283 research outputs found
Comparison of sulfur hexafluoride microbubble (SonoVue)-enhanced myocardial contrast echocardiography with gated single-photon emission computed tomography for detection of significant coronary artery disease: a large European multicenter study
No full textThe purpose of this study was to compare sulfur hexafluoride microbubble (SonoVue)-enhanced myocardial contrast echocardiography (MCE) with single-photon emission computed tomography (SPECT) relative to coronary angiography (CA) for assessment of coronary artery disease (CAD)
Potential clinical applications of myocardial contrast echocardiography in evaluating myocardial perfusion in coronary artery disease
No full textMyocardial contrast echocardiography (MCE) is a relatively new technique that uses microbubbles to produce myocardial opacification. Recent advances in echocardiography have resulted in improved detection of microbubbles within the myocardium allowing combined acquisition of function and perfusion data, thus making MCE suitable for bedside use. Regardless of the imaging modality chosen or the type of stress used, MCE detects changes developing in the coronary microcirculation, providing important information for the evaluation of severity of coronary artery disease and for the detection of viable myocardial tissue in acute or chronic coronary artery disease. (c) 2005 Elsevier Ireland Ltd. All rights reserved
Paradoxical low-flow low-gradient severe aortic stenosis in a woman with apical hypertrophy
No full textThe cemeteries of Ambracia during the Archaic and Classical period
No full textThe thesis studies the cemeteries of Ambracia, a Corinthian colony in the innards of the Ambracian gulf, during the Archaic and Classical period. As an introduction, it presents the topography of Ambracia, the geomorphology of the area and the different image it presented in antiquity, the countryside with its borders and the city’s urban organization. Following is a brief overview of the history of the city with emphasis on the Archaic and Classical period and a presentation of the history of research of its cemeteries. Then the study deals with the spatial planning and organization of the two cemeteries of Ambracia. In the western cemetery, which is the larger of the two, begins at the end of the 5th c. BC the construction of enclosures, which takes on a more systematic character during the 4th c. BC, making the road that crosses it a real "Gräberstrasse", a formation that remains unique in the region of northwestern Greece. In the eastern cemetery of the city, which is crossed by a smaller road, the tombs are in a rather sparse arrangement, in clusters or pairs. During the Archaic and Classical period the main way of treatment of the dead body is the inhumation, as in most ancient Greek cemeteries. In relation to the inhumations, issues such as the orientation of the dead and the multiple burials in a tomb are analyzed, while in relation to the cremation, the issue of selecting specific types of vessels as funerary urns is discussed, as well as the connection of iconography of red-figure pelikai that were used as funerary urns in the 4th c. BC. In the next chapter are presented the types of tombs that were preferred in each period. As it concerns the grave goods, the vases are examined, which are mainly divided into two big categories, the drinking vessels and the perfume containers, and their burial use is commented. The figurines and the other types of grave goods are also examined, as well as the preference according to the sex of the deceased. Based on the grave goods, two special categories of the dead are commented on: the untimely dead women and the children. The next chapter includes the analysis of the typology of the findings by period and species (pottery, figurines, vases made from other materials, other small objects). The percentage data of the imported and the locally made pottery are presented and the types of all kinds of grave goods are analyzed with bibliographic documentation for their dating. From the summary of the imported pottery it results that during the 6th c. BC Corinthian pottery dominates the burials, to be succeeded by Attic pottery during the 5th c. BC. In the 4th c. BC the local pottery is preferred by, and we follow the evolution of the workshops of Ambracia throughout the Archaic and especially the Classical period. An important subsection is the one that deals with the relations of Ambracia with the West, mainly based on the testimony of the local pottery, while examining the historical data. The last section presents the conclusions for the systematic organization of the burial sites of Ambracia, the special relationship of the burial customs with those of the metropolis Corinth during the Archaic period and the gradual removal from them during the Classical era, the differences from the cemeteries of the villages in the mainland of Epirus and the similarities with those of Lefkas, the other Corinthian colony in the area. It also presents the sequence of Ambracia of the pan-Hellenic trend during the 5th c. BC for uniformity in burials and the gradual emergence of a financially strong social class during the 4th c. BC. It is the time when the city developed into the most important urban center of the wider area, so that at the beginning of the 3rd c. BC it became the capital of the state of King Pyrrhus. The volume with the text of the thesis is accompanied by the volume with the catalog of tombs and finds by era and cemetery and the volume with maps, excavation drawings and photographs of the findings, as well as diagrams.Στη διατριβή μελετώνται τα νεκροταφεία της Αμβρακίας, κορινθιακής αποικίας στον μυχό του Αμβρακικού κόλπου, κατά τους αρχαϊκούς και κλασικούς χρόνους. Αρχικά παρατίθενται στοιχεία για την τοπογραφία της Αμβρακίας, τη γεωμορφολογία της περιοχής και τη διαφορετική εικόνα που παρουσίαζε κατά την αρχαιότητα, την ύπαιθρο χώρα με τα σύνορά της και το άστυ με την πολεοδομική του οργάνωση. Ακολουθεί σύντομη επισκόπηση της ιστορίας της πόλης με έμφαση στους αρχαϊκούς και κλασικούς χρόνους και παρουσιάζεται η ιστορία της έρευνας των νεκροταφείων της. Στη συνέχεια η μελέτη πραγματεύεται τη χωροταξία και την οργάνωση των δύο νεκροταφείων της Αμβρακίας. Στο δυτικό νεκροταφείο, που είναι το μεγαλύτερο από τα δύο, ξεκινά στα τέλη του 5ου αι. π.Χ. η κατασκευή περιβόλων, η οποία λαμβάνει πιο συστηματικό χαρακτήρα κατά τη διάρκεια του 4ου αι. π.Χ., καθιστώντας τη λεωφόρο που το διασχίζει μία πραγματική «Gräberstrasse», διαμόρφωση που παραμένει μοναδική για την περιοχή της βορειοδυτικής Ελλάδας. Στο ανατολικό νεκροταφείο της πόλης, το οποίο διασχίζει μικρότερων διαστάσεων οδός, οι τάφοι είναι σε μάλλον αραιή διάταξη, κατά συστάδες ή ζεύγη. Στις περιόδους αναφοράς της μελέτης ο κύριος τρόπος ταφής είναι ο ενταφιασμός, όπως και στην πλειονότητα των αρχαιοελληνικών νεκροταφείων. Σε σχέση με τους ενταφιασμούς, αναλύονται θέματα όπως ο προσανατολισμός των νεκρών και οι πολλαπλές ταφές μέσα σε έναν τάφο, ενώ σε σχέση με τις καύσεις συζητείται το θέμα της επιλογής συγκεκριμένων τύπων αγγείων ως τεφροδόχων, καθώς και της σύνδεσης εικονογραφίας των ερυθρόμορφων πελικών του 4ου αι. π.Χ. με τη χρήση τους ως τεφροδόχων. Στη συνέχεια παρουσιάζονται οι τύποι των τάφων που προτιμώνται ανά εποχή. Σε σχέση με την κτέριση των ταφών εξετάζονται τα αγγεία ως κτέρισμα, τα οποία χωρίζονται κατά κύριο λόγο σε δύο μεγάλες κατηγορίες, τα αγγεία πόσεως και τα αρωματοδοχεία και σχολιάζεται η ταφική τους χρήση. Εξετάζονται επίσης τα ειδώλια και σχολιάζονται τα άλλα είδη κτερισμάτων, καθώς και η προτίμηση ανάλογα με το φύλο του νεκρού. Με βάση τα κτερίσματα σχολιάζονται δύο ιδιαίτερες κατηγορίες νεκρών: οι άωρες νεκρές και τα παιδιά. Ακολουθεί η ανάλυση της τυπολογίας των ευρημάτων ανά περίοδο και είδος (κεραμική, ειδώλια, αγγεία από άλλα υλικά, άλλα μικροευρήματα). Παρουσιάζονται τα ποσοστιαία δεδομένα της εισηγμένης κεραμικής και των εγχώριων αγγείων που αποσύρονται στους τάφους και αναλύονται οι τύποι όλων των ειδών κτερισμάτων με βιβλιογραφική τεκμηρίωση για τη χρονολόγησή τους. Από τη σύνοψη της εισηγμένης κεραμικής προκύπτει ότι κατά τον 6ο αι. π.Χ. στις ταφές κυριαρχεί η κορινθιακή κεραμική, για να την διαδεχθεί η αττική κατά τον 5ο αι. π.Χ. Κατά τον 4ο αι. π.Χ. προτιμώνται τα αγγεία εγχώριας κατασκευής από τα εργαστήρια της πόλης, την εξέλιξη των οποίων παρακολουθούμε σε όλη τη διάρκεια των αρχαϊκών και κυρίως των κλασικών χρόνων. Σημαντική υποενότητα αποτελεί αυτή που πραγματεύεται τις σχέσεις της Αμβρακίας με τη Δύση, κυρίως με βάση τη μαρτυρία της εγχώριας κεραμικής, εξετάζοντας παράλληλα τα ιστορικά δεδομένα. Στην τελευταία ενότητα παρουσιάζονται τα συμπεράσματα για τη συστηματική οργάνωση των χώρων ταφής της Αμβρακίας, την ιδιαίτερη σχέση των ταφικών εθίμων με αυτά της μητρόπολης Κορίνθου κατά τους αρχαϊκούς χρόνους και τη σταδιακή απομάκρυνση από αυτά κατά τη διάρκεια των κλασικών χρόνων, τις διαφορές από τα νεκροταφεία των κωμών στην ηπειρωτική ενδοχώρα και τις ομοιότητες με τη Λευκάδα, την άλλη κορινθιακή αποικία στην περιοχή, την ακολουθία της πανελλήνιας τάσης κατά τον 5ο αι. π.Χ. για ομοιομορφία στις ταφές και τη σταδιακή ανάδειξη μιας εύρωστης οικονομικά τάξης κατά τη διάρκεια του 4ου αι. π.Χ., όταν η πόλη αναπτύσσεται στο σημαντικότερο αστικό κέντρο της ευρύτερης περιοχής, ώστε να καταλήξει στις αρχές του 3ου αι. π.Χ. πρωτεύουσα του κράτους του Πύρρου. Τον τόμο με το κείμενο της διατριβής συνοδεύει ο τόμος με τον κατάλογο των τάφων και των ευρημάτων ανά εποχή και νεκροταφείο και ο τόμος με τους χάρτες, σχέδια ανασκαφών και τις φωτογραφίες των ευρημάτων, καθώς και γραφήματα
Jezus – Ewangelizator [Ὁ Ἰησοῦς] κηρύσσων καὶ εὐαγγελιζόμενος τὴν βασιλείαν τοῦ θεοῦ (Łk 8,1)
No full textThe article is the 19th of the series on Jesus Titles which had been published in „Goœæ Niedzielny” weekly magazine since 1994–1996. The previous ones were a popular presentation of the New Testament Christology whilst the 19s article is a scientifically approached summary of the series. It was specially written for the Commemoration Book dedicated to Petr Pokorný who is professor in biblistics at the Department of Protestant Theology at Charles University in Prague (the Czech Republic) to celebrate his 65th birthday in 1998. As the title Jesus – the Evangelizer has not been used in the Bible (althhough it is used even in the Church’s official documents) the author puts forward the question – Is the title „Jesus Evangelizer” rooted in the Bible and what are its contents? This title has appeared recently with the new evangelization. John Paul II made a postulate in TMA: To discover Jesus Christ again as the only Redeemer of the world. The basis for it is a pericope about a rejection of Jesus Christ in Nazareth (Luke 4,16–30). From the philological point of view basing on BH, LXX and NT the line leeds from the Hebrew term me baœer (RAB:M) throng a Greek substantial form o( eu)aggelizo/menoj (LXX,NT) to the corresponding form evangelizer in medival Latin and the derived from this form neologisms in modern languages, especially in Roman languages up to its presence in Polish theological literature. Polish spelling is „evangelizator” (ewangelizator) but it can not be found in any dictionary of Polish. The author looked for this title in contemporary translations of the Bible and found a term „G³osiciel Ewangelii” (he who preaches the Gospel) as the closest and the most appropriate one.Analysis of the texts in NT where o( eu)aggelizo/menoj refers to Jesus showed topos of the verb eu)aggeli/zein in the New Testament; philological and exegetical analysis of the texts have been carried out and showed evidence that Jesus was in the function of a subject. The word eu)aggeli/zw/eu)aggeli/- zein is present in 55 places in the New Testament and it is also used 9 times in the context which refers to Jesus’s activities: Matt 11,5; Luke 3,14; 4,18; 4,43; 7,22; 8,1; 9,6; 16,16; 20,1. It is used as participium 20 times in the New Testament only in medial and passive form.The author presents the results of his own research and gives the definition: What is the definition of Jesus – Evangelizer? The most accurate and the shortest answer can be found in Luke 8,1 summarium: I)hsou=j diodeu/wn kata\ po/lin kai\ kw/mhn, khru/sswn kai\ eu)aggelizo/menoj th\n basilei/an tou= Qeou= which means Jesus constantly on his way (diodeu/wn) through towns and villages, proclaiming (khru/sswn) Good News about the Kingdom of God which has already come. This is what He was sent for. He himself is the Gospel (Mark 1,1). Basing on the original Greek text it is justfied to use the title I)hsou=j o( eu)aggelizo/menoj (the evangelizing Jesus) which can be translated into Latin used by the Church as Jesus Evangelizans, so the contemporary version of the title is Jesus – the Evangelizer. The author’s bibliography contains 32 items which were used as justification of the subject matter of this paper. Item no 27: Carlo Maria Martini, Głosiciel Ewangelii u św. Łukasza. Medytacje, WAM, Kraków 1993 (Duc in altum – wypłyń na głębię 9); Carlo Maria Martini, He who proclaims the Gospel in the Gospel according to Luke. Meditations, WAM, Cracow 1993 (Duc in altum – set out on deep waters 9).The article is the 19th of the series on Jesus Titles which had been published in „Goœæ Niedzielny” weekly magazine since 1994–1996. The previous ones were a popular presentation of the New Testament Christology whilst the 19s article is a scientifically approached summary of the series. It was specially written for the Commemoration Book dedicated to Petr Pokorný who is professor in biblistics at the Department of Protestant Theology at Charles University in Prague (the Czech Republic) to celebrate his 65th birthday in 1998. As the title Jesus – the Evangelizer has not been used in the Bible (althhough it is used even in the Church’s official documents) the author puts forward the question – Is the title „Jesus Evangelizer” rooted in the Bible and what are its contents? This title has appeared recently with the new evangelization. John Paul II made a postulate in TMA: To discover Jesus Christ again as the only Redeemer of the world. The basis for it is a pericope about a rejection of Jesus Christ in Nazareth (Luke 4,16–30). From the philological point of view basing on BH, LXX and NT the line leeds from the Hebrew term me baœer (RAB:M) throng a Greek substantial form o( eu)aggelizo/menoj (LXX,NT) to the corresponding form evangelizer in medival Latin and the derived from this form neologisms in modern languages, especially in Roman languages up to its presence in Polish theological literature. Polish spelling is „evangelizator” (ewangelizator) but it can not be found in any dictionary of Polish. The author looked for this title in contemporary translations of the Bible and found a term „G³osiciel Ewangelii” (he who preaches the Gospel) as the closest and the most appropriate one.Analysis of the texts in NT where o( eu)aggelizo/menoj refers to Jesus showed topos of the verb eu)aggeli/zein in the New Testament; philological and exegetical analysis of the texts have been carried out and showed evidence that Jesus was in the function of a subject. The word eu)aggeli/zw/eu)aggeli/- zein is present in 55 places in the New Testament and it is also used 9 times in the context which refers to Jesus’s activities: Matt 11,5; Luke 3,14; 4,18; 4,43; 7,22; 8,1; 9,6; 16,16; 20,1. It is used as participium 20 times in the New Testament only in medial and passive form.The author presents the results of his own research and gives the definition: What is the definition of Jesus – Evangelizer? The most accurate and the shortest answer can be found in Luke 8,1 summarium: I)hsou=j diodeu/wn kata\ po/lin kai\ kw/mhn, khru/sswn kai\ eu)aggelizo/menoj th\n basilei/an tou= Qeou= which means Jesus constantly on his way (diodeu/wn) through towns and villages, proclaiming (khru/sswn) Good News about the Kingdom of God which has already come. This is what He was sent for. He himself is the Gospel (Mark 1,1). Basing on the original Greek text it is justfied to use the title I)hsou=j o( eu)aggelizo/menoj (the evangelizing Jesus) which can be translated into Latin used by the Church as Jesus Evangelizans, so the contemporary version of the title is Jesus – the Evangelizer. The author’s bibliography contains 32 items which were used as justification of the subject matter of this paper. Item no 27: Carlo Maria Martini, Głosiciel Ewangelii u św. Łukasza. Medytacje, WAM, Kraków 1993 (Duc in altum – wypłyń na głębię 9); Carlo Maria Martini, He who proclaims the Gospel in the Gospel according to Luke. Meditations, WAM, Cracow 1993 (Duc in altum – set out on deep waters 9)
Risk and Protective Factors for Sudden Cardiac Death: An Umbrella Review of Meta-Analyses
No full textBackground: Sudden cardiac death (SCD) is a global public health issue, accounting for 10–20% of deaths in industrialized countries. Identification of modifiable risk factors may reduce SCD incidence. Methods: This umbrella review systematically evaluates published meta-analyses of observational and randomized controlled trials (RCT) for the association of modifiable risk and protective factors of SCD. Results: Fifty-five meta-analyses were included in the final analysis, of which 31 analyzed observational studies and 24 analyzed RCTs. Five associations of meta-analyses of observational studies presented convincing evidence, including three risk factors [diabetes mellitus (DM), smoking, and early repolarization pattern (ERP)] and two protective factors [implanted cardiac defibrillator (ICD) and physical activity]. Meta-analyses of RCTs identified five protective factors with a high level of evidence: ICDs, mineralocorticoid receptor antagonist (MRA), beta-blockers, and sodium-glucose cotransporter-2 (SGLT-2) inhibitors in patients with HF. On the contrary, other established, significant protective agents [i.e., amiodarone and statins along with angiotensin-converting enzyme (ACE) inhibitors in heart failure (HF)], did not show credibility. Likewise, risk factors as left ventricular ejection fraction in HF, and left ventricular hypertrophy, non-sustain ventricular tachycardia, history of syncope or aborted SCD in pediatric patients with hypertrophic cardiomyopathy, presented weak or no evidence. Conclusions: Lifestyle risk factors (physical activity, smoking), comorbidities like DM, and electrocardiographic features like ERP constitute modifiable risk factors of SCD. Alternatively, the use of MRA, beta-blockers, SGLT-2 inhibitors, and ICD in patients with HF are credible protective factors. Further investigation targeted in specific populations will be important for reducing the burden of SCD. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020216363, PROSPERO CRD42020216363. Copyright © 2022 Tsartsalis, Korela, Karlsson, Foukarakis, Svensson, Anastasakis, Venetsanos, Aggeli, Tsioufis, Braunschweig, Dragioti and Charitakis
Left Atrial Function Post Radiofrequency and Cryoballoon Ablation Assessed by Volume-Pressure Loops
No full textBackground: Left atrial (LA) function is linked to atrial fibrillation (AF) pathogenesis. AF catheter ablation decreases disease burden with potentially favorable effects on cardiac function. Atrial volume-pressure loops can optimally assess the LA function. Objective: To investigate changes in LA function by volume-pressure loops after paroxysmal AF ablation and explored potential differences between the radiofrequency and cryoballoon ablation. Methods: We analyzed 44 patients undergoing paroxysmal AF ablation from 2 centers, 22 treated with radiofrequency and 22 with cryoablation. Pre- and post-procedure, all patients underwent a real-time three-dimensional transthoracic ECG to evaluate LA volume, while simultaneously recording LA pressure following transseptal puncture. Volume-pressure loops pre- and post-procedure were created by paired data. Areas of A-loop (LA booster pump function) and V-loop (LA reservoir function), and the stiffness constant determining the slope of the exponential curve during LA filling were calculated. Results: Average LA pressure, A-wave amplitude, and V-wave amplitude were increased post-procedurally (p < 0.001). Overall, A-loop area decreased (p = 0.001) and V-loop area tended to increase (p = 0.07). The change in both A-loop and V-loop areas was similar between radiofrequency- and cryoballoon-treated patients (p = 0.18 and p = 0.52, respectively). However, compared with cryoballoon-treated patients, radiofrequency-treated patients had higher increase in the stiffness constant (b = 0.059; 95% CI: 0.022–0.096; p = 0.006). Conclusion: AF catheter ablation by the radiofrequency or cryoballoon is associated with the decrease of the booster pump function and increase of the reservoir function. Moreover, there is a post-procedural increase of LA pressure which is associated with an acute increase in LA stiffness in radiofrequency ablation, but not in cryoablation. Copyright © 2022 Karanasos, Tyrovolas, Tsiachris, Efremidis, Kordalis, Karmpalioti, Prappa, Karagiannis, Aggeli, Gatzoulis, Tousoulis, Tsioufis and Toutouzas
Total gastrectomy for the treatment of Menetrier's disease persistent to medical therapy: A case report
No full textBackground: Menetrier's disease is a rare hyperproliferative protein-losing gastropathy of the gastric foveolar epithelium. It is characterized by giant hypertrophic folds, excess mucus secretion, decreased acid secretion and hypoproteinemia due to selective loss of serum proteins across the gastric mucosa. The discovery of transforming growth factor-α overexpression opened the way of epidermal growth factor receptor blockade with cetuximab as first-line treatment modality for Menetrier's disease. Case report- ethods: We present the case of a 46-year-old female patient with Menetrier's disease. The diagnosis was based on clinical, endoscopic and histological criteria. Two years before the diagnosis of the disease the patient had an episode of deep vein thrombosis and pulmonary embolism. Real time PCR revealed mutation of the gene responsible for coagulation factor II. The patient received anticoagulation therapy and after a period of 6 months a severe anemia due to a gastrointestinal bleeding was presented. The appropriate investigation revealed the presence of Menetrier's disease. The patient was referred to the surgical clinic with persistence of symptoms such as excessive weight loss, anemia and weakness, even after multiple medical treatment, including the monoclonal antibody against the EGFR receptor. A total gastrectomy was performed and the postoperative course was uneventful. One year follow up showed remarkable improvement of her health status. Conclusion: A combination of clinical, laboratory, endoscopic and histopathologic findings is necessary for the diagnosis of this rare disease. Gastrectomy is the treatment of choice for those patients with intractable symptoms and signs refractory to medical therapy. © 2020 The Author(s
Differential roles of p38-MAPK and JNKs in mediating early protection or apoptosis in the hyperthermic perfused amphibian heart
No full textIn the present study the activation of p38 mitogen-activated protein kinase (p38-MAPK) and c-Jun N-terminal kinases (JNKs) by hyperthermia was investigated in the isolated perfused Rana ridibunda heart. Hyperthermia (42°C) was found to profoundly stimulate p38-MAPK phosphorylation within 0.5 h, with maximal values being attained at 1 h [4.503(±0.577)-fold relative to control, P&lt;0.01]. JNKs were also activated under these conditions in a sustained manner for at least 4 h [2.641 (±0.217)-fold relative to control, P&lt;0.01]. Regarding their substrates, heat shock protein 27 (Hsp27) was maximally phosphorylated at 1 h [2.261 (±0.327)-fold relative to control, P&lt;0.01] and c-Jun at a later phase [3 h: 5.367(±0.081)-fold relative to control, P&lt;0.001]. Hyperthermia-induced p38-MAPK activation was found to be dependent on the Na+/H+ exchanger 1 (NHE1) and was also suppressed by catalase (Cat) and superoxide dismutase (SOD), implicating the generation of reactive oxygen species (ROS). ROS were also implicated in the activation of JNKs by hyperthermia, with the Na +/K+-ATPase acting as a mediator of this effect at an early stage and the NHE1 getting involved at a later time point. Finally, JNKs were found to be the principal mediators of the apoptosis induced under hyperthermic conditions, as their inhibition abolished poly(ADP-ribose) polymerase (PARP) cleavage after 4 h at 42°C. Overall, to our knowledge, this study highlights for the first time the variable mediators implicated in the transduction of the hyperthermic signal in the isolated perfused heart of an ectotherm and deciphers a potential salutary effect of p38-MAPK as well as the fundamental role of JNKs in the induced apoptosis
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