Published: July 2016

Myocardial viability plays an important role in preventing the development of left ventricular remodeling following an acute myocardial infarction. A preserved viability in the infarcted area has been demonstrated to be associated with a lower amplitude of the remodeling process, while the extent of the non-viable myocardium is directly correlated with the amplitude of the remodeling process. A number of methods are currently in use for the quantification of the viable myocardium, and some of them are based on the estimation of myocardial perfusion during pharmacologic stress. 64-slice Multi-detector Computed Tomography (MDCT) during vasodilator stress test, associated with CT Coronary Angiography (CCTA) has a high diagnostic accuracy in evaluating myocardial perfusion. In this article, we present a sequence of 3 clinical cases that presented with symptoms of myocardial ischemia, who underwent 64-slice MDCT imaging at rest and during adenosine stress test, in order to assess the extent of the hypoperfused myocardial areas. Coronary artery anatomy and the Coronary Calcium Score was assessed for all 3 patients by performing CT Coronary Angiography. The combination of CT Angiography and adenosine stress CT myocardial perfusion imaging can accurately detect atherosclerosic lesions that cause perfusion abnormalities, compared with the combination of invasive angiography and single-photon emission computed tomography (SPECT).
Performance Analysis of Different Modulation Formats in Optical Communication
Authors: Singh Kulwinder , Singh Maninder , Bhatia Kamaljit Singh , Ryait Hardeep Singh
Published: July 2016

In this paper, we demonstrated the variation of different parameters with quadrature amplitude modulation (QAM) and differential phase shift key (DPSK) sequence generator, which generates modulated signals, in data transmission for communication and analysed that how the difference of these sequence generators effect its resonant frequency (RF) value, eye diagram and electrical constellation representation of the system.
Successive Interference Cancellation for DS-Optical PPM-CDMA Systems
Authors: Alsowaidi N. , Eltaif Tawfig , Mokhtar M. R.
Published: July 2016

In this paper we introduce a successive interference cancellation (SIC) scheme for direct sequence optical code division multiple access (DS-OCDMA) systems using pulse position modulation (PPM). Considering double-padded modified prime code (DPMPC) as a signature sequence code, results show that the system has better performance in terms of both capacity and bit error rate (BER) as compared to the one without cancellation scheme, where the system with SIC scheme can support up to 88 users while the system without SIC scheme can support only 38 users at similar BER=10
Secured Hash Based Burst Header Authentication Design for Optical Burst Switched Networks
Authors: Balamurugan A. M. , Sivasubramanian A. , Parvathavarthini B.
Published: July 2016

The optical burst switching (OBS) is a promising technology that could meet the fast growing network demand. They are featured with the ability to meet the bandwidth requirement of applications that demand intensive bandwidth. OBS proves to be a satisfactory technology to tackle the huge bandwidth constraints, but suffers from security vulnerabilities. The objective of this proposed work is to design a faster and efficient burst header authentication algorithm for core nodes. There are two important key features in this work, viz., header encryption and authentication. Since the burst header is an important in optical burst switched network, it has to be encrypted; otherwise it is be prone to attack. The proposed MD5&RC4-4S based burst header authentication algorithm runs 20.75 ns faster than the conventional algorithms. The modification suggested in the proposed RC4-4S algorithm gives a better security and solves the correlation problems between the publicly known outputs during key generation phase. The modified MD5 recommended in this work provides 7.81 % better avalanche effect than the conventional algorithm. The device utilization result also shows the suitability of the proposed algorithm for header authentication in real time applications.
Analysis of DWDM System Using DPSK Modulation Technique with Raman–EDFA Hybrid Optical Amplifier
Authors: Gill Manveer Singh , Dewra Sanjeev
Published: July 2016

This paper evaluates the performance of differential phase shift keying (DPSK) optical system based on Raman–erbium-doped fiber amplifier (EDFA) hybrid optical amplifier (HOA) is obtained at 64×20 Gbps with 0.1 THz channel spacing. A DPSK signal with bit rate of 20 Gbps is transmitted up to 210 km at 0 dBm signal input power and up to 166 km at –10 dBm signal input power with acceptable quality factor and bit error rate (BER). It is also found that the transmission distance up to 264 km has been covered at 10 dBm signal input power using Raman–EDFA HOA.
Quality Analysis in Phase Modulated Radio over Fiber in WDM/DWDM Network
Authors: Sahoo S. , Kiran K. V. , Kumar V. , Yadav D. , Barpanda N. K. , Das Santos Kumar
Published: July 2016

There has been increasing demand for connection setup with a higher quality of service (QoS) in WDM/DWDM networks, especially in fields like radio over fiber, where phase modulation affects the link quality. Hence to meet guaranteed QoS in a phase modulated link, the effects of phase modulation on link quality are very much needed. The link quality is termed as quality factor (Q-factor). The primary objective is to use effectively the connections available to optimize the computed number of connections and reduce the blocked connections but at the same time guaranteeing QoS as per client’s need. The analysis has been done by taking care of routing and wavelength assignment (RWA) techniques. The performance analysis is presented in terms of blocking probability.
Homogenizing surface pressure time-series from
operational numerical weather prediction models
for geodetic applications
Authors: Dobslaw H.
Published: July 2016

Global surface pressure grids from 14.5 years
of 6-hourly analyses out of both the operational ECMWF
weather prediction model and ERA-Interim are mapped
to a common reference orography by means of ECMWF’s
mean sea-level pressure diagnostic. The approach reduces
both relative biases and residual variability by about one
order of magnitude and thereby achieves a consistency
among both data sets at the level of about 1 hPa. Remaining
differences rather reflect temperature biases and also
resolution limitations of the reanalysis data set, but are not
anymore related to the local roughness in orography or to
changes in the spatial resolution of the operational model.
The presented reduction method therefore allows to obtain
surface pressure time series with the long-time consistency
of a reanalysis from an operational numerical weather
model with much higher resolution and much shorter latency,
making the results suitable for geodetic near realtime
applications requiring continuously updated time series
that are homogeneous over many years.
Measurement of turbulent flow in a narrow open channel
Authors: Sarkar Sankar
Published: July 2016

The paper presents the experimental results of turbulent flow over hydraulically smooth and rough beds. Experiments were conducted in a rectangular flume under the aspect ratio b/h = 2 (b = width of the channel 0.5 m, and h = flow depth 0.25 m) for both the bed conditions. For the hydraulically rough bed, the roughness was created by using 3/8″ commercially available angular crushed stone chips; whereas sand of a median diameter d50 = 1.9 mm was used as the bed material for hydraulically smooth bed. The three-dimensional velocity components were captured by using a Vectrino (an acoustic Doppler velocimeter). The study focuses mainly on the turbulent characteristics within the dip that were observed towards the sidewall (corner) of the channel where the maximum velocity occurs below the free-surface. It was also observed that the nondimensional Reynolds shear stress changes its sign from positive to negative within the dip. The quadrant plots for the turbulent bursting shows that the signs of all the bursting events change within the dip. Below the dip, the probability of the occurrence of sweeps and ejections are more than that of inward and outward interactions. On the other hand, within the dip, the probability of the occurrence of the outward and inward interactions is more than that of sweeps and ejections.
Identifying the relationships of climate and physiological responses of a beech forest using the Standardised Precipitation Index: a case study for Slovakia
Authors: Vido Jaroslav , Střelcová Katarína , Nalevanková Paulína , Leštianska Adriana , Kandrík Radoslav , Pástorová Alena , Škvarenina Jaroslav , Tadesse Tsegaye
Published: July 2016

The paper presents relationship between the Standardised Precipitation Index (SPI) and physiological responses of individual trees in a beech stand using an example of an experimental plot in Bienska valley (Zvolen, Slovakia). SPI is a widely used tool for monitoring both short-term and long-term droughts, and for the assessments of drought impacts on agriculture. Due to the complex ecosystem bonds, monitoring of drought in forests often requires a sophisticated technological approach. The aim of the paper was to correlate the SPI on the physiological responses of trees that were recorded during the performed physiological research (sap flow, and stem circumference increment) at the site in the growing seasons (May to September) of the years 2012-2014. The results revealed a relationship between the index and the physiological responses, although the problem with the impact of other environmental factors has also come up. The secondary correlation, in which soil water potential that significantly affects physiological responses of forest tree species was used as a dependent variable, showed a tighter relationship with the SPI. We found the highest correlation between the soil water potential and the values of SPI aggregated for five weeks. This indicates that the beech forest has a five week resistance to drought stress. The results also enable simple monitoring of the initiation of the drought stress by applying SPI for five weeks.
Interpretation of ponded infiltration data using numerical experiments
Authors: Dohnal Michal , Vogel Tomas , Dusek Jaromir , Votrubova Jana , Tesar Miroslav
Published: July 2016

Ponded infiltration experiment is a simple test used for in-situ determination of soil hydraulic properties, particularly saturated hydraulic conductivity and sorptivity. It is known that infiltration process in natural soils is strongly affected by presence of macropores, soil layering, initial and experimental conditions etc. As a result, infiltration record encompasses a complex of mutually compensating effects that are difficult to separate from each other. Determination of sorptivity and saturated hydraulic conductivity from such infiltration data is complicated. In the present study we use numerical simulation to examine the impact of selected experimental conditions and soil profile properties on the ponded infiltration experiment results, specifically in terms of the hydraulic conductivity and sorptivity evaluation. The effect of following factors was considered: depth of ponding, ring insertion depth, initial soil water content, presence of preferential pathways, hydraulic conductivity anisotropy, soil layering, surface layer retention capacity and hydraulic conductivity, and presence of soil pipes or stones under the infiltration ring. Results were compared with a large database of infiltration curves measured at the experimental site Liz (Bohemian Forest, Czech Republic). Reasonably good agreement between simulated and observed infiltration curves was achieved by combining several of factors tested. Moreover, the ring insertion effect was recognized as one of the major causes of uncertainty in the determination of soil hydraulic parameters.
Rainfall timing and runoff: The influence of the criterion for rain event separation
Authors: Molina-Sanchis Isabel , Lázaro Roberto , Arnau-Rosalén Eva , Calvo-Cases Adolfo
Published: July 2016

Rain is not uniform in time and space in semiarid areas and its distribution is very important for the runoff process. Hydrological studies usually divide rainfall into events. However, defining rain events is complicated, and rain characteristics vary depending on how the events are delimited. Choosing a minimum inter-event time (MIT) is a commonly used criterion. Our hypothesis is that there will be an optimal MIT that explains the maximum part of the variance of the runoff, with time to runoff used as a surrogate. The objective is to establish a procedure in order to decide upon this optimal MIT. We developed regressions between time to runoff (T0) and three descriptive variables of rain. Our results show that the optimum MIT is 1 hour, which seems to be the minimum period of time required for water in larger macropores to drain and sufficiently modify the effect of antecedent soil moisture on the runoff generation process. Rain events are classified into three significantly different groups: (1) large and intense rains, (2) light rains on wet soil, and (3) light rains on dry soil. Intense rains produce most of the runoff, but there were significant differences between small events in the runoff generated. Of rain events, 63.75% are single-tip events, and many could be dew.