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Contrast enhancement of vascular walls of intracranial high flow malformations in black blood MRI indicates high inflammatory activity

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Chinese Neurosurgical Journal 2018年第2期4卷 89-93页

作者： Athanasios k.petridis Maxine Dibue-Adjei Jan F.Cornelius Marian Preetham Suresh Lan Li Marcel A.kamp Yousef Abusabha Bernd Turowski Hans Jakob Steiger Rebecca May Department of Neurosurgery Heinrich Heine UniversityDuesseldorfGermany LivaNova Deutschland GmbH(a LivaNova PLC-owned subsidiary) Lindberghstr 25D-80939 MunichGermany Diagnostic and Interventional Neuroradiology Heinrich Heine UniversityDuesseldorfGermany Department of Neurosurgery Niederrhein HospitalDuisburgGermany

Background: There are controversies concerning the natural history of arteriovenous malformations (AVMs) in literature and it is not clear which AVMs should be treated and which should be just observed. Objective criteria beyond growth in serial MRIs or angiographies are needed. The use of black blood MRI is currently under investigation for evaluating the rupture risk of cerebral aneurysms, however its use for assessment of AVMs has yet to be evaluated. We therefore conducted a feasibility study on the application of black blood MRI (bbMRI) in AVMs to assess rupture risk. Methods: Retrospective study of 10 patients with intracranial AVMs and 4 patients with arteriovenous fistulas who received a black blood MRI before treatment. Results: AVM niduses (9/10) show contrast enhancement irrespective of rupture or size. All arteriovenous fistulas (4/4) were contrast enhancing irrespective of rupture. Conclusion: High flow malformations are in a permanent stage of inflammation which does not seem to allow conclusions on their rupture risk at the current stage. BbMRI is a feasible method of identifying inflammation in AVMs and arteriovenous fistulas. However, future prospective studies are needed to evaluate whether bbMRI contrast enhancement correlates with rupture risk.

关键词： Arteriovenous malformation Arteriovenous fistula Black blood MRI Inflammation

Cavernous brain malformations and their relation to black blood MRI in respect to vessel wall contrast enhancement

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Chinese Neurosurgical Journal 2018年第2期4卷 65-68页

作者： Athanasios k.petridis Marian P.Suresh Jan F.Cornelius Richard Bostelmann Maxine Dibué-Adjei Lan Li Marcel A.kamp Hans Jakob Steiger Bernd Turowski Rebecca May Department of Neurosurgery Heinrich Heine University DüsseldorfMoorenstr 540225 DüsseldorfGermany Diagnostic and Interventional Neuroradiology Heinrich Heine University DüsseldorfDüsseldorfGermany LivaNova Deutschland(a LivaNova PLC-owned subsidiary) Lindberghstr 2580939 MunichGermany

Background: Inflammatory responses are implicated as crucial patho-mechanisms of vascular brain malformations. Inflammation is suggested to be a key contributor to aneurysm rupture; however it is unclear whether inflammation contributes similarly to bleeding of cerebral cavernous malformations (CCMs). Black blood MRI is a sequence which identifies inflammation in blood vessel walls and in the present study is used to detect inflammatory response in CCMs. Methods: Fifteen patients with 17 CCMs treated in our department in 2017 were retrospectively analysed. All patients received black blood MRIs and the results were analysed in correlation with, size and bleeding of CCMs. Results: Size and bleeding status of CCMs did not correlate with contrast enhancement in the CCM wall. One of 3 patients with bleeding displayed contrast enhancement in black blood MRI, whereas the others had non enhancing lesions. Because of the small number of cases a statistical analysis was not performed. Conclusion: In this limited cohort, inflammatory reactions in CCMs could not be detected by black blood MRI suggesting that the level of inflammation is minimal in these lesions and those different patho-mechanisms play a more important role in the rupture of CCMs.

关键词： Cavernous malformations Inflammation Black blood MRI

The effect of platform switching on the levels of metal ion release from different implant–abutment couples

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International Journal of Oral Science 2016年第2期8卷 117-125页

作者： Ghada O Alrabeah Jonathan C knowles Haralampos petridis Division of Biomaterials and Tissue Engineering UCL Eastman Dental Institute University College London London UK Prosthodontic Unit Department of Restorative Dentistry UCL Eastman Dental Institute University College London London UK

The improved peri-implant bone response demonstrated by platform switching may be the result of reduced amounts of metal ions released to the surrounding tissues. The aim of this study was to compare the levels of metal ions released from platform-matched and platform-switched implant-abutment couples as a result of accelerated corrosion. Thirty-six titanium alloy （Ti-6AI-4V） and cobalt-chrome alloy abutments were coupled with titanium cylinders forming either platform-switched or platform-matched groups （n = 6）. In addition, 18 unconnected samples served as controls. The specimens were subjected to accelerated corrosion by static immersion in 1% lactic acid for 1 week. The amount of metal ions ion of each test tube was measured using inductively coupled plasma mass spectrometry. Scanning electron microscope （SEM） images and energy dispersive spectroscopy X-ray analyses were performed pre- and post-immersion to assess corrosion at the interface. The platform-matched groups demonstrated higher ion release for vanadium, aluminium, cobalt, chrome, and molybdenum compared with the platform-switched groups （P〈 0.05）. Titanium was the highest element to be released regardless of abutment size or connection （P〈0.05）. SEM images showed pitting corrosion prominent on the outer borders of the implant and abutment platform surfaces. In conclusion, implant-abutment couples underwent an active corrosion process resulting in metal ions release into the surrounding environment. The highest amount of metal ions released was recorded for the platform-matched groups, suggesting that platform-switching concept has a positive effect in reducing the levels of metal ion release from the implant-abutment couples.

关键词： corrosion dental implants ion release peri-implant bone loss platform-switching titanium

The art of daily life

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The art of daily life

Endoscopic treatment of biliary complications after liver transplantation

作者： Constantine petridis

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World Journal of Gastroenterology 2008年第26期14卷 4185-4189页

作者： Ilaria Tarantino Luca Barresi Ioannis petridis Riccardo Volpes Mario Traina Bruno Gridelli Department of Gastroenterology Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT)University of Pittsburgh Medical Center (UPMC)Palermo 90100Italy Department of Surgery Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT)University of Pittsburgh Medical CenterPalermo 90100Italy

AIM： To evaluate the efficacy of endoscopic treatment in patients who undergo OLTx or LRLTx and develop biliary complications. METHODS： This is a prospective, observational study of patients who developed biliary complications, after OLTx and LRLTx, with duct-to-duct anastomosis performed between June 2003 and June 2007. Endoscopic Retrograde Cholangiopancreatography （ERCP） was considered unsuccessful when there was evidence of continuous bile leakage despite endoscopic stent placement, or persistence of stenosis after i year, despite multiple dilatation and stent placement. When the ERCP failed, a percutaneous trans-hepatic approach （PTC） or surgery was adopted. RESULTS： From June 2003 to June 2007, 261 adult patients were transplanted in our institute, 68 from living donors and 193 from cadaveric donors. In the OLTx group the rate of complications was 37.3%, while in the LRLTx group was 64.7%. The rate of ERCP failure was 19.4% in the OLTx group and 38.6% in LRLTx group. In OLTx group, i patient was retransplanted and 8 patients died. In the LRLTx group, 2 patients underwent OLTx and 8 patients died. The follow-up was 23.3±13.13 mo and 21.02± 14.10 mo, ***： Albhough ERCP is quite an effective mode of managing post-transplant bile duct complications, a significant number of patients need other types of approach. Further prospective studies are necessary in order to establish whebher obher endoscopic protocols or new devices, could improve bhe current results.

关键词： Endoscopic retrograde cholangiopancreatography Biliary complication Liver transplant Benignstenosis Biliary leak

Transjugular intrahepatic portosystemic shunt with accidental diagnosis of persistence of the left superior vena cava

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World Journal of Gastroenterology 2010年第9期16卷 1158-1160页

作者： Ioannis petridis Roberto Miraglia Gianluca Marrone Salvatore Gruttadauria Angelo Luca Giovanni Battista Vizzini Bruno Gridelli Department of Gastroenterology and Hepatology Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IsMeTT)University of Pittsburgh Medical Center Department of Diagnostic and Interventional Radiology Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IsMeTT)University of Pittsburgh Medical Center Department of Abdominal Surgery and Organ Transplantation Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IsMeTT)University of Pittsburgh Medical Center

Transjugular intrahepatic portosystemic shunt (TIPSS) is considered a valid therapeutic option for the treatment of portal hypertension and its *** guidelines for this procedure have already been established on the basis of the normal vascular anatomy and of various technical radiological *** some few rare cases,diagnosis of a congenital vascular anomaly can be made accidentally by interventional radiologists,making the procedure of the TIPSS placement extremely difficult or in some cases technically *** report describes a rare vascular malformation characterized by the absence of the right superior vena cava and persistence of the left superior vena cava in a patient with a diagnosis of advanced liver cirrhosis who needed a TIPSS placement in order to control refractory ascites.

关键词： Left superior vena cava persistence Liver cirrhosis Refractory ascites Transjugular intrahepatic portosystemic shunt

Multimodal teaching,learning and training in virtual reality:a review and case study

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Virtual Reality & Intelligent Hardware 2020年第5期2卷 421-442页

作者： Stéphanie PHILIPPE Alexis DSOUCHET Petros LAMERAS Panagiotis petridis Julien CAPORAL Gildas COLDEBOEUF Hadrien DUZAN Department of Research ManzalabParisFrance Paragraph Laboratory Paris 8 UniversitySaint-DenisFrance School of Computing Electronics and MathematicsCoventry UniversityUnited Kingdom Aston Business School Aston UniversityUnited Kingdom Manzalab Singapore

It is becoming increasingly prevalent in digital learning research to encompass an array of different meanings,spaces,processes,and teaching strategies for discerning a global perspective on constructing the student learning *** is an emergent phenomenon that may influence how digital learning is designed,especially when employed in highly interactive and immersive learning environments such as Virtual Reality(VR).VR environments may aid students'efforts to be active learners through consciously attending to,and reflecting on,critique leveraging reflexivity and novel meaning-making most likely to lead to a conceptual *** paper employs eleven industrial case-studies to highlight the application of multimodal VR-based teaching and training as a pedagogically rich strategy that may be designed,mapped and visualized through distinct VR-design elements and *** outcomes of the use cases contribute to discern in-VR multimodal teaching as an emerging discourse that couples system design-based paradigms with embodied,situated and reflective praxis in spatial,emotional and temporal VR learning environments.

关键词： Virtual reality Multimodality Training Teaching and learning Semiotic resources

Efficacy of transcatheter embolization/chemoembolization (TAE/TACE) for the treatment of single hepatocellular carcinoma

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World Journal of Gastroenterology 2007年第21期13卷 2952-2955页

作者： Roberto Miraglia Giada Pietrosi Luigi Maruzzelli Ioannis petridis Settimo Caruso Gianluca Marrone Giuseppe Mamone Giovanni Vizzini Angelo Luca Bruno Gridelli Istituto Mediterraneo Trapianti e Terapie ad Alta Specializzazione (IsMeTT).University of Pittsburgh Medical Center Italy

AIM:To investigate the efficacy of transcatheter embolization/chemoembolization (TAE/TACE) in cirrhotic patients with single hepatocellular carcinoma (HCC) not suitable for surgical resection and percutaneous ablation therapy. METHODS:A cohort of 176 consecutive cirrhotic patients with single HCC undergoing TAE/TACE was reviewed; 162 patients had at least one image examination (helical CT scan or triphasic contrastenhanced MRI) after treatment and were included into the study. TAE was performed with Lipiodol followed by Gelfoam embolization; TACE was performed with Farmorubicin prepared in sterile drip at a dose of 50 mg/m2,infused over 30 min using a peristaltic pump,and followed by Lipiodol and Gelfoam embolization. RESULTS:Patients characteristics were:mean age,62 years; male/female 117/45; Child-Pugh score 6.2 ± 1.1; MELD 8.7 ± 2.3; mean HCC size,3.6 (range 1.0-12.0) cm. HCC size class was ≤ 2.0 cm,n = 51; 2.1-3.0 cm,n = 35; 3.1-4.0 cm,n = 29; 4.1-5.0 cm,n = 22; 5.1-6.0 cm,n = 11; and > 6.0 cm,n = 14. Patients received a total of 368 TAE/TACE (mean 2.4 ± 1.7). Complete tumor necrosis was obtained in 94 patients (58%),massive (90%-99%) necrosis in 16 patients (10%),partial (50%-89%) necrosis in 18 patients (11%) and poor ( 6.0 cm,respectively. kaplan-Mayer survival at 24-mo was 88%,68%,59%,59%,45%,and 53% for lesions of ≤ 2.0,2.1-3.0,3.1-4.0,4.1-5.0,5.1-6.0,and > 6.0 cm,respectively. CONCLUSION:Our study showed that in cirrhotic patients with single HCC smaller than 6.0 cm,TAE/TACE produces complete local control of tumor in a significant proportion of patients. TAE/TACE is an effective therapeutic option in patients with single HCC not suitable for surgical resection or percutaneous ablation therapies. Further studies should investigate if the new available embo

关键词： Transcatheter embolization/chemoembolization Hepatocellular carcinoma

Predictive factors of tumor response to trans-catheter treatment in cirrhotic patients with hepatocellular carcinoma:A multivariate analysis of pre-treatment findings

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World Journal of Gastroenterology 2007年第45期13卷 6022-6026页

作者： Roberto Miraglia Giada Pietrosi Luigi Maruzzelli Ioannis petridis Settimo Caruso Gianluca Marrone Giuseppe Mamone Giovanni Vizzini Angelo Luca Bruno Gridelli Department of Radiology Mediterranean Institute for Transplantation and A dvanced Specialized Therapies(IsMeTT)University of Pittsburgh Medical Center Palermo90127Italy Department of Hepatology Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IsMeTT) University of Pittsburgh Medical Center Palermo 90127 Italy Department of Transplantation Surgery Mediterranean Institute for Transplantation and AdvancedSpecialized Therapies (IsMeTT) University of Pittsburgh MedicalCenter Palermo 90127 Italy

AIM： To elucidate the pre-treatment clinical and imaging findings affecting the tumor response to the transcatheter treatment of unresectable hepatocellular carcinoma （HCC）. METHODS： Two hundred cirrhotic patients with HCC received a total of 425 transcatheter treatments. The tumor response was evaluated by helical CT and a massive necrosis （MN） was defined as a necrosis 〉 90%. Twenty-five clinical and imaging variables were analyzed： uninodular/multinodular HCC, unilobar/bilobar, tumor capsula, hypervascular lesion, portal vein thrombosis, portal hypertension, ascites, platelets count, aspartate transaminases/alanine transaminases （AST/ALT）, alfa- fetoprotein （AFP）〉 100, AFP 〉 400, serum creatinine, virus hepatitis C （VHC） cirrhosis, performance status, age, Okuda stage, ChUd-Pugg stage, sex, CLIP （Cancer of the Liver Italian Program） score, serum bilirubin, constitutional syndrome, serum albumine, prothrombin activity, BCLC （Barcelona Clinic Liver Cancer） stage. Prognostic factors of response were subjected to univariate analysis and thereafter, when significant, to the multivariate analyses. RESULTS： On imaging analysis, complete response wasobtained in 60 （30%） patients, necrosis 〉 90% in 38 （19%） patients, necrosis 〉 50% in 44 （22%） patients, and necrosis 〈 50% in 58 （29%） patients. Ninety-eight （49%） of the 200 patients were considered to have a MN. In univariate analysis, significant variables （P 〈 0.01） were： uninodular tumor, unilobar, tumor size 2-6 cm, CLIP score 〈 2, absence of constitutional syndrome, and BCLC stage 〈 2. In a multivariate analysis, the variables reaching statistical significance were： presence of tumor capsule （P 〈 0.0001）, tumor size 2-6 cm （P 〈 0.03）, CLIP score 〈 2 （P 〈 0.006）, and absence of constitutional syndrome （P 〈 0.03）. kaplan-Mayer cumulative survival at 12 mo was 80% at 24 mo was 56%. MN was associated with a longer survival （P 〈 0.0001）. CONCLUSION： MN after transcatheter treatment is more common in the presence of tumor

关键词： Hepatocellular carcinoma Trans-catheterembolization/chemoembolization Tumor response