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Biomedical subjects

R Razavi

Publications and source records attributed to R Razavi.

At least 19 recordsLinked to original sources

Cardiac function estimation from MRI using a heart model and data assimilation: advances and difficulties.

In this paper, we present a framework to estimate local ventricular myocardium contractility using clinical MRI, a heart model and data assimilation. First, we build a generic anatomical model of the ventricles including muscle fibre orientations and anatomical subdivisions. Then, this model is deformed to fit a clinical MRI, using a semi-automatic fuzzy segmentation, an affine registration method and a local deformable biomechanical model. An electromechanical model of the heart is then presented and simulated. Finally, a data assimilation procedure is described, and applied to this model. Data assimilation makes it possible to estimate local contractility from given displacements. Presented results on fitting to patient-specific anatomy and assimilation with simulated data are very promising. Current work on model calibration and estimation of patient parameters opens up possibilities to apply this framework in a clinical environment.

Adult↗

Localization of abnormal conduction pathways for tachyarrhythmia treatment using tagged MRI.

Tachyarrhythmias are pathological fast heart rhythms often caused by abnormally conducting myocardial areas (foci). Treatment by radio-frequency (RF) ablation uses electrode-catheters to monitor and destroy foci. The procedure is normally guided with x-rays (2D), and thus prone to errors in location and excessive radiation exposure. Our main goal is to provide pre- and intra-operative 3D MR guidance in XMR systems by locating the abnormal conduction pathways. We address the inverse electro-mechanical relation by using motion in order to infer electrical propagation. For this purpose we define a probabilistic measure of the onset of regional myocardial activation, derived from 3D motion fields obtained by tracking tagged MR sequences with non-rigid registration. Activation isochrones are then derived to determine activation onset. We also compare regional motion between two different image acquisitions, thus assisting in diagnosing arrhythmia, in follow up of treatment, and in determining whether the ablation was successful. Difference maps of isochrones and other motion descriptors are computed to determine abnormal patterns. Validation was carried out using an electromechanical model of the heart, synthetic data, a cardiac MRI atlas of motion and geometry, MRI data from 6 healthy volunteers (one of them subjected to stress), and an MRI study on a patient with tachyarrhythmia, before and after RF ablation. A pre-operative MRI study on a second patient with tachyarrhythmia was used to test the methodology in a clinical scenario, predicting the abnormally conducting region.

Adult↗

Simulation of cardiac pathologies using an electromechanical biventricular model and XMR interventional imaging.

Simulating cardiac electromechanical activity is of great interest for a better understanding of pathologies and for therapy planning. Design and validation of such models is difficult due to the lack of clinical data. XMR systems are a new type of interventional facility in which patients can be rapidly transferred between X-ray and MR systems. Our goal is to design and validate an electromechanical model of the myocardium using XMR imaging. The proposed model is computationally fast and uses clinically observable parameters. We present the integration of anatomy, electrophysiology, and motion from patient data. Pathologies are introduced in the model and simulations are compared to measured data. Initial qualitative comparison on the two clinical cases presented is encouraging. Once fully validated, these models will make it possible to simulate different interventional strategies.

Algorithms↗

The expression of inducible cAMP early repressor (ICER) is altered in prostate cancer cells and reverses the transformed phenotype of the LNCaP prostate tumor cell line.

Inducible cAMP early repressor (ICER) has been shown to be an important mediator of cAMP antiproliferative activity. In this report, it was found that cAMP retards LNCaP cell growth; in contrast, cAMP inhibits the growth of PC-3 and DU-145 cells. ICER protein levels were markedly reduced in prostate cancer epithelial cells and undetectable and uninducible by cAMP in LNCaP and DU 145 cells. Forced expression of ICER in LNCaP cells caused inhibition of cell growth and thymidine incorporation and halted cells at the G(1) phase of the cell cycle. These ICER-bearing LNCaP cells were rendered unable to grow in soft agar and unable to form tumors in nude mice. These results suggest that deregulation of ICER expression may be related to carcinogenesis of the prostate gland.

8-Bromo Cyclic Adenosine Monophosphate↗

Mitogen-activated protein kinase phosphorylates and targets inducible cAMP early repressor to ubiquitin-mediated destruction.

Inducible cAMP early repressor (ICER) is an important mediator of cAMP antiproliferative activity that acts as a putative tumor suppressor gene product. In this study, we examined the regulation of ICER protein by phosphorylation and ubiquitination in human choriocarcinoma JEG-3 and mouse pituitary AtT20 cells. We found that cAMP stabilized ICER protein by inhibiting the mitogen-activated protein kinase (MAPK) cascade. Activation of the MAPK pathway increased ICER phosphorylation. ICER phosphorylation was abrogated by inhibition of the MAPK pathway either by cAMP or directly by the MAPK inhibitor PD098059. The MAPKs extracellular signal-regulated kinases 1 and 2 physically interact with ICER and mediated the phosphorylation of ICER on a critical serine residue (Ser-41). A mutant form of ICER in which Ser-41 was substituted by alanine had a half-life 4-5 h longer than its wild-type counterpart. This alteration in stability was due to the inability of the Ser-41-mutant ICER to be efficiently ubiquitinated and degraded via the ubiquitin-proteasome pathway. These results present a novel cell signaling cross-talk mechanism at the cell nucleus between the MAPK and cAMP pathways, whereby MAPK targets a repressor of the cAMP-dependent gene expression for ubiquitination and proteasomal degradation.

Animals↗

Pulmonary arterial thrombosis in a neonate with homozygous deficiency of antithrombin III: successful outcome following pulmonary thrombectomy and infusions of antithrombin III concentrate.

We report a newborn male who presented with severe central cyanosis on the third day of life. Partial thrombotic obstruction of the pulmonary trunk secondary to Antithrombin III (homozygous defect of heparin binding site) deficiency was subsequently diagnosed. Surgical thrombectomy, and infusions of Antithrombin III concentrate, led to a successful outcome. We postulate that intrauterine thrombosis occurred to give this unusual presentation.

Anticoagulants↗

ICER-IIgamma is a tumor suppressor that mediates the antiproliferative activity of cAMP.

The second messenger cAMP inhibits the proliferation of most cell types. The nuclear response of cAMP is mediated by transcription factors like the cAMP-Responsive Element Modulator (CREM) gene. One of the products of the CREM gene, the transcriptional repressor Inducible cAMP Early Repressor-IIgamma (ICER-IIgamma), is induced by cAMP. ICER-IIgamma blocks cells at the G2/M boundary of the cell cycle. Here we show that ICER-IIgamma dramatically inhibits the growth and DNA synthesis of mouse pituitary tumor cells and human choriocarcinoma cells. This alteration in cell growth is coupled with reduced ability of these cells to grow in an anchorage-independent manner and to form tumors in mice. These data demonstrate that ICER-IIgamma is a tumor suppressor gene product mediating the antiproliferative activity of cAMP.

Agar↗

Radiation dose perturbation at tissue-titanium dental interfaces in head and neck cancer patients.

PURPOSE: To determine the dose perturbation effects at the tissue-metal implant interfaces in head and neck cancer patients treated with 6 MV and 10 MV photon beams. METHODS AND MATERIALS: Phantom measurements were performed to investigate the magnitude of dose perturbation to the tissue adjacent to the titanium alloy implants with (100 mu and 500 mu thick) and without hydroxylapatite (HA) coating. Radiographic and radiochromic films were placed at the upper (and lower) surface of circular metal discs (diameter x thickness: 15 x 3.2, 48 x 3.2, 48 x 3.8 mm2) in a solid water phantom and were exposed perpendicular to radiation beams. The dosimeters were scanned with automatic film scanners. Using a thin-window parallel-plate ion chamber, dose perturbation were measured for a 48 x 3.2 mm2 disc. RESULTS: At the upper surface of the tissue-dental implant interface, the radiographic data indicate that for 15 x 3.2 mm2 uncoated, as well as 100 mu coated discs, dose perturbation is about +22.5% and +20.0% using 6 MV and 10 MV photon beams, respectively. For 48 x 3.2 mm2 discs, these values basically remain the same. However, for 48 x 3.8 mm2 discs, these values increase slightly to about +23.0% and +20.5% for 6 MV and 10 MV beams, respectively. For 48 x 3.2 mm2 discs with 500 mu coating, dose enhancement is slightly lower than that obtained for uncoated and 100 mu coated discs for each beam energy studied. At the lower interface for 15 x 3.2 mm2 and 48 x 3.2 mm2 uncoated and 100 mu coated discs, dose reduction is similar and is about -13.5% and -9.5% for 6 MV and 10 MV beams, respectively. For 48 x 3.8 mm2 discs, dose reduction is about -14.5% and -10.0% for 6 MV and 10 MV beams, respectively. For 48 x 3.2 mm2 discs with 500 mu coating, the dose reduction were slightly higher than those for uncoated and 100 mu coated discs. CONCLUSIONS: For the beam energies studied, dose enhancement is slightly larger for the lower energy beam. The results of dose perturbation were similar for 100 mu coated and uncoated discs. These results were slightly lower for the 500 mu coated discs but are not clinically significant. The dosimetry results obtained from radiochromic films were similar to the ones obtained from radiographic film. The dose enhancement results obtained from ion chamber dosimetry are higher than those obtained from film dosimetry. The ion chamber data represent the data at "true" tissue-titanium interface, whereas the ones obtained from film dosimetry represent the data at film-titanium interface.

Biocompatible Materials↗

Anatomic site evaluation of edentulous maxillae for dental implant placement.

PURPOSE: This study evaluated 17 edentulous cadavers for bone quantity and quality of the alveolar process of the maxilla for the purpose of dental implant placement. MATERIALS AND METHODS: The maxillary arch was divided into four anatomically defined regions for measurements of bone quantity. Bone quality was assessed histologically and described by trabecular bone patterns and tissue composition. RESULTS: Average bone height with a minimum thickness of 4 mm was as follows: region 1, 12.1 +/- 4.9 mm; region 2, 14.1 +/- 7.2 mm; region 3, 6.1 +/- 2.8 mm; and region 4, 8.5 +/- 2.2 mm. Histological evaluation showed increased trabeculation and thicker cortex in the maxillary anterior area, regions 1 and 2. Region 3, the floor of the maxillary sinus area, had the least amount of bone; however, the quality of bone was superior to that of region 4, the maxillary tuberosity area. Trabecular distance or marrow spaces ranged from 40 microns to 2 mm with larger spaces associated with the posterior maxilla. CONCLUSIONS: Maxillary tuberosity is the least desirable site for the placement of implants in the maxilla. The area corresponding to the first and second molars had the least bone thickness. All measures of bone preservation need to be considered, especially in this area.

Aged↗

Use of dental implants for rehabilitation of mandibulectomy patients prior to radiation therapy.

The use of dental implants can aid in prosthetic rehabilitation of patients after ablative cancer surgery of the oral cavity. Biological effects of radiation therapy and the enhancement of radiation by metal implants have limited the use of dental implants. This article presents a case of dental implants used prior to radiation therapy for rehabilitation of a mandibulectomy patient and discusses the current understanding of radiation effects on bone and metal implants.

Alveolar Process↗

Clinical applications of a polyphosphazene-based resilient denture liner.

The use of resilient denture liners provides an invaluable modality in removable prosthodontic treatment. Treatment of atrophic mandibles, preoperative and postoperative soft tissue management, and retention of removable prosthesis are a few applications of these materials. This article describes the clinical application of a polyphosphazene-based liner (Novus, Hygenic Corp, Dayton, OH) as a denture liner and retentive material in conventional and implant overdenture rehabilitation.

Dental Implants↗

The bond strength of a visible light-cured reline resin to acrylic resin denture base material.

The introduction of Triad visible light-cured denture resin has led to several applications. Among them is direct intraoral relining of complete and partial dentures. This study investigated the bonding characteristics of Triad reline resin to four commonly used heat-cured denture base resins. The shear and tensile bond strengths of Triad resin and four denture base resins were determined and compared with intact tensile strengths. The findings of this study indicate that the bond strength of Triad resin to denture base resin is sufficiently high to suggest its clinical applicability.

Acrylic Resins↗