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Biomedical subjects

A Chatziioannou

Publications and source records attributed to A Chatziioannou.

At least 19 recordsLinked to original sources

Effect of green tea on angiogenesis and severity of atherosclerosis in cholesterol-fed rabbit.

BACKGROUND AND AIMS: Since the development of the atherosclerotic plaque requires the growth of new microvessels in the plaque itself (vasa vasorum), we postulated that green tea may exert an anti-atherogenic effect. METHODS AND RESULTS: Thirteen male New Zealand white rabbits were studied for 17 weeks. All rabbits were fed an hypecholesterolemic diet. After 2 weeks of adaptation rabbits were randomly assigned into two groups. Animals in Group A were fed the hypercholesterolemic diet and received plain tap water ad libitum. Animals in Group B were fed with the same diet and furthermore received 2.5% (g/g) green tea for 17 weeks. CONCLUSION: According to our results the atherosclerotic lesions were more severe in Group B than in Group A specimens. Also, the number of VEGF positively stained foam cells and smooth muscle cells of Group B were significantly greater than in Group A. About 30% less plaque was found in Group A than in the control group (Group B). So, our study showed that the consumption of green tea leads to a reduction of atherosclerosis as well as a significant decrease of VEGF expression in the atherosclerotic plaque of rabbit aorta. The hypothesis that probably green tea may produce its anti-atherogenetic effect through an anti-angiogenetic mechanism needs more investigation.

Angiogenesis Inhibitors↗

Readout of the Optical PET (OPET) Detector.

The design of an imaging system capable of detecting both high-energy γ-rays and optical wavelength photons is underway at the Crump Institute for Molecular Imaging. This system will noninvasively image small animal models in vivo for the presence of positron emission tomographic (PET) and optical signals. The detector will consist of modules of multichannel photomultiplier tubes (MC-PMT) coupled to arrays of scintillator crystals. The MC-PMT will detect both the photons produced due to bioluminescence and the photons generated by the interaction of γ-rays within the crystals. The long wavelength photons produced through bioluminescence are only slightly attenuated by these crystals and are detected directly at the photocathode of the MC-PMT, resulting in signals of small (5-10 mV) short (~15 ns) pulses. In contrast, annihilation (511 keV) γ-rays interacting in the scintillator crystal send large bursts of photons to the PMT, and result in pulses that can be as large as 500 mV and > 200 ns duration. The processing of pulses with such different characteristics in a single circuit requires significant alteration of the standard pulse processing circuitry used in PET scanners. In this paper, we discuss the requirements of such a circuit and show the results of implementation of one design using single and multiple channel PMTs.

Journal Article↗

Endovascular treatment of renal arteriovenous malformations.

We report a case of renal arteriovenous malformation treated with superselective endovascular embolization using a light mixture of n-butyl-2-cyanoacrylate and Lipiodol. Diagnostic imaging modalities and treatment methods are discussed. In conclusion, successful superselective embolization should be the standard of care.

Adult↗

Effects of superselective embolization for renal vascular injuries on renal parenchyma and function.

AIM: Our objective was to evaluate the outcome of superselective embolization used for treatment of renal vascular injuries on renal parenchyma and renal function. MATERIALS AND METHODS: Between January 1999 and December 2001, 6 consecutive patients (five males, one female, mean age 45 years) underwent embolization to treat bleeding from renal vascular injuries, resulting from iatrogenic interventions (4) and blunt abdominal trauma (2). Five patients had increased serum creatinine. Angiography depicted a pseudoaneurysm (PA) in three, PA with arteriovenous fistula (AVF) in one, and active extravasation in two patients. Superselective catheterization was achieved using a 5-F catheter in three, and coaxial microcatheter in the remaining three cases. All lesions were successfully embolized with 0.035" or 0.018" coils. RESULTS: Bleeding was ceased in all patients and did not recur. Mean post-embolization parenchymal ischemic area was 11.7% (range: 0-30%). Imaging follow-up (mean: 12 months, range: 5-23) showed that mean parenchymal infarcted area was 6% (range: 0-15%). Serum creatinine level was normal in all patients one week after the procedure and at the latest follow-up. CONCLUSION: Superselective embolization resulted in permanent cessation of bleeding. Serious parenchymal infarction was prevented and serum creatinine level returned to the pre-bleeding values. Embolization should be considered as the treatment of choice in this patient population.

Abdominal Injuries↗

Detector Concept for OPET-A Combined PET and Optical Imaging System.

The design of an imaging system capable of detecting both high-energy γ-rays and optical wavelength photons is underway at the UCLA Crump Institute for Molecular Imaging. This system, which we call optical PET (OPET), will be capable of non-invasively and repeatedly imaging small animal models in vivo for the presence of PET and optical signals. In this study, we describe the physical principles behind the operation of the OPET imaging system and discuss the design concept for one of the detector modules. Additionally, we demonstrate the operation of an initial prototype detector module for simultaneous detection and imaging of annihilation radiation and single optical photons emanating from separate sources. These results indicate that the construction of an imaging system based on this detector technology is feasible.

Journal Article↗

Stent therapy for malignant superior vena cava syndrome: should be first line therapy or simple adjunct to radiotherapy.

UNLABELLED: The goal of this paper is to present our experience with superior vena cava (SVC) stenting, as first line procedure for immediate relief, in patients with malignancy, and its potential influence in the subsequent radiotherapy (XRT). Over a 1-year period, 18 patients with SVC syndrome due to severe stenosis secondary to mediastinal malignancy were referred for stent insertion. A SVC score was used to measure treatment effectiveness. Stent insertion had been successful in 18/18 patients (technical success 100%). All patients experienced symptomatic relief within few hours of the procedure. There were no major complications. In all patients we were able to start radiotherapy (XRT) the next day, after stenting according to our new institutional protocol. All patients were able to comply with the XRT program, perfectly well. CONCLUSIONS: SVC stenting provides immediate significant relief of the very annoying SVC syndrome symptoms, thus facilitating excellent compliance of all the patients to the subsequently XRT protocols. We strongly recommend SVC stenting as first line procedure, in patients with SVC syndrome due to malignancy prior to radiotherapy.

Adult↗

Assessing food additive toxicity using a cell model.

Food additives are widely used for technological purposes and their presence is often substantial daily diet. They have also been accused forvarious toxic reactions in humans. The toxicity of the food color tartrazine, the preservatives sodium nitrate and sodium benzoate, and the antioxidant BHT, was studied using the protozoan Tetrahymenapyriformis as a toxicological model. The 4 food additives were added to Tetrahymena cultures and DNA content of the protozoan nuclei measured by an image analysis system. These food additives caused a statistically significant increase in DNA content suggesting stimulation of the mitotic process. This system may contribute to the investigation of the cellular action of food additives, since mitogenic stimuli substantially alter susceptibility to chemical carcinogenesis.

Animals↗

Model-based normalization for iterative 3D PET image reconstruction.

We describe a method for normalization in 3D PET for use with maximum a posteriori (MAP) or other iterative model-based image reconstruction methods. This approach is an extension of previous factored normalization methods in which we include separate factors for detector sensitivity, geometric response, block effects and deadtime. Since our MAP reconstruction approach already models some of the geometric factors in the forward projection, the normalization factors must be modified to account only for effects not already included in the model. We describe a maximum likelihood approach to joint estimation of the count-rate independent normalization factors, which we apply to data from a uniform cylindrical source. We then compute block-wise and block-profile deadtime correction factors using singles and coincidence data, respectively, from a multiframe cylindrical source. We have applied this method for reconstruction of data from the Concorde microPET P4 scanner. Quantitative evaluation of this method using well-counter measurements of activity in a multicompartment phantom compares favourably with normalization based directly on cylindrical source measurements.

Algorithms↗

Abdominal aortic aneurysm and renal artery stenosis: renal function and blood pressure before and after endovascular treatment.

We describe three patients with abdominal aortic aneurysm (AAA) and renal artery stenosis (RAS). These patients were treated by placement of an aortic endograft and angioplasty or stenting of the renal artery. After the procedure renal function improved or remained stable in two patients and deteriorated slightly in one. Blood pressure was reduced in one hypertensive patient and remained normal in the other two normotensive patients. In conclusion, simultaneous treatment of AAA and RAS with aortic endograft placement and renal artery angioplasty with or without stent, is a safe and effective technique for selected high-risk patients.

Aged↗

Renal artery stenting for renal insufficiency in solitary kidney in 26 patients.

OBJECTIVE: to present our experience with stent placement in renal arteries in solitary kidneys for treating renal insufficiency. DESIGN: retrospective analysis. MATERIALS: in 26 patients with solitary kidney (17 men, 9 women, mean age: 63 years), presented with renal insufficiency (se-creat >0.144 mmol/l), stent was placed in a stenosed renal artery. We analysed the clinical outcome, based on the level of creatinine at 3 months following the procedure. Clinical benefit was considered when there was a decrease compared to the baseline creatinine by >20% or a stabilisation of the creatinine value (+/-20% of the baseline). RESULTS: in 16 of the 26 patients (62%), clinical benefit was achieved. However, 38% of the study population, renal function continued to deteriorate. Baseline creatinine value was the single best predictor for clinical benefit achievement (odds ratio: 13; 95% confidence intervals: 1.6-107, p=0.01). CONCLUSION: renal stenting results in improvement or stabilisation of renal function in the majority of the patients with solitary kidneys and renal artery stenosis, presenting with renal insufficiency. Because best outcome was observed mainly in those patients with not progressed renal insufficiency, intervention should be focused on that group.

Creatinine↗

Detector development for microPET II: a 1 microl resolution PET scanner for small animal imaging.

We are currently developing a small animal positron emission tomography (PET) scanner with a design goal of 1 microlitre (1 mm3) image resolution. The detectors consist of a 12 x 12 array of 1 x 1 x 10 mm lutetium oxyorthosilicate (LSO) scintillator crystals coupled to a 64-channel photomultiplier tube (PMT) via 5 cm long optical fibre bundles. The optical fibre connection allows a high detector packing fraction despite the dead space surrounding the active region of the PMT. Optical fibre bundles made from different types of glass were tested for light transmission, and also their effects on crystal identification and energy resolution, and compared to direct coupling of the LSO arrays to the PMTs. We also investigated the effects of extramural absorber (EMA) in the fibre bundles. Based on these results, fibre bundles manufactured from F2 glass were selected. We built three pairs of prototype detectors (directly coupled LSO array, fibre bundle without EMA and fibre bundle with EMA) and measured flood histograms, energy resolution, intrinsic spatial resolution and timing resolution. The results demonstrated an intrinsic spatial resolution (FWHM) of 1.12 mm (directly coupled), 1.23 mm (fibre bundle without EMA coupling) and 1.27 mm (fibre bundle with EMA coupling) using an approximately 500 microm diameter Na-22 point source. Using a 330 microm outer diameter steel needle line source filled with F-18, spatial resolution for the detector with the EMA optical fibre bundle improved to 1.05 mm. The respective timing and energy FWHM values were 1.96 ns, 21% (directly coupled), 2.20 ns, 23% (fibre bundle without EMA) and 2.99 ns, 30% (fibre bundle with EMA). The peak-to-valley ratio in the flood histograms was better with EMA (5:1) compared to the optical fibre bundle without EMA (2.5:1), due to the decreased optical cross-talk. In comparison to the detectors used in our current generation microPET scanner, these detectors substantially improve on the spatial resolution, preserve the timing resolution and provide adequate energy resolution for a modern high-resolution animal PET tomograph.

Animals↗

Performance evaluation of the microPET P4: a PET system dedicated to animal imaging.

The microPET Primate 4-ring system (P4) is an animal PET tomograph with a 7.8 cm axial extent, a 19 cm diameter transaxial field of view (FOV) and a 22 cm animal port. The system is composed of 168 detector modules, each with an 8 x 8 array of 2.2 x 2.2 x 10 mm3 lutetium oxyorthosilicate crystals, arranged as 32 crystal rings 26 cm in diameter. The detector crystals are coupled to a Hamamatsu R5900-C8 PS-PMT via a 10 cm long optical fibre bundle. The detectors have a timing resolution of 3.2 ns, an average energy resolution of 26%, and an average intrinsic spatial resolution of 1.75 mm. The system operates in 3D mode without inter-plane septa, acquiring data in list mode. The reconstructed image spatial resolution ranges from 1.8 mm at the centre to 3 mm at 4 cm radial offset. The tomograph has a peak system sensitivity of 2.25% at the centre of the FOV with a 250-750 keV energy window. The noise equivalent count rate peaks at 100-290 kcps for representative object sizes. Images from two phantoms and three different types of laboratory animal demonstrate the advantage of the P4 system over the original prototype microPET. including its threefold improvement in sensitivity and a large axial FOV sufficient to image an entire mouse in a single bed position.

Animals↗

Embolisation of a traumatic aneurysm of the posterior circumflex humeral artery in a volleyball player.

Repetitive minor vascular injuries caused by physical activity in athletes may lead to ischaemia of the upper extremities. In volleyball players in particular, traumatic aneurysm of the posterior circumflex humeral artery has been reported to be a cause of ischaemia of the arm and hand. Such an aneurysm is described here; it was treated successfully with endovascular embolisation.

Adult↗

Comparison of 3-D maximum a posteriori and filtered backprojection algorithms for high-resolution animal imaging with microPET.

We have evaluated the performance of two three-dimensional (3-D) reconstruction algorithms with data acquired from microPET, a high resolution tomograph dedicated to small animal imaging. The first was a linear filtered-backprojection algorithm (FBP) with reprojection of the missing data, and the second was a statistical maximum a posteriori probability algorithm (MAP). The two algorithms were evaluated in terms of their resolution performance, both in phantoms and in vivo. Sixty independent realizations of a phantom simulating the brain of a baby monkey were acquired, each containing three million counts. Each of these realizations was reconstructed independently with both algorithms. The ensemble of the 60 reconstructed realizations was used to estimate the standard deviation as a measure of the noise for each reconstruction algorithm. More detail was recovered in the MAP reconstruction without an increase in noise relative to FBP. Studies in a simple cylindrical compartment phantom demonstrated improved recovery of known activity ratios with MAP. Finally, in vivo studies also demonstrated a clear improvement in spatial resolution using the MAP algorithm. The quantitative accuracy of the MAP reconstruction was also evaluated by comparison with autoradiography and direct well counting of tissue samples and was shown to be superior.

Algorithms↗

Embolization of a segmental renal artery pseudoaneurysm after partial nephrectomy in a solitary kidney.

Renal pseudoaneurysms are a well-documented complication following trauma or after percutaneous biopsy. When symptomatic, patients present with hematuria and deteriorating renal function. We present the case of a 62-year-old man who, due to development of a pseudoaneurysm, presented with gross hematuria 10 days after partial nephrectomy for a renal cell carcinoma in a single kidney. A segmental artery was embolized with stainless steel coils without significant loss of the limited renal vascularization.

Aneurysm, False↗

Selective arterial embolization in the management of symptomatic renal angiomyolipomas.

Current management of renal angiomyolipomas (AMLs) include observation, transcatheter embolization and partial or total nephrectomy. Patients symptoms and size of the lesion are the determinants for the choice of the treatment. In general symptomatic or greater than 8 cm masses require intervention. A retrospective study of five patients presented with symptomatic lesions and treated with selective transcatheter embolization, over a 3 year period was performed in our hospital. A total of eight embolizations were performed, all on an emergency basis due to retroperitoneal bleeding or significant hematuria. Surgical intervention was necessary in one case, due to massive rebleeding on the fourth post-procedural day. Two patients rebled within 6 months and 2 years respectively, and were managed successfully with additional embolization. The remaining two patients are still asymptomatic 26 and 18 months after the successful initial result. Experience with this procedure is reported on with emphasis to the clinical outcome. It is believed that selective arterial embolization should be the standard initial therapy for symptomatic renal AMLs.

Adolescent↗

High-resolution 3D Bayesian image reconstruction using the microPET small-animal scanner.

A Bayesian method is described for reconstruction of high-resolution 3D images from the microPET small-animal scanner. Resolution recovery is achieved by explicitly modelling the depth dependent geometric sensitivity for each voxel in combination with an accurate detector response model that includes factors due to photon pair non-collinearity and inter-crystal scatter and penetration. To reduce storage and computational costs we use a factored matrix in which the detector response is modelled using a sinogram blurring kernel. Maximum a posteriori (MAP) images are reconstructed using this model in combination with a Poisson likelihood function and a Gibbs prior on the image. Reconstructions obtained from point source data using the accurate system model demonstrate a potential for near-isotropic FWHM resolution of approximately 1.2 mm at the center of the field of view compared with approximately 2 mm when using an analytic 3D reprojection (3DRP) method with a ramp filter. These results also show the ability of the accurate system model to compensate for resolution loss due to crystal penetration producing nearly constant radial FWHM resolution of 1 mm out to a 4 mm radius. Studies with a point source in a uniform cylinder indicate that as the resolution of the image is reduced to control noise propagation the resolution obtained using the accurate system model is superior to that obtained using 3DRP at matched background noise levels. Additional studies using pie phantoms with hot and cold cylinders of diameter 1-2.5 mm and 18FDG animal studies appear to confirm this observation.

Animals↗