Medicine and Health Sciences Commons^™

Improving Attenuation Correction In Hybrid Positron Emission To Mography, Hua Asher Ai

Dissertations and Theses (Open Access)

Hybrid positron emission tomography imaging techniques such as PET/CT and PET/MR have undergone significant developments over the last two decades and have played increasingly more important roles both in research and in the clinic. A unique advantage PET has over other clinical imaging modalities is its capability of accurate quantification. However, as the most critical component of PET quantification, attenuation correction in hybrid PET systems is challenged in several different aspects, including the spatial- temporal mismatch between the PET emission images and the associated attenuation images provided by the complementary modality, and the difficulty in bone identification in the MR-based …

Successful Use Of Therapeutic Hypothermia In A Pregnant Patient, Kevin N Oguayo, Ola O Oyetayo, David Stewart, Steven M Costa, Richard O Jones

The Texas Heart Institute Journal

Out-of-hospital cardiac arrest is a leading cause of death in the United States. Pregnant women are not immune to cardiac arrest, and the treatment of such patients can be difficult. Pregnancy is a relative contraindication to the use of therapeutic hypothermia after cardiac arrest.

A 20-year-old woman who was 18 weeks pregnant had an out-of-hospital cardiac arrest. Upon her arrival at the emergency department, she was resuscitated and her circulation returned spontaneously, but her score on the Glasgow Coma Scale was 3. After adequate family discussion of the risks and benefits of therapeutic hypothermia, a decision was made to initiate …

Primary Prevention Of Sudden Cardiac Death In Adults With Transposition Of The Great Arteries: A Review Of Implantable Cardioverter-Defibrillator Placement, Sandeep S Sodhi, Ari M Cedars

The Texas Heart Institute Journal

Transposition of the great arteries encompasses a set of structural congenital cardiac lesions that has in common ventriculoarterial discordance. Primarily because of advances in medical and surgical care, an increasing number of children born with this anomaly are surviving into adulthood. Depending upon the subtype of lesion or the particular corrective surgery that the patient might have undergone, this group of adult congenital heart disease patients constitutes a relatively new population with unique medical sequelae. Among the more common and difficult to manage are cardiac arrhythmias and other sequelae that can lead to sudden cardiac death. To date, the question …

Modified Maze Procedure For Atrial Fibrillation As An Adjunct To Elective Cardiac Surgery: Predictors Of Mid-Term Recurrence And Echocardiographic Follow-Up, Claudia Loardi, Francesco Alamanni, Fabrizio Veglia, Claudia Galli, Alessandro Parolari, Marco Zanobini

The Texas Heart Institute Journal

The radiofrequency maze procedure achieves sinus rhythm in 45%–95% of patients treated for atrial fibrillation. This retrospective study evaluates mid-term results of the radiofrequency maze—performed concomitant to elective cardiac surgery—to determine sinus-rhythm predictive factors, and describes the evolution of patients' echocardiographic variables.

From 2003 through 2011, 247 patients (mean age, 64 ± 9.5 yr) with structural heart disease (79.3% mitral disease) and atrial fibrillation underwent a concomitant radiofrequency modified maze procedure. Patients were monitored by 24-hour Holter at 3, 6, 12, and 24 months, then annually. Eighty-four mitral-valve patients underwent regular echocardiographic follow-up. Univariate and multivariate analysis for risk factors …

Transcatheter Aortic Valve Replacement: A Physician-Patient's Story, Herbert L Fred

The Texas Heart Institute Journal

No abstract provided.

Gating Mechanisms Of The Canonical Trp Channel Isoform Trpc4, Dhananjay P. Thakur

Dissertations and Theses (Open Access)

Non-selective cation channels formed by Transient Receptor Potential Canonical (TRPC) proteins play important roles in regulatory and pathophysiological processes. These channels are known to be activated downstream from phospholipase C (PLC) signaling. However, the mechanism by which the PLC pathway activates TRPC4/C5 remains unclear. Uniquely, TRPC4 is maximally activated only when two separate G protein pathways, G_q/11 and G_i/o, are co-stimulated, making it a coincidence detector of G_q/11- and G_i/o -coupled receptor activation. Using HEK293 cells co-expressing mouse TRPC4β and selected G protein-coupled receptors, I observed that coincident stimulation of G_i/o proteins and …

Investigating The Role Of Cholesterol Metabolism And Synthesis In Metastasis And Radiation Response In Aggressive Subtypes Of Breast Cancer, Adam Wolfe

Dissertations and Theses (Open Access)

Aggressive breast cancers, triple-negative breast cancer (TNBC) and inflammatory breast cancer (IBC), metastasize at a high rate and are notoriously resistant to standard treatments. Research has shown diets high in cholesterol increase the incidence of aggressive breast cancers and pre-clinical research has shown cholesterol can fuel the growth of breast cancer in vivo. Studies at MD Anderson have shown that IBC patients taking cholesterol lowering drugs, statins, have improved survival outcomes, and also statins can improve the response to radiation in vitro. Furthermore, statins have been shown to target the cells with stem like-properties called cancer stem cells (CSCs) which …

Reduction Of Dose Calculation Errors For Patients With Metal Implants Receiving Photon Radiation Therapy, Jessie Huang-Vredevoogd

Dissertations and Theses (Open Access)

Many patients receiving external beam radiation therapy have metal implants that can affect their treatment, and these metal implants can degrade the accuracy of dose calculations. Dose calculation errors result from limitations of modern dose calculation algorithms in modeling metal/tissue interface effects. Metals also cause streak artifacts in the computed tomography (CT) images that are used for treatment planning, and these artifacts can also degrade dose calculation accuracy. Metal based-energy deposition kernels are a potential solution for the calculation errors associated with the limitations of the convolution/superposition (C/S) dose calculation method as they better model photon interactions and scatter in …

New Insights On The Role Of Jmjd2a In Cancer Progression, Yuan Gao

Dissertations and Theses (Open Access)

Changes in chromatin architecture are known to be one of the underlying causes of cancer because of its ability to alter gene transcription. Histone methylation is one of the most intricate epigenetic marks because it adds multiple layers of modification on the targeted sites. Therefore, many studies have brought histone methylases and demethylases into focus, hoping to decipher their roles in cancer progression. Among these enzymes, JMJD2A is the first to shown to have demethylation activity against trimethylation, and to regulate gene expression, development, and cancer progression. While many studies have mainly focused on its role in transcriptional regulation, only …

Feasibility Of Using Virtual Unenhanced Images To Replace Pre-Contrast Images In Multiphase Renal Ct Examinations, Dawn Olivia Popnoe

Dissertations and Theses (Open Access)

Multiphase renal CT exams are a commonly used imaging technique for the diagnosis of renal masses. The pre-contrast, or true unenhanced (TUE), image provides a baseline for enhancement measurements which is an important criteria used to characterize renal lesions, consequently it is crucial that CT numbers measured in TUE images be accurate. The purpose of this work is to assess the feasibility of replacing TUE with virtual unenhanced (VUE) images derived from DECT data in renal CT exams. Eliminating TUE image acquisition would reduce patient dose and increase patient throughput, improving clinical efficiency.

A retrospective study was conducted for 60 …

Identification Of Familial Wilms Tumor Predisposition Genes Using Whole Genome Sequencing, Timothy B. Palculict

Dissertations and Theses (Open Access)

Wilms tumor, a childhood tumor arising from undifferentiated renal mesenchyme, is diagnosed in North America at a frequency of 1 in 10,000 live births and accounts for 5% of all pediatric cancers. The etiology of Wilms tumor is heterogeneous with multiple genes known to have an effect on Wilms tumor development; however, these genes are rarely associated with familial Wilms tumor. Gene mutations in WT1, WTX, CTNNB1 and TP53 are observed in a third of sporadic tumors, while the causative gene(s) responsible for familial Wilms tumor are largely unknown. Approximately 2% of Wilms tumor patients have a family …

Merlin Mediated Regulation Of Hair Follicle Morphogenesis, Megan K. Fentress

Dissertations and Theses (Open Access)

Epidermal homeostasis is paramount for the ongoing function of the skin as the primary barrier between a mammalian organism and the external environment. Homeostasis is achieved through a complex and delicate balance of cell death, cell proliferation and cell differentiation. Critical for regeneration and maintenance of the skin are epidermal stem cells. Within the epidermis two distinct stem cell compartments exist, the bulge and interfollicular/basal stem cell niches, which play a central role in the regeneration of the epidermis through self-renewal and contribution to the differentiated cells of the epidermis. The bulge stem cell niche is established early in epidermal …

Ex Vivo Expanded Cord Blood Natural Killer Cells As A Novel Therapeutic For Multiple Myeloma, Nina Shah

Dissertations and Theses (Open Access)

Multiple myeloma (MM) is the second most common hematologic malignancy in adults and, to date, is incurable. Allogeneic natural killer (NK) cells are active in various hematologic malignancies and may have a role against MM. Umbilical cord blood is a potential source for allogeneic NK cells and ex vivo expanded umbilical cord blood-derived NK (CB-NK) cells demonstrate activity comparable to that of peripheral blood-derived NK cells. However, large-scale expansion of these cells is required for clinical translation. Here we studied a potential method for ex vivo expansion of NK cells from fresh and cryopreserved CB. Using artificial antigen presenting cells …

In Vivo Significance Of The Mdm4 And P73 Interaction During Development And Tumorigenesis, Mehrnoosh Tashakori

Dissertations and Theses (Open Access)

The tumor suppressor protein p53 is negatively regulated by Mdm4 protein. The significance of such regulation was determined from mouse models. Mdm4-deficient mice are embryonic lethal at E7.5 in a p53-dependent manner. p73, a member of the p53-family, is a transcription factor with tumor suppressor activity. In vitro studies show that Mdm4 binds to p73 and, further, comprehensive biochemical studies revealed that Mdm4 has higher affinity for p73 than p53. However, little is known about the significance of the Mdm4 and p73 interaction in vivo. This study aimed to elucidate the biological consequences of this interaction during embryogenesis …

Methylation Of Egfr By Arginine Methyltransferase Prmt1 Enhances Egfr Signaling And Cetuximab Resistance, Hsin-Wei Liao

Dissertations and Theses (Open Access)

Protein modifications of epidermal growth factor receptor (EGFR) intracellular domain are well known regulators of EGFR functions whereas those of its extracellular domain remain relatively unexplored. Here, we report that methylation at R198 and R200 of EGFR extracellular domain by protein arginine methyltransferase 1 (PRMT1) upregulates its binding to EGF and subsequent receptor dimerization and signaling activation. Methylation-defective EGFR mutant reduced tumor growth in mouse orthotopic xenograft model. Importantly, increased EGFR methylation sustains its signaling activation and cell proliferation in the presence of therapeutic EGFR monoclonal antibody, cetuximab. EGFR methylation level also correlates with higher recurrence rate after cetuximab treatment …

Investigating The Interaction Of Aurka And Ube2c In Colorectal Cancer Cells, Apurva M. Hegde

Dissertations and Theses (Open Access)

Colorectal cancer (CRC) is the third leading cause of cancer-related deaths in the US. Among the many genomic aberrations previously implicated in colorectal cancer, recurrent amplification of chromosome 20q is frequently associated with liver metastasis. Previous research in our lab identified a gene signature on chromosome 20q associated with colorectal cancer progression. In this study, one of the genes in the signature, the ubiquitin conjugating enzyme UBE2C, was identified through preliminary bioinformatics analysis as a candidate for further examination of its role in CRC progression. Co-expression analysis of UBE2C in tumor-normal datasets from the public database Oncomine revealed all the …

Quality Assurance Of Advanced Treatment Modalities Using Presage® Dosimeters, Ryan G. Lafratta

Dissertations and Theses (Open Access)

Computer-controlled therapy machines allow for increasingly complex plans, as there are more variables that can be tuned to produce the ideal result. This makes it increasingly difficult to assure the intended calculated dose is being delivered correctly using current techniques that are 2D-based because the resultant dose distributions can differ markedly in various sections of the target. A measurement of composite dose from the entire plan should be included in patient-specific IMRT QA. A volumetric dosimeter such as PRESAGE^® is able to provide a complete 3D measured dosimetry dataset with one treatment plan delivery. It was hypothesized that a …

Prophylactic Cranial Irradiation Reduces The Incidence Of Brain Metastasis In A Mouse Model Of Metastatic Breast Cancer, Daniel L. Smith

Dissertations and Theses (Open Access)

Prophylactic cranial irradiation (PCI) is a preventative whole-brain irradiation technique used to reduce the incidence of brain metastasis and improve overall survival in select patients with small cell lung cancer and acute lymphoblastic leukemia. A population of breast cancer patients – stage IV, HER2+ or triple-negative – has emerged as having a high risk of developing brain metastases. Because only 10-20% of breast cancer patients diagnosed with brain metastases survive longer than one year, in this high-risk population the benefit of PCI – potential for reduced incidence of brain metastasis and improved overall survival – may outweigh the risks – …

Metabolic Profiling Of Prions In The Gastro-Intestinal Tract, Uffaf Khan

Dissertations and Theses (Open Access)

Metabolic profiling of prions in the gastro-intestinal tract

Uffaf Khan, B.S.

Thesis Advisor: Claudio Soto, Ph.D.

Abstract

Prion diseases, also known as transmissible spongiform encephalopathies (TSEs), are a group of debilitating neurodegenerative disorders that affect both humans and animals. They can be spread by horizontal transmission as seen in chronic wasting disease in deer and elk population. In addition, transmission to humans has also been documented which includes bovine spongiform encephalopathy in cattle to variant Creutzfeldt-Jakob disease in humans due to consumption of contaminated meat. The most probable natural route of transmission is by oral consumption of infectious material. Even …

Ankyrin-B And Mtor Complex 1 In The Regulation Of Electrical Activities In The Heart, Henry C. Wu, Henry C. Wu

Dissertations and Theses (Open Access)

The mammalian target of rapamycin complex 1 (mTORC1) activity is paramount in the regulation of electrical activities in the brain and the heart. In the brain, the tumor suppressor gene TSC2 encodes the protein product tuberin that interacts with hamartin to form a heterodimer Tuberous Sclerosis Complex (TSC) that regulates mTORC1. When TSC2 is disrupted, mTORC1 activity becomes dysregulated resulting in abnormal electrical activities in the brain manifesting in the form of epileptic seizures. In the heart, mTORC1 activity is triggered by a sustained increase in hemodynamic pressure causing the heart to electrically remodel. A likely candidate serving as the …

Detection Of Genes Influencing Chronic And Mendelian Disease Via Loss-Of-Function Variation, Alexander H. Li

Dissertations and Theses (Open Access)

A typical human exome harbors dozens of loss-of-function (LOF) variants predicted to severely disrupt or abolish gene function. These variants are enriched at the extremely rare end of the allele frequency spectrum (< 0.1%), suggesting purifying selection against these sites. However, most previous population-based sequencing studies have not included analysis of genotype-phenotype relationships with LOF variants. Thus, the contribution of LOF variation to health and disease within the general population remains largely uncharacterized.

Using whole exome sequence from 8,554 participants in the Atherosclerosis Risk in Communities (ARIC) study, we explored the impact of LOF variation on a broad spectrum of human phenotypes. First, we selected 20 common chronic disease risk factor phenotypes and performed gene-based association tests. Analysis of this sample verified two relationships in well-studied genes (PCSK9 and APOC3) and identified eight new loci. Novel relationships included …

Computational Modeling Of Rna-Small Molecule And Rna-Protein Interactions, Lu Chen

Dissertations and Theses (Open Access)

The past decade has witnessed an era of RNA biology; despite the considerable discoveries nowadays, challenges still remain when one aims to screen RNA-interacting small molecule or RNA-interacting protein. These challenges imply an immediate need for cost-efficient while predictive computational tools capable of generating insightful hypotheses to discover novel RNA-interacting small molecule or RNA-interacting protein. Thus, we implemented novel computational models in this dissertation to predict RNA-ligand interactions (Chapter 1) and RNA-protein interactions (Chapter 2).

Targeting RNA has not garnered comparable interest as protein, and is restricted by lack of computational tools for structure-based drug design. To test the potential …

Regulation Of Autoimmune Germinal Center Reaction By Tfh Cells And Application Of Tfr-Like Cells For The Treatment Of Autoimmune B Cell Responses, Young Uk Kim

Dissertations and Theses (Open Access)

Excessive follicular helper T (Tfh) cell responses to self-antigens are associated with antibody-mediated autoimmune diseases in humans including systemic lupus erythematosus (SLE). Numeral and functional aberrations of T regulatory T (Treg) cells are common in patients with autoimmune diseases. Although different types of immunosuppressive agents have been used clinically to treat antibody-mediated autoimmune diseases, they generally have side effects due to the lack of target-specificity. To minimalize the adverse effects, there is a need to develop target-specific therapeutics which specifically control auto-reactive B cell responses and auto-reactive Tfh cell responses. Recent studies unveiled that Foxp3⁺ Treg cells expressing CXCR5 …

Quantification Of Imrt Severity Scores For Improvement Of Fmea Results, Jacqueline T. Faught

Dissertations and Theses (Open Access)

Accurate delivery of intensity modulation radiation therapy (IMRT) requires perfect execution of a long, complicated chain of events; failure of any component of this process may contribute to dose delivery errors, compromising treatment quality and, more importantly, patient safety. Prospective, process-wide risk mitigation techniques are becoming more prevalent in radiotherapy to establish comprehensive quality management (QM) programs, such as failure modes and effects analysis (FMEA). The subjective nature of the ordinal scores used for FMEA leads questionable reliability and validity of the results. Additionally, physics components are commonly grouped together, leaving out valuable details important to physics QM. While the …

Functional Analysis Of Synthetic Gene Circuits Controlling A Protein Pump In Yeast, Junchen Diao

Dissertations and Theses (Open Access)

Synthetic biology aims to build biological devices to understand living systems and explore new applications. Synthetic gene circuits such as genetic switches, oscillators and logic gates are at the core of many synthetic biology applications. These gene circuits often include a sensor/regulator protein capable to detect small molecules and then transduce them into a regulatory signal to generate measurable output. Similar signal transduction networks are also abundant in nature. However, in many natural and engineered scenarios, the output also affects the regulator/sensor protein. How such interactions between the regulator/sensor and the output affect synthetic gene circuit function has not been …

Yap1 Expression Predicts Sensitivity To Dual Akt/P70s6k Inhibition In Ovarian And Uterine Malignancies, Rebecca A. Previs

Dissertations and Theses (Open Access)

Purpose: The PI3K/AKT/P70S6K pathway is an attractive therapeutic target in ovarian and uterine malignancies due to its high rate of dysregulation and key roles in tumor growth. Here, we examined the biological effects of MSC2363318A, which is a novel inhibitor of AKT1, AKT3, and P70S6K.

Experimental Design: Orthotopic murine models of ovarian and uterine cancer were utilized to study the effect of MSC2363318A on survival and regression. Moreover, in vitro experiments (MTT, Western blot analysis, plasmid transfection, and reverse phase protein array [RPPA]) were carried out to characterize underlying mechanisms and potential biomarkers of response.

Results: MSC2363318A decreased tumor growth …

Assessment Of Uncertainty In Planning And Dose Delivery Of Proton Therapy In An Iroc- Houston Qa Phantom Due To Variable Ct Technique And Proton Energy, Mattie M. Mcinnis

Dissertations and Theses (Open Access)

As proton therapy increases in popularity, so does the need for effective quality assurance. Proton therapy institutions participating in NCI funded clinical trials rely heavily on the credentialing and auditing services of IROC-H and therefore the process must be well understood. The purpose of this project is to understand the uncertainties in proton therapy treatment planning for the IROC-H proton phantom QA program due to variations in CT technique and proton energy. It was hypothesized that variations in CT technique and proton energy will alter the delivered dose distributions of typical proton treatments by reducing the percent of passing pixels …

Ultrasound Biomicroscopic Imaging For Interleukin-1 Receptor Antagonist-Inhibiting Atherosclerosis And Markers Of Inflammation In Atherosclerotic Development In Apolipoprotein-E Knockout Mice, Rong-Juan Li, Yan Sun, Qin Wang, Jiao Yang, Ya Yang, Li Song, Zheng Wang, Xiang-Hong Luo, Rui-Juan Su

The Texas Heart Institute Journal

We sought to validate the hypothesis that the development of atherosclerosis can be suppressed by the interleukin-1 receptor antagonist (IL-1Ra) in murine models of atherosclerosis in vivo, noninvasively seen by means of high-resolution ultrasound biomicroscopy, and we studied changes in inflammatory markers such as IL-1 and C-reactive protein (CRP) plasma levels in these models of atherosclerosis.

We divided IL-1Ra+/−/apolipoprotein-E (apoE)−/− and IL-1Ra+/+/apoE−/− mice into 2 age groups, used as atherosclerotic models. The control groups were age-matched IL-1Ra+/+/apoE+/+ mice. Plaque thickness was measured in the ascending aorta in short-axis images by means of ultrasound and histology. Plasma levels of IL-1 and …

Impact Of Insulin Resistance On Neointimal Tissue Proliferation After 2nd-Generation Drug-Eluting Stent Implantation, Takaaki Komatsu, Isao Yaguchi, Sachiko Komatsu, Shiro Nakahara, Sayuki Kobayashi, Yoshihiko Sakai, Isao Taguchi

The Texas Heart Institute Journal

Percutaneous coronary intervention is established as an effective treatment for patients with ischemic heart disease; in particular, drug-eluting stent implantation is known to suppress in-stent restenosis. Diabetes mellitus is an independent risk factor for restenosis, so reducing insulin resistance is being studied as a new treatment approach. In this prospective study, we sought to clarify the factors associated with in-stent restenosis after percutaneous coronary intervention, and we evaluated the homeostasis model assessment of insulin resistance (HOMA-IR) index as a predictor of restenosis.

We enrolled 136 consecutive patients who underwent elective percutaneous coronary intervention at our hospital from February 2010 through …

Is Autologous Or Heterologous Pericardium Better For Valvuloplasty? A Comparative Study Of Calcification Propensity, Wen-Jian Jiang, Yong-Chao Cui, Jin-Hua Li, Xiu-Hui Zhang, Huan-Huan Ding, Yong-Qiang Lai, Hong-Jia Zhang

The Texas Heart Institute Journal

Pericardial calcification is detrimental to the long-term durability of valvuloplasty. However, whether calcification susceptibility differs between heterologous and autologous pericardium is unclear. In this study, we compared the progression of calcification in vivo between autologous and heterologous pericardium.

We randomly divided 28 rabbits into 4 equal groups. Resected rabbit pericardium served as autologous pericardium, and commercial bovine pericardium served as heterologous pericardium. We subcutaneously embedded one of each pericardial patch in the abdominal walls of 21 of the rabbits. The 7 control rabbits (group A) received no implants. The embedded samples were removed at 2 months in group B, at …