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- Sarkar, N., et al.
(författare)
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Effects of intramyocardial injection of phVEGF-A(165) as sole therapy in patients with refractory coronary artery disease - 12-month follow-up : Angiogenic gene therapy
- 2001
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 250:5, s. 373-381
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To test the safety and bioactivity of phVEGF-A(165) after intramyocardial injection during 12-month follow-up. Design. Open-labelled study. Subjects. Inclusion criteria were angina pectoris, Canadian Cardiovascular Society (CCS) class III-IV, unamenable to further revascularization, ejection fraction (EF) >30%, perfusion defects extending over >10% of the anterolateral left ventricle wall detectable with adenosine single photon emission computerized tomography (SPECT) and at least one patent vessel visible by coronary angiography. Seven of 39 patients referred for gene therapy were included. Intervention. Via a mini-thoracotomy under general anaesthesia, phVEGF-A(165) was injected directly into the myocardium at four sites in the anterolateral region of the left ventricle. Results. Operative procedures were uneventful. Perioperative release of myocardial markers and electrocardiogram (ECG) changes were detected in two patients. There were no perioperative deaths but one patient died 7 months postoperatively because of myocardial infarction. Plasma vascular endothelial growth factor (VEGF)-A levels increased two to threefold peaking 6 days postoperatively (P<0.004) and returning to baseline by day 30. A significant reduction in angina pectoris was reported. The CCS class improved from 3.30.2 to 1.9 +/-0.3 (P<0.01) and nitroglycerine intake decreased from 3915 to 12 +/-5 tablets week(-1) (P<0.001) 2 months after gene transfer. Improvements remained after 12 months when nitroglycerine consumption approached zero. Improved myocardial function in the phVEGF-A(165) injection region was documented in all patients (P<0.016) by tissue velocity imaging (TVI). Reduced reversible ischaemia was detected by adenosine SPECT in four patients. Improved collateralization was detected in four patients with coronary angiography. Conclusion. Intramyocardial injection of phVEGF-A(165) is safe and may lead to improved myocardial perfusion and function with longstanding symptomatic relief in end-stage angina pectoris. Based on these results this therapeutic potential is being tested in a double-blind placebo controlled multicentre trial, EUROINJECT ONE.
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| 3. |
- Sylven, C., et al.
(författare)
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Myocardial Doppler tissue velocity improves following myocardial gene therapy with VEGF-A(165) plasmid in patients with inoperable angina pectoris
- 2001
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Ingår i: Coronary Artery Disease. - : Ovid Technologies (Wolters Kluwer Health). - 0954-6928 .- 1473-5830. ; 12:3, s. 239-243
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Tidskriftsartikel (refereegranskat)abstract
- Background Myocardial tissue velocity and perfusion were studied in patients with severe angina pectoris following gene therapy by intramyocardial injection of phVEGF-A(165) via thoracotomy. Plasma concentrations of VEGF-A increased postoperatively. Two months after treatment anginal status and myocardial tissue velocity improved and perfusion showed a tendency to improve. Tissue velocity imaging appears to be a sensitive, objective method for detecting changes in myocardial function following gene therapy. Objective To study effects on myocardial tissue velocity and perfusion in patients with angina pectoris following intramyocardial injection of phVEGF-A(165) via thoracotomy. Design Open label, phase I/II. Methods Six patients with Canadian Cardiovascular Society (CCS) angina pectoris functional Glass III - IV and with major defects at adenosine stress single-photon emission computerized tomography (SPECT) were studied. In addition to SPECT, coronary angiography and dobutamine stress echocardiography with tissue Doppler velocity imaging were performed before and two months after gene transfer. Results Plasma concentrations of VEGF-A increased 2 to 3 times (P < 0.04) over baseline from 2 to 14 days after injection with normalization after 4 weeks. The CCS class improved about 40%, from 3.3 +/- 0.2 to 2.0 +/- 0.3 (P < 0.02) and nitroglycerine consumption decreased 30 - 40%, from 44 +/- 17 to 15 +/- 5 tablets per week (P < 0.05). The maximal systolic myocardial tissue velocity increased in all patients about 25% (P < 0.02) but did not reach the reference range. Myocardial perfusion at SPECT improved in four of the six patients. Conclusions Anginal status, myocardial tissue velocity and perfusion can be improved by phVEGF-A(165) intramyocardial injection. Tissue velocity imaging appears to be a sensitive, objective method for detecting changes in myocardial function following gene therapy. Coron Artery Dis 12:239-243
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- Hassan, Osama A. B.
(författare)
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Application of value - focused thinking on the environmental selection of wall structures
- 2004
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Ingår i: Journal of Environmental Management. - : Elsevier BV. - 0301-4797 .- 1095-8630. ; 70:2, s. 181-187
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Tidskriftsartikel (refereegranskat)abstract
- The decision of selecting building structures with respect to the environmental demand is an issue commonly addressed in environmental management. In this paper, the importance of considering the decision analysis technique value-focused thinking in the environmental selection of wall structures is investigated. In this context, a qualitative value model is developed in which the external and internal environmental factors are considered. The model is applied on a case study in which a decision should be made on three categories of exterior wall structures: wood, masonry and concrete. It is found that the wall structure made of wood is the most compatible option with respect to the external and internal environmental requirements of building structures.
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- Hassan, Osama A. B.
(författare)
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Isolation of buildings from ground-borne noise using a sand stratum
- 2004
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Ingår i: Building Acoustics. - : SAGE Publications. - 1351-010X .- 2059-8025. ; 11:2, s. 97-114
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Tidskriftsartikel (refereegranskat)abstract
- The effect of an elastic stratum in reducing ground-borne sound transmission in buildings to be built above railway tunnels is investigated, by considering a sand layer between the bedrock and load bearing elements of the building. It is assumed that the initial vibrational energy that propagates from the foundation is in the form of quasi-longitudinal waves. The complete model as presented by the author in a previous paper is considered. Calculated results are compared with previous results for a typical building and it is shown that a sand layer can considerably reduce upward sound transmission in the building. The results of a parametric study to investigate the influence of the type of load-bearing elements and the thickness of the layer, on transmission of structure-borne sound in the building, are presented.
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| 7. |
- Hassan, Osama A. B., 1969-
(författare)
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New Methods for Reducing Ground-Borne Noise in Buildings above Railway Tunnels
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The rapid expansion of major cities in the west Europeancountries has accentuated the need to exploit every potentialsite for new establishments, e.g. areas over train tunnels andnear railway tracks in general. A significant impediment toexploit such areas is the structure-borne noise generated bythe train traffic, which is transmitted into buildings via theground. Reliable prediction methods and cost-effective noisecontrol measures are therefore needed and are also the objectof the present work. In this thesis, the studied buildings areconsidered as wave-guides for the sound transmitted from theground. The work is restricted to the case of hard ground suchas granite. The chosen technique permits comparison betweendifferent potential measures to reduce the transmission ofstructure-borne sound upward in buildings. It is shown that thedesign of the load-bearing structures is important in thiscontext, and a design with relocated columns has givenpromising results. It is also shown that the stiffness of theground plays an important role in the transmission process.This leads to the idea that a sand layer between the foundationof the building and the bedrock may reduce the transmission.New methods have thus been developed in the course of this workto evaluate the stiffness of the layer using approximate andexact techniques. Results are presented and a comparison ismade with previous results for a "normal" building and it isshown that the insertion of sand layer has a potential toconsiderably reduce the sound level in the building.Keywords:Ground-borne noise, railway noise, in-planewaves, wave-guides, scattering, propagation constant, inputmobility, elastic stratum, dual integral equations.
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