Life of Riley

Good news from stem cell pioneer and cardiologist Zannos Grekos

From the onset it was clear that a conversation with Doctor Zannos Grekos  would not be purely medical or academical. The Greek-American Clinical Professor of Cardiology at NOVA Southeastern University in Florida’s Fort Lauderdale, USA, has in recent years been progressing the treatment of heart, pulmonary and circulatory diseases with stem cells. Hotly debated and awaiting approval from most national regulating agencies, stem cell therapy for many still constitutes a medical grey zone. However, whereas no treatment has yet been undertaken with Embryonic stem cells, the root of most concerns, Grekos has already made great therapeutical strides using a patient’s own Adult Stem Cells to regenerate damaged, even dead human nerves, tissue and organs. Invited to Athens by Anti-aging specialist Kostas Koutoudis, Zannos Grekos gave two eye-opening dialexeis about developments in stem cell therapy, in impeccable greek, to medical university students and clinical staff at the Metropolitan Hospital. In an exclusive interview with L’Officiel Hommes he talks about the positive impact adult stem cell treatment is having on patients with heart and circulatory complications, and its potential for helping incurable conditions like stroke, dementia and cancer.

When did you get involved with adult stem cell treatment?

It was serendipity. I heard about it first when a friend of mine left for Thailand in 2006 to have stem cell therapy, and seeing the potential it could have in cardiovascular treatment I became entirely submerged in its capabilities. You try to keep your head above water and go in the right direction.

In your presentation you showed cases where patients injected with their own adult stem cells showed signs of regenerated tissue, in the case of the American Football player whose limbs had become mummified due to necrotizing meningitis, and grown new blood vessels in legs with vascular circulation problems in a matter of months. How do you go about this procedure?

The process begins with a complete medical evaluation to determine the patient’s medical status and qualification for therapy. Once testing is complete, we draw 300cc of the patient’s blood, from which peripheral blood stem cells are extracted. The very few naturally occurring stem cells in the blood sample are then cultivated and multiplied. They are then injected back into the patient’s target organ. Since it is the patient’s own stem cells, there is no possibility of rejection.       

How can stem cells be trained to regenerate an affected part of the body?

Using naturally occurring growth factors that we have in our bodies. So If we want the stem cell to become and promote blood vessels, we multiply it and differentiate it with Vascular Endothelial Growth Factors (VEGF), that’s a growth factor that our own bodies produce. When somebody has a blockage in their artery of their heart and the body naturally wants to develop collaterals, or natural bypasses, there’s a higher concentration of VEGF that’s produced in that area, and the body will generate new blood vessels. The problem is that when you have a huge heart attack, the amount of VEGF that is produced is not enough to overcome all the damage and you progress towards congestive heart failure. All we are doing is taking the natural repair systems that the body has in place and augmenting them, amplifying them, and then redelivering them to the area of damage.

You are also Director of Cardiology and Vascular Disease at Regenocyte, the first US-based regenerative cell therapy clinic that is actively treating patients with Adult Stem Cells. What are the risks involved with such therapies?

Regenocyte therapy, derived from the Latin terms ‘regeneratus’ (created again) and ‘cyte’ meaning cell, is the commercial-coined term of utilizing expanded and partially differentiated cells. It conveys the difference between a stem cell that has not been activated and/or differentiated towards the organ system that we’re looking to repair, which carries therapeutic advantages. We have never seen an untoward or negative side effect from the stem cells themselves. The risks are all secondary to the procedure that is utilized to implant the stem cells. For instance, if the cells are being injected with a hypodermic needle directly into the calf muscle, then there’s only the theoretical risk of infection and such involved with those 30 or so injections. But really it’s an extremely non-risky procedure. The risks associated with delivering the stem cells to the heart is similar to a cardiac catheterization. The sicker the patient or the older the patient, the higher the risk, but it’s still in the less than 1-2% complication rate with a 1-in-8,000 to 1-in-15,000 death rate.     

Are you applying established vascular intervention techniques?

Yes, we’re using very similar catheters used in a technique on a regular basis daily throughout the world. There’s an injection catheter that we use to inject into the myocardium, and that’s been looked at in several clinical trials in Europe and in the U.S. which has a very good safety record. The procedures of the catheter carry very little difference from putting in a pacemaker wire, the risks are parallel with those of injecting stem cells into the heart.

How could you minimize even these risks?

I believe that in the future we will become better and better at delivering stem cells to the area of damage. That may be nano technology, it may be the utilization of magnetic carriers that can be focussed using an external magnetic beam, it may be receptor-specific where we place receptors on these cells that will be attracted to specific organ receptors. The technology is out there, it’s just a matter of applying it to the therapy that we’re talking about. And of course the greater volume that an operator has with delivery of the stem cells, the lower the risk comes from the delivery, like any surgical procedure. In Medicine any procedure always carries some degree of risk because humans are not engineered machines that are exactly the same one to the other. You need a physician that is an artist at the same time that knows how to utilize  the technology that he has to achieve the best result in that individual patient. A doctor never stops learning

Does the art also lie in a holistic approach of talking to the patients, knowing what their symptoms are and applying your acquired knowledge of stem cells with the tools at your disposal to achieve the best result? 

That is absolutely correct, and interestingly enough there’s a concept that is recently becoming popular called Personalised Medicine, where we look at the patient as an individual and personalise the treatment for that patient. What I find interesting is that it’s being hailed as a new concept, and yet that’s the way medicine used to be. The doctor would spend time with the patient and found and potentially compounded the right  medication or treatment for that individual patient. It all started in Ancient Greece, and we’ve come away from that and de-personalised medicine which I believe has been a disservice to society.

Why do you think that happened, was it because of the corporatisation of medicine and pharmaceuticals?

Absolutely. Especially in the United States when health care management came into play and we took away the luxury that the physicians had, which was time to spend with the patient, and forced them to see many patients in a day.

What are your views on President Obama’s new bill for government-paid universal healthcare?

How it was initially crafted and how it will eventually end up is something that we will get to see, because it has gone through several iterations. It’s interesting that I speak to healthcare professionals who are upset that Illegal immigrants will be covered by the new healthcare plan, and I look at them and wonder “this was the same person who was complaining two days ago that they were not getting paid for taking care of an illegal alien in the US.” Now, because of political ideation or “brainwashing” they’re defeating the same bill that’s supposed to reimburse them for something they were complaining about just recently. But I’m not very involved with the politics of the healthcare plan. 

Could we train our own stem cells to be healthier?

Of course, we do this in medicine all the time. When I have a patient who has poor circulation to their legs, I tell them to walk, and what does walking do? It induces new vasculature. So there are things that we can do in our daily lives to train ourselves, that’s why exercise is good thing. Exercise is not an arbitrary recommendation by physicians. For the most part we don’t even know why it is good for us, but as we get to know stem cells better we understand that exercise induces increased circulating stem cells which in turn slows the aging process. People that die in their 100s have much higher circulating stem cells than people that die at a younger age. Now whether that’s genetic or whether it’s induced by activity and exercise, that I don’t know, but there are certain things that we know will lengthen longevity and increase the quality of life of the patient. 

In the history of life on earth, the presence of mankind has taken up merely a speck of time. What are the benefits of prolonging a human life a fraction of its natural course?

We’re not just hoping to help people live longer, we want them to live better and happier, and many times that’s what we achieve with the stem cell treatments for these patients. We take them from becoming cardiac cripples where they can barely get off the couch to being to do things in their life. I’ve had patients we treated, we gave them a very good year in life and at the end of that year they died, suddenly. But up until then they were traveling to Europe, they were going on cruises, they were doing all kinds of things that before they couldn’t. And the family was very grateful, as was the patient before passing away, that we were able to improve their quality of life. A lot of patients that we treat have said: “If I die tomorrow, I’ll be happy, because I got two or three years of good quality rather than a slow deterioration sitting on a couch not being able to move.”            

Sitting with us at lunch, Kostas Koutoudis joins in the conversation.

K.K.: Δεν προσπαθούμε να παρατείνομε ανώμαλα τη ζωή ένας ανθρώπου. Δεν υπάρχει κάτι διαβολικό μέσα σ' αυτό. Σε αυτή την φάση προσπαθούμε να ικανοποιήσουμε αυτό το potential που μας έδωσε ίδια η ζωή. Η ίδια η ζωή μέσα τον γονιδίων και τον χρωματοσωμάτων έχει δώσει ένα δυναμικό ζωή σε ένα άτομω. Το μομέντουμ είναι περίπου για 125-130 χρόνια, όλη οι υπολογισμοί συμφωνούν σε αυτό, βιοχημική και φυσική υπολογισμοί, και οι άνθρωποι πεθαίνουν 80 ετών. Οι άνθρωποι πεθαίνουν πρόωρα. In a way we are satisfying evolution’s wish.                   

Z.G. Our basic natural role is to perpetuate, so from a biological point of view our primary task is done by the time we are 35. However, if we truly believe that we are on this earth to live a good life and enjoy our life, we are reaching the potential of what that life ought to be. So we’re extending the ability to enjoy the quality of life, and if we happen to extend life itself, then that’s an added benefit. There are two kinds of people, the ones who fear death and those who don’t want to leave life. The ones who are afraid to die are miserable. Those who like their life wouldn’t mind if they died tomorrow, they are happy now. If with stem cell therapies we can reduce or even eliminate the suffering associated with the top five terminal diseases, prostate cancer, colon cancer, heart attack, stroke and breast cancer, I think people will be able to live much more peacefully. 

This article was first published in the spring 2010 edition of L’Officiel Hommes Hellas

© Marq Riley 

From Neoclassical academic temples to Lycabettus hill as an arcadian retreat, a wall-to-wall exhibition at the National Gallery casts light on Athens as envisioned by architect Ernst Ziller.

Oscar Wilde once said that a map without Utopia is a map not worth looking at. 21st century idealism may be a lot more pragmatic in its quest for quality of life and a greener society, but the yearning for a perfect world is everlasting. 

Standing on Korai square in central Athens amid a chaotic cacophony of car horns, sirens and motorcycles, it is hard to imagine this was once the epicentre of a modern Arcadian dream.     With traffic growling its way down to Omonia one way, pushing towards Syntagma on the other and meandering into all kinds of side streets top and bottom, Athens is, at times literally, a city going nowhere. Majestic ancient monuments now coexist with fatigued concrete office blocks, but one man attempted to craft a more harmonious future for Athena’s heritage. 

The Hellenic capital as we know it only started to take shape in the early 1860s, when vast fields around the ancient Acropolis became the designated grounds for a Neoclassical renaissance. A comprehensive exhibition at the National Gallery is now honouring the architect who, more than any of his contemporaries, defined the look and layout of this new European metropolis. Showcasing a wealth of original studies, sketches and blueprints from its own archives, the National Gallery displays the legacy of Ernst Ziller in great detail, as well as highlighting countless unfulfilled projects that might have formed part of today’s cityscape. 

As a young disciple of the revered Danish architect Theofilus Hansen, Ziller accepted an intriguing mission from his mentor; Travel to Athens and oversee the construction of the Academy of Sciences and National Library on Akadimias street. Commissioned by King Otto and funded by Viennese benefactor Simon Sinas, the accurate and impressive execution of these buildings rapidly established Ziller’s talents. His services became highly coveted by the burgeoning capital’s middle class and affluent society. It was his attention to details, love of cultural aesthetics and efficient work ethos that made him the talk of the town. 

Although Ziller fused various historic influences in his designs, his name became synonymous with an ability to blend the best of western techniques and Neoclassical elegance. “This is how we explain the different parts of his inventions,” says curator Marilena Cassimati in front of an enlarged mural at the Exhibition entrance. “The Vassiliou Mela building consists partly of renaissance architecture, especially in the Venetian style, then we have baroque, then a little Michelangelo, but this is how architecture worked at that time. The thing is how much talented is one to compose and express a new idea. Ziller managed to incorporate all styles which were in progress in Europe at that time and placed them in a virtual no-man’s land. It was an empty city.” 

International archaeologists were brought in to clean up the ‘upper city‘ around the Parthenon, shoddy shacks squatting on top of the holy rock, probably the only favela Athens ever knew. Ziller became friends with these classical academics, observing their work and participating in the documentation of excavations. He would faithfully reproduce ornamental details uncovered at these monuments and later incorporate them in interiors of theatres and private mansions. Later on he would also become the first excavator of the Panathenaic stadium, also known as Kallimarmaro. 

The decision to establish Athens as Greece’s capital was only taken in 1834 by King Ludwig, who wanted to revive the city’s ancient cultural patrimony. As Athens had not been liberated from Ottoman rule, the safer Peleponesian port of Nafplio had served as the capital of free Hellas. “Little by little, efforts were made to build Athens as a new city in the traces of European culture.”

The rebirth of Athens is inextricably linked with Ziller, who made it his life’s work—from his arrival in Athens as a 24-year old in 1861 to his death in September 1923. From the Numismatic Museum (previously Schlieman’s residence) to the National (Royal) Theatre and from the Megas Alexandros hotel on Omonia to the law courts on Evelpidon street, Ziller’s proliferous career in Athens created a vast portfolio of edifices. Countless structures did not withstand the city’s rapid expansion, following the fall of Smyrna or torn down during the military junta in the 1960s. Other plans were never realised, either because of financial constraints or municipal and state indecision. 

The current layout of central Athens, between the Acropolis and Lycabettus, can be partly attributed to German romanticism. “The architects tried to cultivate nature, to put a bit of green in this very dusty city,” explains Cassimati. “There were no streets, no pavements. Hansen decided to dress up the university grounds and created what is until today the most beautiful street in Athens, Akadimias.” From there the metropolis expanded, but without a distinct orientation. “The first city planners Kleanthis and Schaubert, Greek and German pupils of Schinkel, imagined a city for only up to 200,000 inhabitants. therefor they could not agree on which way the city should face, whether toward the sea or toward the mountains. There is no centre. It was a coincidence that we had two central squares with Syntagma and Omonia. Athens in that sense is a bit like American cities Everything is built by omission and nobody takes care of gaps, voids to create free spaces.” 

Standing beside an LED-lit display, she dwells on Ziller’s original National Library drawings, a revealing anatomy of the period’s aspirations. “You see the classical spirit in a very modern technological way. He uses iron constructions to lead the light in to the library with glass constructions, which is very difficult to do. He needs a cellar, he needs reading rooms and he needs his decorations, which are Ionic pillars and romantic historical drawings.” A fascinating insight into his methods is also portrayed by original photographs of the time. Over one image of a temple Ziller drew a grid, enabling him to recreate the pillars as drawings and eventually as full-sized reproductions.  

Cassimati invited contemporary architects and architecture historians to collaborate on the exhibition, notably Vassilis Kolonas’ contribution which includes a theatrical reproduction of Kotzia square in the early 1900s. Visitors are surrounded by Ziller’s Vasiliou Mela and Municipal Theatre facades, giving them a sense of ambling through ‘his’ Athens. “Most modernist architects of the  1960s onward despised Ziller’s ornamental work,” Cassimati muses, “but with a closer look at his intentions and inventions they gained a new appreciation for what he created.” 

The accompanying exhibition book featuring introductory essays by 11 architects has all but sold out, a pleasant surprise for Cassimati. “I couldn’t bear to see them lying dormant in their beds,” she says referring to the collection of prints and drawings bought for the National Gallery by Marinos Kalligas in 1961. “so I proposed the exhibition and was given 3 months to set up the whole affair. But we printed 3,000 copies of the catalogue and only 300 are left. I was amazed to find out that the exhibition is also a commercial success.” 

The reason why it has been so popular, a big question according to Cassimati, is perhaps a longing by current Athenians to feel good about their home town. “They feel that they live in very low standards as far as housing and the streets are concerned. So it leads them to a dream-like position. You want to see expositions and art in times of crises, you want to experience culture. Athens was a special place for the Germans and architects of Ziller’s time. People want it to be special.” 

A collection of 370 letters written by Ziller to Hansen, a selection of which are also on display, along with his memoirs have now been translated by Cassimati and will be published in the near future. From them one can draw many parallels between construction projects then and now, with Ziller specifically dismayed by the lack of cost-control on materials and wastage by local workmen. Indeed, Ziller’s tenure as Professor of Architecture at the Athens School of Arts was revoked in 1882 because he refused to cover up mounting expenses delaying the completion of the Zappeion building. Cassimati however says that Ziller possessed the most important of talents of all when it comes to building in Greece: “He was a very funny man, he had a big sense of humour. This was something he needed given the conditions he met. That’s why I adore him.” 

Cassimati points out another similarity between private clients of Ziller’s period and today’s nouveau-riche. “People, as they get richer, want to avoid simple constructions for their own house. It has to be beautiful. They want decorations, and of course Neo-classicism as they understood it at that time was very ‘chique’, it was a matter of class. How much beauty could they add? They called Ziller, no matter whether it was a rich banker or a rich butcher. People who moved up from another class, mostly agrarians who came to Athens and to whom times were good, tried to avoid their past.” Various villas and mansions in Kifissia are a testament to those new lives, as was the Grande Cafe Neon on Omonia square, which started out as a dairy farmer’s shop whose products sold like hot galaktoboureka.        

Ziller didn’t limit himself to the Attican peninsula, but accepted assignments from Zakynthos to  Syros Island. “He built 500, some say even 600 projects, whatever came into his hands.” Only about 38 remain standing in Athens today, a leaflet worth of landmarks mapped out in a special National Gallery edition.    

Seeing the rapid growth of Athens during his lifetime, to which he was a major contributor, Ziller attempted to propose to successive rulers a particular project intended to safeguard a tranquil haven amid the hustle and bustle. From 1885 up until 1913, ten years before his passing, Ernst Ziller continued to draw up spectacular topographical layouts and designs for Lycabettus hill as a ‘Luft-Kurort’, a lush green reserve for Athenians to relax and revive their spirits. The plan foresaw the whole area, from the foot of the hill to its peak, as a  rich park of trees, gardens and fountains, untainted by multi-story constructions and free from traffic. It was to become his elusive Athenian utopia. 

There are honest efforts nowadays to preserve the unique sights of Athens, as unsightly billboards are taken down from roadsides and buildings to clear views. But even with a fresh coat of paint on bland grey monoliths, could Athens ever return to an ideal once dreamt up by a Saxon architect? “Akadimias will now be paved,” Cassimati says with a sly smile. “It is within the new city plans to pedestrianise the street. Whether it will come out I do not know.” 

The eternal conflict of idealism versus practicality continuously feeds the streets with conversation, and whether or not decisions made in stately marble buildings result in concrete actions remains to be seen. Ernst Ziller may have been the instigator of the “Anonym-architektur” which lasted well into the 1930s, but his Athenian legacy may also be in danger of  diminishing into the anonymous and unseen. “There needs to be a much greater effort to preserve monumental buildings,” presses Marilena Cassimati. “A simple plaque on the wall goes a long way. Ziller created his family here, married pianist Sofia Doudou and had four children. He loved this country more than Greeks do. He just wanted things done properly.” There is no denying that the National Gallery’s homage to Ziller is at the same time an affectionate embrace of his work as well as Athens, as it was, as it is, and as it could be. 

This article first featured in the summer 2010 edition of Odyssey Magazine       

©2010 Marq Riley

Sculptor Ingbert Brunk and the lure of Naxian Marble

 

At the back of a large stonework yard, tucked away behind raw blocks of marble, a pair of whitened hands carefully whets a rounded object. In stark contrast to the adjacent machinery cleaving massive chunks of rock into practical tiles, a serene scene emerges from amid the industrial humdrum, where that same stone is being shaped into objects of surprising stature. It is here that sculptor Ingbert Brunk has steadily been casting new light on an ancient art form and carving out a unique niche with his works.  

Brunk attests that his attraction to Naxian marble is due in part to the stone’s translucency and large crystals, which impart a more brilliant surface to the finished work. “It possesses a v ery strong vibrancy,” says Brunk, “a high purity, one could almost say freshness. The fascinating aspect is that you’ve got this homogenous, solid material which, by its diaphanous character, suddenly becomes light and gains a conscious immaterialism. Then there is also this phenomenon where other types of stone are sometimes embedded within the marble, various minerals that produce highly interesting structures.”

After starting his first atelier in 1985, following an initial visit with a Berlin University of the Arts student group, he chose to work exclusively with pure white marble, the favoured stone of ancient Hellenic masters. But in recent years Brunk specifically seeks out the yellow, amber or black veins and specks to accentuate his pieces. Indeed, these characteristics define the shape the works will eventually take. This organic approach has produced sculptures of minimalist foundations with oftentimes mystical effects. His signature “Leibchen”—little garment-like bodies with spread out sleeves—are hung in a space where backlight exposes clouded patterns within, as if unveiling the hidden characteristics of its soul.

Throughout his work Brunk’s style manifests itself in abstract themes. On this sunny spring day Daniel Cordes, a close friend and musician who periodically flies out from Germany to assist Brunk, applies the final polish to a curved, almost elastic strip, hewn meticulously from one block of marble. The new piece is to be part of an exhibition in The Netherlands two weeks later, and as these sculptures demand time the extra hands are essential.

“If I knew right from the start exactly what I wanted, the work could be done relatively quickly,” smiles Brunk. “Sometimes I may have an idea beforehand of which effect it should have, the appearance and statement it should make, but the search for getting to that point requires time. It is an emotion I have, but I approach it from a more passive stance, something that comes towards me and I accept or assume and then try to clarify. It’s very important for me that a work has a positive and clear appearance. There should be a secret within, but at least what one sees should be logically justifiable.” He adds that in the final stage the aim is for the work to develop an artistic breath, that breath being the elusive, indescribable element. “And when it has that I’m very satisfied with the work, but when it does not I’m highly un satisfied and am incapable of exhibiting it.”

 Recognition for Brunk’s work has been growing exponentially in the past decade. His sculptures are being showcased in an increasing amount of countries, and even within Greece he is regarded as one of today’s foremost innovators of his art. The people of Naxos were a little slower in appreciating his creations, but Brunk is happy that at least the marble factory’s owner has displayed pride in the artist’s renderings of his island’s famed resource.

The archaic Greek structures and Cycladic figurines may influence Ingbert Brunk, but an important source of inspiration has also been the work of Romanian-French modernist sculptor Constantin Brancusi. His blending of simplicity and sophistication in the early 20th century pioneered abstraction in sculpting. Brunk feels related to the geist initiated by Brancusi in Paris during the 1920s, and in his own way attempts to reformulate it for the 21st century.

Looking into the future, Brunk says that as long as he is physically able Naxos will remain his productive epicentre. The island’s mountains are still filled with an abundance of shining white stone, and having recently built a new atelier on the island’s remote east coast he has assured himself a creative space away from distractions. An exhibition in Japan is still on his wish list, but even though today’s cultural metropolises of New York, London, and Berlin manifest themselves in vibrant artistic exchange, Brunk goes his own way. “I just keep working for myself. That’s us sculptors, we’re einzelgänger.”

This article first featured in the September/October edition of Odyssey magazine