Biomedical subjects

D S Paik

Publications and source records attributed to D S Paik.

14 recordsLinked to original sources

PubMed2001

Quantitative determination of age-related geometric changes in the normal abdominal aorta.

PURPOSE: We conducted a novel quantitative three-dimensional analysis of computed tomography (CT) angiograms to establish the relationship between aortic geometry and age, sex, and body surface area in healthy subjects. METHODS: Abdominal helical CT angiograms from 77 healthy potential renal donors (33 men/44 women; mean age, 44 years; age range, 19-67 years) were selected. In each dataset, orthonormal cross-sectional area and diameter measurements were obtained at 1-mm intervals along the automatically calculated central axis of the abdominal aorta. The aorta was subdivided into six consecutive anatomic segments (supraceliac, supramesenteric, suprarenal, inter-renal, proximal infrarenal, and distal infrarenal). The interrelated effects of anatomic segment, age, sex, and body surface area on cross-sectional dimensions were analyzed with linear mixed-effects and varying-coefficient statistical models. RESULTS: We found that significant effects of sex and of body surface area on aortic diameters were similar at all anatomic levels. The effect of age, however, was interrelated with anatomic position, and gradually decreasing slopes of significant diameter-versus-age relationships along the aorta, which ranged from 0.14 mm/y (P <.0001) proximally to 0.03 mm/y (P =.013) distally in the abdominal aorta, were shown. CONCLUSION: The abdominal aorta undergoes considerable geometric changes when a patient is between 19 and 67 years of age, leading to an increase of aortic taper with time. The hemodynamic consequences of this geometric evolution for the development of aortic disease still need to be established.

Adult↗

PubMed2001

A statistical 3-D pattern processing method for computer-aided detection of polyps in CT colonography.

Adenomatous polyps in the colon are believed to be the precursor to colorectal carcinoma, the second leading cause of cancer deaths in United States. In this paper, we propose a new method for computer-aided detection of polyps in computed tomography (CT) colonography (virtual colonoscopy), a technique in which polyps are imaged along the wall of the air-inflated, cleansed colon with X-ray CT. Initial work with computer aided detection has shown high sensitivity, but at a cost of too many false positives. We present a statistical approach that uses support vector machines to distinguish the differentiating characteristics of polyps and healthy tissue, and uses this information for the classification of the new cases. One of the main contributions of the paper is the new three-dimensional pattern processing approach, called random orthogonal shape sections method, which combines the information from many random images to generate reliable signatures of shape. The input to the proposed system is a collection of volume data from candidate polyps obtained by a high-sensitivity, low-specificity system that we developed previously. The results of our ten-fold cross-validation experiments show that, on the average, the system increases the specificity from 0.19 (0.35) to 0.69 (0.74) at a sensitivity level of 1.0 (0.95).

Adult↗

PubMed2001

Iliac arterial injuries after endovascular repair of abdominal aortic aneurysms: correlation with iliac curvature and diameter.

PURPOSE: To determine the relationship between iliac arterial tortuosity and cross-sectional area and the occurrence of iliac arterial injuries following transfemoral delivery of endovascular prostheses for repair of abdominal aortic aneurysms. MATERIALS AND METHODS: Iliac arterial curvature values and orthogonal cross-sectional areas were determined from helical computed tomographic (CT) data acquired in 42 patients prior to transfemoral delivery of aortic stent-grafts. The curvature and luminal cross-sectional area orthogonal to the median centerline were quantified every millimeter along the median centerline of the iliac arteries. An indicator of global iliac tortuosity, the iliac tortuosity index, was defined as the sum of the curvature values for all points with a curvature of 0.3 cm(-1) or greater, and cross-sectional area (CSA) was indexed for all points as the mean cross-sectional diameter (D = 2 radical[CSA/pi]). Following stent-graft deployment, helical CT data were analyzed for the presence of iliac arterial dissections independently by two reviewers. RESULTS: Eighteen dissections were detected in 16 patients. The iliac tortuosity index was significantly larger in iliac arteries with dissections (35.5 +/- 20.8 [mean +/- SD]) when compared with both nondissected contralateral iliac arteries in the same patients (26.1 +/- 21.0, P =.001) and iliac arteries in patients without any iliac arterial injury (20 +/- 9, P =.009). The tortuosity index was higher ipsilateral to the primary component delivery in 10 of 11 iliac dissections that developed along the primary component delivery route. CONCLUSION: A high degree of iliac arterial tortuosity appears to impart greater risk for the development of iliac arterial injuries in patients undergoing transfemoral delivery of endovascular devices.

Aged↗

PubMed2001

Prediction of aortoiliac stent-graft length: comparison of measurement methods.

PURPOSE: To determine the accuracy of helical computed tomography (CT), projectional angiography derived from CT angiography, and intravascular ultrasonographic withdrawal (IUW) length measurements for predicting appropriate aortoiliac stent-graft length. MATERIALS AND METHODS: Helical CT data from 33 patients were analyzed before and after endovascular repair of abdominal aortic aneurysm (Aneuryx graft, n = 31; Excluder graft, n = 2). The aortoiliac length of the median luminal centerline (MLC) and the shortest path (SP) that remained at least one common iliac arterial radius away from the vessel wall were calculated. Conventional angiographic measurements were simulated from CT data as the length of the three-dimensional MLC projected onto four standard viewing planes. These predeployment lengths and IUW length, available in 24 patients, were compared with the aortoiliac arterial length after stent-graft deployment. RESULTS: The mean error values of SP, MLC, the maximum projected MLC, and IUW were -2.1 mm +/- 4.6 (SD) (P =.013), 9.8 mm +/- 6.8 (P <.001), -5.2 mm +/- 7.8 (P <.001), and -14.1 mm +/- 9.3 (P <.001), respectively. The preprocedural prediction of the postprocedural aortoiliac length with the SP was significantly more accurate than that with the MLC (P <.001), maximum projected MLC (P <.001), and IUW (P <.001). CONCLUSION: The shortest aortoiliac path length maintaining at least one radius distance from the vessel wall most accurately enabled stent-graft length prediction for 31 AneuRx and two Excluder stent-grafts.

Aged↗

PubMed2000

delta Ca(2+)/Calmodulin-dependent protein kinase II isozyme-specific induction of neurite outgrowth in P19 embryonal carcinoma cells.

Ca(2+)/calmodulin-dependent protein kinase II (CaMK-II) has been linked to the induction of differentiation in preneuronal cells. In these cells, delta isozymes represent the majority of CaMK-IIs expressed and are activated by differentiation stimuli. To determine whether delta CaMK-IIs are causative or coincident with in vitro differentiation, we overexpressed wild-type, constitutively active, and C-terminal domains of delta and gamma CaMK-II isozymes in mouse P19 and NIH/3T3 cells using high-efficiency transfections. At 1-2 days after transfection, only constitutively active delta CaMK-II isozymes induced branched cellular extensions in both cell types. In P19 cells, retinoic acid induced neurite extensions after 3-4 days; these extensions were coincident with a fourfold increase in endogenous CaMK-II activity. Extensions induced by both retinoic acid and delta CaMK-IIs contained class III beta-tubulin in a discontinuous or beaded pattern. C-terminal CaMK-II constructs disrupted the ability of endogenous CaMK-II to autophosphorylate and blocked retinoic acid-induced differentiation. delta CaMK-II was found along extensions, whereas gamma CaMK-II exhibited a more diffuse, cytosolic localization. These data not only support an extranuclear role for CaMK-II in promoting neurite outgrowth, but also demonstrate CaMK-II isozyme specificity in these early steps of neuronal differentiation.

3T3 Cells↗

PubMed2000

Stair-step artifacts with single versus multiple detector-row helical CT.

PURPOSE: To compare the effects of acquisition parameters on the magnitude and appearance of artifacts between single and multiple detector-row helical computed tomography (CT). MATERIALS AND METHODS: A cylindric (12.7 x 305.0-mm) acrylic rod inclined 45 degrees relative to the z axis was scanned at the isocenter and 100 mm from the isocenter with single detector-row (single-channel) helical CT (beam width, 1-10 mm; pitch, 1.0, 2.0, or 3.0) and multiple detector-row (four-channel) helical CT (detector width, 1. 25, 2.5, 3.75, and 5 mm; pitch, 0.75 or 1.5). The SD of radius measurements along the rod (SD(r)) was used to quantify artifacts in all 72 data sets and to analyze their frequency patterns. Volume-rendered images of the data sets were ranked by six independent and blinded readers; findings were correlated with acquisition parameters and SD(r) measurements. RESULTS: SD(r) was smaller in four- than in single-channel helical CT for any given table increment (TI). In single-channel helical CT, SD(r) increased linearly with beam width and geometrically with pitch. In four-channel helical CT, SD(r) measurements were directly proportional to the TI, regardless of the detector width and pitch combination used. Off-center object position on average increased SD(r) by a factor of 1.6 for single-channel helical CT and by a factor of 2.0 for four-channel helical CT. Subjective rankings of image quality correlated excellently with SD(r) (Spearman r = 0.94, P <.001). CONCLUSION: Artifacts are quantitatively and subjectively smaller with four- compared with single-channel helical CT for any given TI.

Artifacts↗

PubMed1999

The pharmacokinetic characteristics of glycolated humanized anti-Tac Fabs are determined by their isoelectric points.

To evaluate a method for preventing the nephrotoxicity caused by the high renal accumulation of radiolabeled or toxin-conjugated small immunoproteins used for cancer therapy, we conjugated humanized anti-Tac Fab fragments with various numbers of glycolate molecules [glycolated Fab fragments (glyco-Fabs)] and separated the conjugates by means of ion-exchange columns into three fractions, depending on their isoelectric points (pIs). We evaluated the biodistribution, pharmacokinetics, and catabolism in normal nude mice of nonglycolated Fab (pI > or = 9.3) and three different preparations of glyco-Fab, including strongly anionic glyco-Fab (sa-glyco-Fab: pI < or = 4.5), mildly anionic glyco-Fab (pI = 4.5-7), and mildly cationic glyco-Fab (pI = 7-9.3). In addition, the biodistributions of 125I-labeled sa-glyco-Fab and 131I-labeled nonglycolated Fab were evaluated in normal nude mice coinjected with 50 mg of L-lysine and/or 1 microg of furosemide and in a control group without coinjection. We then evaluated the serial biodistribution of 125I-labeled sa-glyco-Fab (4 microCi/1 microg) and 131I-labeled nonglycolated Fab (5 microCi/1 microg) in Tac antigen-positive (ATAC4) and -negative (A431) tumor-bearing nude mice with s.c. tumor xenografts derived from Tac antigen-positive ATAC4 cells and receptor-negative A431 cells. These animals were coinjected with 30 mg of lysine i.v. and 30 mg of lysine i.p. 15 min after the radiolabeled Fab injection. To evaluate the biodistribution data and study scintigraphic imaging, we performed serial scintigraphy on normal and tumor-bearing mice with all four 131I-labeled preparations. 125I-labeled mildly cationic glyco-Fab and 131I-labeled nonglycolated Fab had similar distributions, except in the kidney. However, both 125I-labeled anionic glyco-Fab preparations showed significantly different distributions from both cationic Fabs in the blood, liver, lung, and spleen. Renal accumulation of all four radiolabeled Fab preparations increased significantly as the pI increased (P < 0.01). In addition, the intact fraction of Fab excreted into urine increased as pI decreased. Therefore, the glomerular filtration depended on whether the charge on the Fab was positive or negative. The proportion of Fab reabsorbed by the proximal tubules increased as pI increased. 125I-labeled sa-glyco-Fab and 125I-labeled mildly anionic glyco-Fab showed a similar distribution in the blood and all organs except the kidney. Lysine led to an additional blocking effect on proximal tubular uptake of both sa-glyco-Fab and nonglycolated Fab. Addition of furosemide yielded only a small effect when used with lysine. With lysine, the sa-glyco-Fab:nonglycolated Fab estimated integral radioactivity ratios were 4.7 and 0.7 in the ATAC4 tumor and in the kidney, respectively. The use of anionic fragments, which may be used in conjunction with lysine, represents a promising approach that may help decrease the renal toxicity of other small fragments, the molecular weights of which range from Mr 40,000 to 70,000, and, thereby, allow higher doses of radiation to the tumor.

Animals↗

PubMed1999

Fast 3D cardiac cine MR imaging.

We describe a technique for three-dimensional cine MR imaging. By using short repetition times (TR) and interleaved slice encoding, volumetric cine data can be acquired throughout the cardiac cycle with a temporal resolution of approximately 80 msec. A T1-shortening agent is used to produce contrast between blood and myocardium. A comparison between the acquisition times of this and several other two-dimensional techniques is presented.

Contrast Media↗

PubMed1999

Display modes for CT colonography. Part II. Blinded comparison of axial CT and virtual endoscopic and panoramic endoscopic volume-rendered studies.

PURPOSE: To determine the sensitivity of radiologist observers for detecting colonic polyps by using three different data review (display) modes for computed tomographic (CT) colonography, or "virtual colonoscopy." MATERIALS AND METHODS: CT colonographic data in a patient with a normal colon were used as base data for insertion of digitally synthesized polyps. Forty such polyps (3.5, 5, 7, and 10 mm in diameter) were randomly inserted in four copies of the base data. Axial CT studies, volume-rendered virtual endoscopic movies, and studies from a three-dimensional mode termed "panoramic endoscopy" were reviewed blindly and independently by two radiologists. RESULTS: Detection improved with increasing polyp size. Trends in sensitivity were dependent on whether all inserted lesions or only visible lesions were considered, because modes differed in how completely the colonic surface was depicted. For both reviewers and all polyps 7 mm or larger, panoramic endoscopy resulted in significantly greater sensitivity (90%) than did virtual endoscopy (68%, P = .014). For visible lesions only, the sensitivities were 85%, 81%, and 60% for one reader and 65%, 62%, and 28% for the other for virtual endoscopy, panoramic endoscopy, and axial CT, respectively. Three-dimensional displays were more sensitive than two-dimensional displays (P < .05). CONCLUSION: The sensitivity of panoramic endoscopy is higher than that of virtual endoscopy, because the former displays more of the colonic surface. Higher sensitivities for three-dimensional displays may justify the additional computation and review time.

Colonic Polyps↗

PubMed1999

Display modes for CT colonography. Part I. Synthesis and insertion of polyps into patient CT data.

PURPOSE: To develop and validate a method for the insertion of digitally synthesized polyps into computed tomographic (CT) images of the human colon for use as ground truth for evaluation of virtual colonoscopy. MATERIALS AND METHODS: Spiral CT simulator software was used to generate 10 synthetic polyps in various configurations. Additional software was developed to insert these polyps into volume CT scans. Ten polyps in eight patients were selected for comparison. Three radiologists evaluated whether two-dimensional (2D) CT images and three-dimensional (3D) volume-rendered CT images showed synthetic or real polyps. RESULTS: Edge-response profiles and noise of simulated polyps matched those of native polyps. Frequency distributions of reviewers' responses were not significantly different for synthetic versus real polyps in either 3D or 2D images. Responses were clustered around the response of "unsure" if lesions were real or synthetic. Receiver operating characteristic curves had areas of 0.54 (95% CI = 0.39, 0.68) for 3D and 0.39 (95% CI = 0.25, 0.53) for 2D images, which were not significantly different from random guessing (P = .70 and .28 for 3D and 2D images, respectively). CONCLUSION: Synthetic polyps were indistinguishable from real polyps. This method can be used to generate ground truth experimental data for comparison of CT colonographic display and detection methods.

Adult↗

PubMed1999

Favorable effects of glycolate conjugation on the biodistribution of humanized antiTac Fab fragment.

UNLABELLED: One of the major limitations of using intact immunoglobulins for targeting tumors is poor penetration into tissues. Although Fab fragments have been used because of their improved kinetics, they have undesirable high renal accumulation. In this study we tested a new approach to block renal accumulation of Fab. METHODS: We conjugated humanized antiTac Fab fragments, which are directed against the interleukin-2 receptor, with glycolate. The biodistribution, pharmacokinetics and catabolism of glycolated Fab (glyco-Fab) were evaluated at two different levels of substitution (heavy and light) compared with nonglycolated Fab in Tac-antigen-positive (ATAC4) and -negative (A431) tumor-bearing nude mice. The mice received coinjections of 125I-labeled glyco-Fab (3 microCi/1 microg) and 131I-labeled nonglycolated Fab (5 microCi/1 microg). In addition, groups of mice receiving these reagents were also coinfused with 50 mg L-lysine. RESULTS: Significantly less glyco-Fab than nonglycolated Fab accumulated in the kidney (21 versus 189 %ID/g; P < 0.001). A higher proportion of glyco-Fab was excreted into the urine in its intact form. The glyco-Fab survived longer in circulation than nonglycolated Fab. The peak tumor accumulation of glyco-Fab was 2.3-fold greater than that of nonglycolated Fab. Furthermore, the ATAC4 tumor-to-normal tissue ratio of glyco-Fab was much higher in all organs than that of nonglycolated Fab. The heavily glyco-Fab accumulated less in the kidney than the lightly glyco-Fab. The coinjected lysine reduced the renal accumulation of both nonglycolated Fab and glyco-Fab. CONCLUSION: Glyco-Fab is a promising agent because of its lower renal accumulation, higher tumor uptake and higher tumor-to-normal tissue ratio.

Animals↗

PubMed1998

Automated flight path planning for virtual endoscopy.

In this paper, a novel technique for rapid and automatic computation of flight paths for guiding virtual endoscopic exploration of three-dimensional medical images is described. While manually planning flight paths is a tedious and time consuming task, our algorithm is automated and fast. Our method for positioning the virtual camera is based on the medial axis transform but is much more computationally efficient. By iteratively correcting a path toward the medial axis, the necessity of evaluating simple point criteria during morphological thinning is eliminated. The virtual camera is also oriented in a stable viewing direction, avoiding sudden twists and turns. We tested our algorithm on volumetric data sets of eight colons, one aorta and one bronchial tree. The algorithm computed the flight paths in several minutes per volume on an inexpensive workstation with minimal computation time added for multiple paths through branching structures (10%-13% per extra path). The results of our algorithm are smooth, centralized paths that aid in the task of navigation in virtual endoscopic exploration of three-dimensional medical images.

Algorithms↗

PubMed1998

Measurement of the aorta and its branches with helical CT.

Contiguous orthonormal arterial cross sections, segment lengths, and curvature were semiautomatically quantified from helical computed tomographic (CT) angiographic data in phantoms and two patients. Measurements of mean diameter and curvature correlated with reference values (r2 = .99), and mean fractional errors were 0.07 and 0.06 for mean diameter and curvature measurements, respectively. Volumetric measurement showed a potential to increase the accuracy, precision, and diagnostic utility of CT angiography.

Adult↗

PubMedDate not supplied

Visualization modes for CT colonography using cylindrical and planar map projections.

PURPOSE: The purpose of this study was to demonstrate the limitations to the effectiveness of CT colonography, colloquially called virtual colonoscopy (VC), for detecting polyps in the colon and to describe a new technique, map projection CT colonography using Mercator projection and stereographic projection, that overcomes these limitations. METHOD: In one experiment, data sets from nine patients undergoing CT colonography were analyzed to determine the percentage of the mucosal surface visible in various visualization modes as a function of field of view (FOV). In another experiment, 40 digitally synthesized polyps of various sizes (10, 7, 5, and 3.5 mm) were randomly inserted into four copies of one patient data set. Both Mercator and stereographic projections were used to visualize the surface of the colon of each data set. The sensitivity and positive predictive value (PPV) were calculated and compared with the results of an earlier study of visualization modes using the same CT colonography data. RESULTS: The percentage of mucosal surface visualized by VC increases with greater FOV but only approaches that of map projection VC (98.8%) at a distorting, very high FOV. For both readers and polyp sizes of > or =7 mm, sensitivity for Mercator projection (87.5%) and stereographic projection (82.5%) was significantly greater (p < 0.05) than for viewing axial slices (62.5%), and Mercator projection was significantly more sensitive than VC (67.5%). Mercator and stereographic projection had PPVs of 75.4 and 78.9%, respectively. CONCLUSION: The sensitivity of conventional CT colonography is limited by the percentage of the mucosal surface seen. Map projection CT colonography overcomes this problem and provides a more sensitive method with a high PPV for detecting polyps than other methods currently being investigated.

Adult↗