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Synthesis of coronary 4D CT Image by denoising diffusion probabilistic model

Sat, 01 Aug 2026 00:00:00 GMT

Title: Synthesis of coronary 4D CT Image by denoising diffusion probabilistic model Authors: Han, Tae Ho; Kim, Young Woo; Lee, Hyeong Jun; Kim, Jung-Sun; Lee, Seul-Gee; Yang, Dong Hyun; Oh, Hong Min; Kim, Doosang; Shin, Seung Yong; Song, Simon; Lee, Joon Sang Abstract: Purpose: Fluctuations in the pressure drop during the cardiac cycle can provide prognostic information for coronary artery disease (CAD). However, 4D computed tomography (CT) is required for time-variant flow analysis, which results in high doses of radiation exposure. In this study, we propose a novel diffusion-based framework for synthesizing physiologically consistent 4D CT images and performing 4D CT flow analysis. Methods: A denoising diffusion probabilistic model (DDPM) integrated with a deformation module was used for precise anatomical reconstruction. Subsequently, a computational fluid dynamics (CFD) model coupled with quasi-steady fluid-structure interaction (FSI) was utilized to calculate the 4D hemodynamic flow field. Results: The model achieved a peak signal-to-noise ratio of 32.01 and a structural similarity index measure of 0.937. After 3D construction and segmentation, the average Dice coefficient was 0.973. Furthermore, the computational fluid analysis was also performed with a fractional flow reserve (FFR) accuracy of 90.5%, demonstrating its efficacy in reducing radiation exposure without compromising diagnostic quality. Conclusion: Our results demonstrate that this synthesized 4D CT-based hemodynamic approach provides timevariant information for CAD diagnosis. This method offers valuable guidance for clinical decision-making as well as the possibility of prognostic information based on dynamic lumen evaluation.

Optimal antiplatelet strategy in patients with advanced chronic kidney disease undergoing drug-eluting stent implantation: Design and rationale of the randomized ADAPT-CKD trial

Sat, 01 Aug 2026 00:00:00 GMT

Title: Optimal antiplatelet strategy in patients with advanced chronic kidney disease undergoing drug-eluting stent implantation: Design and rationale of the randomized ADAPT-CKD trial Authors: Jin, In Tae; Lee, Sang-Hyup; Yun, Kyeong Ho; Kim, Weon; Shin, Sanghoon; Jang, Ji-Yong; Cho, Deok-Kyu; Cha, Jung-Joon; Kang, Tae Soo; Lee, Ji Hyun; Cho, Yun-Kyeong; Heo, Jung Ho; Ahn, Sung Gyun; Lee, Jaeoh; Lee, Yong-Joon; Lee, Seung-Jun; Hong, Sung-Jin; Ahn, Chul-Min; Kim, Byeong-Keuk; Ko, Young-Guk; Choi, Donghoon; Hong, Myeong-Ki; Jang, Yangsoo; Kim, Jung-Sun; 이재오; 이승준 Abstract: Background Although shortened dual antiplatelet therapy (DAPT) strategies have demonstrated favorable outcomes in the general percutaneous coronary intervention (PCI) population, patients with advanced chronic kidney disease (CKD) have been underrepresented in randomized clinical trials. The optimal duration of DAPT after PCI remains uncertain in patients with CKD, who are at increased risk for both ischemic and bleeding events. Methods The ADAPT-CKD trial is an investigator-initiated, multicenter, open-label, randomized, superiority study designed to compare an abbreviated vs a standard DAPT strategy in patients with advanced CKD undergoing PCI with contemporary drug-eluting stents. A total of 900 patients with an estimated glomerular filtration rate < 45 mL/min/1.73 m (2) will be randomly assigned in a 1:1 ratio to abbreviated DAPT ( < 3 months of DAPT after PCI) or standard DAPT ( >= 6 months). The primary endpoint is net adverse clinical events at 1 year, defined as a composite of all-cause death, myocardial infarction, stent thrombosis, stroke, or major bleeding according to the Bleeding Academic Research Consortium criteria. The primary hypothesis is that abbreviated DAPT is superior to standard DAPT in reducing net adverse clinical events at 1 year after randomization. Conclusions The ADAPT-CKD trial will provide randomized evidence on the efficacy and safety of an abbreviated DAPT strategy compared with a standard DAPT strategy in patients with advanced CKD undergoing PCI. The results are expected to inform clinical decision-making regarding optimal antiplatelet therapy in this high-risk population. ClinicalTrialRegistrationhttps://www.clinicaltrials.gov.Uniqueidentifier:NCT04708587.(AmHeartJ2026;298:107437.)

Design, synthesis and biological evaluation of symmetric thiadiazole carboxamide derivative as glutaminase inhibitor

Wed, 01 Jul 2026 00:00:00 GMT

Title: Design, synthesis and biological evaluation of symmetric thiadiazole carboxamide derivative as glutaminase inhibitor Authors: Cyriac, Rajath; Lee, Eun Ji; Kwon, Yeongju; Yun, Mi Ran; Jung, Myoung Eun; Ahn, Sunjoo; Chae, Chang Hak; Choi, Gildon; Cho, Byoung Chul; Lee, Kwangho; 윤미란 Abstract: Metabolic reprogramming toward glutamine anaplerosis is a well-established vulnerability in tumors harboring co-occurring KRAS and KEAP1 mutations, creating a dependency on glutaminase (GLS)-mediated glutaminolysis for survival and growth. Although allosteric GLS inhibitors such as BPTES (Bis-2-(5-phenylacetamido-1,3,4thiadiazol-2-yl)ethyl sulfide) and later-generation analogs such as CB-839 (Telaglenastat) have pharmacologically validated this target, their clinical utility has been constrained by suboptimal drug-like properties, including poor solubility and bioavailability. To overcome these limitations, we developed TRG-192, a novel symmetric amidothiadiazole derivative engineered with a distinct chemical scaffold to enhance physicochemical and pharmacokinetic profiles. In vitro characterization revealed that TRG-192 is a potent GLS inhibitor (IC50 = 68 nM). This biochemical potency translated to a functional effect in a cellular model of glutamine dependence, as evidenced by a significant depletion of intracellular glutamate pools in LDK378-resistant (LR) cells. Furthermore, TRG-192 demonstrated a favorable preclinical safety profile in initial toxicological assessments. Collectively, these data-encompassing potent target engagement, functional on-target activity, and preliminary safety-provide a compelling rationale for the advancement of TRG-192 into in vivo efficacy studies.

Slippery dopamine-fluoropolymer hybrid surface for improving biliary stent longevity

Wed, 01 Jul 2026 00:00:00 GMT

Title: Slippery dopamine-fluoropolymer hybrid surface for improving biliary stent longevity Authors: Kim, Tae Young; Lee, Won-Jong; Lee, Yurim; Kim, Seo Jung; Min, Sungjin; Chung, Seyong; Kim, Soo A.; Yook, Keun-Young; Moon, Chang-Hwan; Lee, Yeontaek; Park, Kijun; Kim, Dae-Hyun; Seo, Jungmok Abstract: Biliary obstruction leads to bile retention and triggers a cascade of pathological events. Bile accumulation induces cholestasis and inflammation, progressing to hepatocellular injury, fibrosis, and ultimately liver failure. To restore bile flow, biliary stents are a necessary option due to their immediate patency. However, their high susceptibility to foreign body reaction (FBR) associated fibrosis, biofilm formation, and biliary sludge accumulation leads to frequent occlusion. To address this limitation, we developed the Enhanced Longevity by antifouling Functional coating for Stent (ELFS), a lubricant-infused coating that prevents stent occlusion. ELFS can be readily fabricated via a simple dip-coating solution process and employ a polydopamine (PDA) adhesion layer. Intravital imaging in mice confirmed that ELFS suppressed the FBR by blocking early neutrophil adhesion, which in turn prevented downstream immune-fibrotic cascades. At 3 h, neutrophil recruitment in the non-coated group was >20-fold higher than in ELFS-coated groups. Additionally, ELFS-coated stents remained free of biofilm for over six months in mice and maintained full open for two months in a rabbit common bile duct model. In contrast, non-coated stents resulted in complete occlusion, bile duct dilation (over 4 times), hepatomegaly (over 2 times), and fibrosis.