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Biomedical subjects

K Nikolaou

Publications and source records attributed to K Nikolaou.

18 recordsLinked to original sources

[Oxygen-enhanced MRI of the lung: optimized calculation of difference images].

BACKGROUND: In oxygen-enhanced lung MRI, difference maps of acquisitions during inhalation of room air and pure oxygen are calculated to assess lung function. The purpose of this study was to analyze how the calculation of these difference maps depends on the delayed signal change after switching the gas supply. METHODS: Ten healthy volunteers were examined with an ECG and respiratory-triggered T1-weighting inversion recovery HASTE sequence with parallel imaging. Four blocks with 20 repetitions of up to 6 coronal slices were continuously acquired; in blocks 1 and 3 room air was supplied, in blocks 2 and 4 oxygen. Data were postprocessed, discarding between 0 and 19 repetitions after each change of gas supply before calculating the relative signal difference. RESULTS: The averaged relative signal difference increases from 9.4 to 17.4% when the number of discarded acquisitions increases; the ratio of signal difference and spatial standard deviation reaches a maximum at 5-8 discarded acquisitions. CONCLUSIONS: An optimized ratio of signal difference and statistical error is found if about 5-8 of 20 respiratory-triggered repetitions are discarded after each change of gas supply for the calculation of difference maps.

Adult↗

Prevalence of Yersinia enterocolitica in goat herds from Northern Germany.

The prevalence of human pathogenic Yersinia enterocolitica isolates in livestock farming is of paramount interest. Raw goat milk has been proposed as a source of human yersiniosis; however, no data on the prevalence of human strains of Y. enterocolitica in goat herds are available. Therefore, fecal samples (n = 575) were collected from 24 goat herds from Lower Saxony, northern Germany. Pre-enrichment in peptone, sorbitol and bile salts broth was followed by plating on cefsuloidin irgasan novobiocin agar. Yersinia enterocolitica was isolated from 17 (3%) samples of five (21%) goat herds. All isolates were biovar 1A, but represented various serovars. PCR assays targeting Yersinia adhesin (yad) gene and the yopT gene, both associated with pathogenicity, produced no amplification products. Therefore, the isolates can be regarded as opportunistic apathogenic bacteria. Consequently, milk, cheese or meat from goats should not be considered as an important source for human yersiniosis.

Animals↗

[Glanders--a comprehensive review].

Since 1990 the number of glanders outbreaks in race, military and pleasure horses in Asia and South America is steadily increasing. Glanders, which is eradicated in Western Europe, Australia and Northern America, is currently considered a re-emerging disease. Consequently, the disease may be introduced into glanders-free regions by subclinical carriers at any time. The causative agent of glanders, Burkholderia (B.) mallei, is highly contagious and leads to chronic disease in horses whereas in donkeys and mules the disease is acute and often fatal. Occurrence of the disease leads to international trading restrictions and infected animals immediately have to be culled and safely disposed off. In humans B. mallei infection results in a severe clinical course, and is fatal without appropriate therapy. Its pathogenicity makes B. mallei a potential biological agent that may be used in bioterroristic attacks. Due to the eradication of glanders in the second half of the last century, veterinarians in western European countries are no longer familiar with its clinical presentation in solipeds. Having these facts in mind, this review describes the epidemiology, clinical signs, pathology and the current eradication strategy of this interesting zoonosis. Pictures of imported endurance horses infected with glanders taken during an eradication campaign in Dubai, United Arab Emirates, in 2004 illustrate most typical clinical findings.

Animals↗

Prevalence of anti-Yersinia outer protein antibodies in goats in lower saxony.

Little is known about the prevalence of caprine yersiniosis in Germany. Only few cases are reported every year. The intention of the survey was to provide representative data on the seroprevalence of anti-Yersinia antibodies in goats in the German state of Lower Saxony. A commercially available Western blot kit was used to identify caprine and ovine anti-Yersinia antibodies against five proteins [YopM, H, D, E and V-antigen (V-Ag)]. Of the 681 investigated goat sera, 449 (66%) had anti-Yop/V-Ag antibodies. Only two of 28 animal holdings housed sero-negative goats. Boxplot analysis showed that the number of non-reactive animals is correlated to the size of a herd and the fact of milk production, respectively. A tendency was observed that various management factors may influence the anti-Yersinia antibody status. No statement was possible on the impact of keeping additional carrier animals such as pigs, cows or sheep on a farm or the type of husbandry on the seroprevalence of anti-Yersinia antibodies. This study provides trend-setting data for yersiniosis in goat-holdings. The impact on consumer health, i.e. especially for risk groups-like people allergic to cow milk and the impact on the profit of a farm will have to be elucidated in further studies.

Animals↗

Aorto-iliac multidetector-row CT angiography with low kV settings: improved vessel enhancement and simultaneous reduction of radiation dose.

The aim of the study was to implement an abdominal CT angiography protocol using 100 kVp and to compare SNR and CNR, as well as subjective image quality, to a standard CT angiography protocol using 120 kVp on a 16 detector-row CT scanner. Forty-eight patients were referred for routine abdominal CT angiography on a 16 detector-row CT scanner. Patients were scanned using either 120 or 100 kVp at constant mAs settings. Vessel opacification was provided by automated contrast injection using similar injection protocols. Density measurements were performed along the aorto-iliac axis with SNR and CNR calculation. In addition, the estimated effective patient radiation dose was calculated. Results of both protocols were compared. The 100-kVp protocol (432+/-80 HU) showed a significantly higher vessel density than the 120-kVp (333+/-90 HU; P<0.001) protocol, corresponding to an average increase in signal intensity of 30.7%. SNR (36.0 vs 37.0) and CNR (31.1 vs 31.7) for the 100-kV protocol were not significantly lower that those for the standard protocol (P=0.79 and P=0.87), whilst the average estimated dose was significantly lower using the 100-kVp protocol (6.7+/-0.4 vs 10.1+/-1.2 mSv; P<0.0001). Tube kVp reduction from 120 to 100 kVp allows for significant reduction of patient dose in abdominal CT angiography, without significant change in SNR,CNR and image quality.

Adult↗

[Evaluating multislice computed tomography for imaging coronary atherosclerosis].

PURPOSE: The purpose of this study was the evaluation of multidetector-row computed tomography (MDCT) for the assessment of atherosclerotic coronary artery vessel wall changes. METHODS: In an ex vivo study, 17 human hearts were scanned with MDCT and results were compared to histopathology. Morphologic imaging criteria of MDCT for various plaque-types were developed. In a following in vivo study, 94 coronary MDCT angiograms (MDCTA) of patients with suspected coronary artery disease (CAD) were reviewed retrospectively, assessing the diagnostic value of the coronary MDCTA, and determining the number and correlations of the various plaques types as described in the ex vivo study. Additionally, volumetry of calcified and noncalcified plaque components was performed. RESULTS: In the ex vivo study, MDCT showed a high sensitivity for calcified and non-calcified plaques. Comparing the results with histopathology, characteristic image criteria could be determined for lipid-rich, fibrous and calcified plaque components. Reviewing the contrastenhanced in-vivo MDCT coronary angiographies, presence of noncalcified plaques was proven in 38% of the patients. In 5 patients with a calcium score of 0, presence of coronary atherosclerosis was proven in the contrastenhanced scan. CONCLUSIONS: MDCT is able to differentiate various plaque components in an ex vivo setting as well as invivo. Contrastenhanced MDCT of the coronary arteries allows for the detection of noncalcified plaques. In vivo volumetry of noncalcified plaques is feasible.

Adult↗

[Indications for multislice CT angiography of coronary arteries].

INTRODUCTION: The newest generation of 16-detector-row CT allows displaying the anatomy and assessment of coronary artery disease (CAD) when slow regular sinus rhythm is present. METHODS: For morphological assessment of cardiac structures by using Multi-detector row CT a dedicated scan protocol is obligatory. The indication for coronary CT angiography (CTA) is currently under investigation by several study groups. RESULTS: Because of the limited spatial and temporal resolution and coronary calcium artefacts, it is not possible with multislice CT angiography to assess coronary arteries in patients with established coronary artery disease. The anatomy of the coronary arteries can well be displayed with this technique. CONCLUSION: The high negative predictive value of coronary CTA may justify the investigation of symptomatic patients with intermediate pretest probability of CAD. Moreover coronary CTA is suitable for patients for displaying the origin and course of abnormal coronary arteries.

Artifacts↗

[ECG-gated bypass CT angiography--application in imaging arterial bypasses].

Nowadays coronary artery bypass grafting is increasingly performed using arterial grafts. Purpose of the study was the evaluation of a appropriate 16 detector-row CT angiography protocol in patients after predominantly arterial bypass grafting. Fourteen patients after bypass grafting were including into the study and CT angiography carried out in the early postoperative period using a 16 detector-row CT system. To reduce cardiac pulsation artifacts data acquisition was implemented using ECG-gating algorithms. Overall 43 grafts (37 arterial, 6 venous) were examined. In 13 patients surgery had been performed using composite grafts with T or TY configuration. The mean heart rate was 74.1 bpm and showed a negative correlation to the image quality (r=-0.65; p=0.01). However, all data sets were diagnostic. Contrast injection protocol allowed for a homogeneous opacification throughout the vessels of interest. All non-delineationable grafts (5) showed a close proximity to the heart (T or Y grafts). Cardiac surgery is increasingly focusing on arterial revascularisation in bypass grafting and therefore leading to new demands for non-invasive bypass graft imaging. 16 detector-row CT allows a reliable visualization of even composite arterial grafts. However, for detection of grafts in the proximity of the heart a reduction of the heart rate (<65-70) still seems to be necessary.

Aged↗

[Determining global heart function with real time TrueFISP in one respiratory cycle].

Real-time multislice cine techniques lead to inaccurate results in ventricular volumes based on limited temporal resolution. The purpose of the study is to evaluate a real-time cine technique with parallel imaging algorithms in comparison to standard segmented techniques. Twelve patients underwent cardiac cine MRI using real-time multislice cine trueFISP. Temporal resolution was improved using parallel acquisition techniques (iPAT) and data acquisition was performed in a single breath-hold along the patients' short axis. Evaluation of EDV, ESV, EF and myocardial mass was performed and results compared to a standard segmented single-slice cine trueFISP. Combination of real-time cine trueFISP and iPAT provided a temporal resolution of 48 ms. Results of the multislice approach showed an excellent correlation to standard single-slice trueFISP for EDV (0.94, p <0.001), ESV (0.97, p <0.001) EF (0.99, p <0.001) and myocardial mass (0.93, p <0.001). No significant differences could be found. The use of parallel acquisition techniques (PAT) allow for a substantial improvement of temporal resolution in real-time cine MRI (<50 ms). Therefore these techniques enable an accurate and exact quantification of global ventricular function.

Algorithms↗

[Cardiovascular whole body MRI with parallel imaging].

PURPOSE: To create a whole-body cardiovascular MRI protocol with parallel imaging (iPAT). MATERIAL AND METHODS: Twenty two persons participated in the whole body scan. Due to iPAT high resolution imaging of the heart could be performed. 3D contrast enhanced MR angiography (3D-CE-MRA) took only 62 s to cover the whole body at a spatial resolution of less than 1.4x1.0x1.5mm(3). Scan time for HASTE lung imaging could be reduced by the factor of 2 while maintaining the signal to noise ratio (SNR). Image quality was rated by 2 radiologists blinded to each other. RESULTS: Mean scan time was 104 min on the standard system and less than 80 min on the new system. 75% of all MRA segments were rated good in terms of vessel conspicuity, more than 80% had no venous overlay. One case of distal occlusion of the anterior tibial artery and two cases of myocardial infarction were detected. CONCLUSION: Parallel imaging offers the possibility of fast whole body imaging. A combination of morphologic and functional imaging can be performed within less than 80 min.

Adult↗

Identification of Yersinia enterocolitica in minced meat: a comparative analysis of API 20E, Yersinia identification kit and a 16S rRNA-based PCR method.

The isolation and identification of Yersinia enterocolitica from minced meat on CIN agar medium is still one of the major problems in food microbiology because of the low selectivity of cefsulodin-irgasan-novobiocin (CIN) agar. A total of 198 minced meat samples were collected from commercial establishments (butcher shops and supermarkets) in seven German cities in order to investigate the sensitivity and specificity of three identification techniques suitable for the differentiation of Y. enterocolitica within the rich background flora on CIN agar plates. As expected isolation of Y. enterocolitica from minced meat on CIN agar medium after 72 h enrichment in peptone, sorbitol and bile salts (PSB) broth was difficult because all plates were abundantly covered with numerous 'typical'Yersinia-like colonies of bull's eye appearance as well as with atypical colonies. Based on the phenotype of the colonies it was possible to detect colonies showing Yersinia-like growth on CIN agar in 52 samples (26%). For identification of Y. enterocolitica the API 20E system (bioMerieux, Nürtingen, Germany), the Yersinia identification kit (Merlin, Bornheim-Hersel, Germany) and a 16S rRNA based PCR assay were compared. Only in one sample (0.5%) a Y. enterocolitica strain was detected by all methods. Of the three identification systems tested for routine laboratory diagnostics the API 20E system was found to be the most suitable tool to identify Y. enterocolitica colonies within the rich background flora from minced meat samples on CIN agar plates.

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[Prevalence of anti-Yersinia antibodies in European brown hares in North-Rhine Westphalia, Germany].

Yersinia (Y.) pseudotuberculosis infections may lead to significant lethality in European brown hare (Lepus europaeus, Pallas) populations especially during the cold and wet seasons. In recent decades, also Y. enterocolitica was isolated from hares found dead. Consequently, a Western-blot technique proved to be valuable for the detection of antibodies against all pathogenic Yersinia isolates was applied to monitor the prevalence of antibodies in hare populations in North-Rhine Westphalia, Germany. A total of 89.6% of the 230 animals tested was seropositive. Further investigations should be performed to elucidate the role of subclinical yersiniosis in the decline of European brown hare populations in Germany.

Animals↗

Identification and characterization of gene products of ORF U90/89 of human herpesvirus 6.

Human herpesvirus 6 (HHV-6) isolates can be classified into two variants, A and B. Comparison of genomic sequences of these variants has highlighted sequence variability in the region spanning U86 to U100. This region includes the immediate early A (IE-A) locus that was defined as positional homologue of the major IE locus of Human cytomegalovirus (HCMV) with little recognizable sequence homologies. A 3.5 kb transcript, one of the four spliced transcripts identified in the IE-A locus, is derived from the U90/89 ORF encoding the IE1 protein. We expressed six Escherichia coli fragments spanning the HHV-6A U90/89 ORF as IE1 fusion proteins. The bacterially expressed fusion protein was used to raise monospecific polyclonal antiserum for detection and identification of the IE1 protein product(s). Using this antiserum we detected 165, 190, and > 190 K proteins in HHV-6A- and HHV-6B-infected cells and the 165 K protein in cells transfected with an IE1 cDNA construct. The IE1 proteins exhibited perinuclear and cytoplasmic localization in infected cells. There was a correlation between the expression level of IE1 and the degree of permissiveness for virus growth in various cell lines. In transient expression experiments a 140 bp fragment from the upstream IE-A region was shown to possess promoter activity. The C-terminal region of IE1 delineated by amino acids (aa) 588 to 636 showed a DNA binding activity in Southwestern blot analysis.

Animals↗

[Radiation dose and dose reduction in multidetector row CT (MDCT)].

Since its introduction a few years ago, multidetector row CT (MDCT) has become a widely used diagnostic procedure and has been proven to be a valuable tool for various indications. A major issue using this new modality is the inherent risk of applying increased radiation exposure, when compared to single-slice CT or other imaging modalities.However, MDCT offers some valuable options to save radiation exposure, such as choosing optimized exposure parameters or its superior dose efficiency in comparison to single-slice CT. Multi-phasic examinations should be restricted to indications where definitely necessary. Modern scanners offer intelligent tools for further reduction of radiation dose, such as ECG- or bodyshape-based realtime dose modulation. A new field of applications is the low-dose CT for early detection of diseases. While acquiring thin slices with high spatial resolution, the dose can be reduced to similar values as in conventional radiography, especially when examining under high-contrast conditions. Using all these various options available, radiation exposure can sometimes even be lower than using a conventional single-slice helical CT.

Artificial Intelligence↗

[Differentiation of benign osteoporotic and neoplastic vertebral compression fractures with a diffusion-weighted, steady-state free precession sequence].

PURPOSE: To evaluate the diagnostic accuracy of a diffusion-weighted, steady-state free precession (SSFP) sequence for the differentiation of acute benign osteoporotic and neoplastic vertebral compression fractures. METHODS: 85 patients with 102 vertebral compression fractures were examined with MR imaging using a spine array surface coil (Siemens, Vision, 1.5 Tesla). The following sequences were performed in sagittal orientation: T1-weighted spin echo (SE), short-tau inversion recovery (STIR) and a diffusion-weighted SSFP sequence (TR = 25 msec, diffusion pulse length delta = 3 msec). The SSFP images were evaluated qualitatively on a 5-grade scale from strongly hypointense to strongly hyperintense. Quantitative analysis was performed with region of interest measurements (ROI) and calculation of a bone marrow ratio. RESULTS: 60 fractures were due to osteoporosis and 42 fractures were caused by malignancy. "Hyperintensity" in a vertebral fracture on a SSFP sequence provided a sensitivity of 100 % and a specificity of 93 %. The positive predictive value was 91 %, the negative predictive value was 100 %. Quantitative analysis of the bone marrow ratio showed a statistically significant difference between the osteoporosis and the tumor group (p < 0.001). The mean value for the osteoporotic fractures was - 0.32 (SD 0.33) and + 2.07 (SD 1.37) for the tumor group. CONCLUSION: The SSFP sequence provides a high accuracy in the differentiation of benign osteoporotic and neoplastic vertebral compression fractures.

Adult↗

Emissions reduction of high and low polluting new technology vehicles equipped with a CeO2 catalytic system

The efficiency of a catalytic system that provides the vehicle combustion chamber with an adequate amount of cerium oxide (CeO2), without affecting the operational parameters of the engine, has been studied for pollutant emissions reduction. New technology gasoline engine passenger cars, equipped with this catalytic system, have been driven on their normal route by the same drivers, in order to obtain the same traffic conditions and the same driving mode, as far as possible. These vehicles were tested for CO and HC emissions before and after the installation of the catalytic system. The new technology passenger cars examined have been divided into two categories using as criterion the level of their initial emissions (before the installation of the CeO2 catalytic system). The two categories are: (a) high polluting cars with CO and HC emissions above the implemented standards; and (b) low polluting cars with emissions below the standards. Both car categories equipped with the CeO2 system, present important reduction of the pollutant emissions. The results are interpreted statistically and they are correlated with other studies.

Journal Article↗

Navigator echo-based respiratory gating for three-dimensional MR coronary angiography: results from healthy volunteers and patients with proximal coronary artery stenoses.

OBJECTIVE: The purpose of our study was to investigate the value of respiratory-gated three-dimensional (3D) MR angiography in identifying coronary arteries in healthy volunteers and in patients with proximal coronary artery stenosis and to compare the results with those of conventional coronary angiography. SUBJECTS AND METHODS: Twenty healthy volunteers and 20 patients with coronary artery stenosis were examined on a 1.5-T scanner with a retrospectively respiratory-gated 3D gradient-echo sequence. Visualization of the main coronary arteries was analyzed after curved multiplanar reconstructions. A six-point grading system was used to evaluate 400 vessel segments. The assessment of stenosis was performed by two observers who were unaware of the results of conventional coronary angiography. RESULTS: The proximal, middle, and distal segments of the coronary arteries were completely identified with or without luminal irregularities in 55%, 47%, and 20%, respectively, of the healthy volunteers. For the 20 patients, results were 69%, 44%, and 20%, respectively. For the assessment of coronary artery stenoses (n = 53), sensitivity was 73% and specificity was 50% after evaluation of the MR angiograms of all patients. A sensitivity of 79% and a specificity of 54% were found for evaluation of the MR coronary angiograms, with an image quality score of at least 3 (i.e., artery segments completely identified with major luminal irregularities). CONCLUSION: With the navigator echo MR imaging technique, a complete 3D visualization of the main coronary arteries was possible in cases with high image quality. However, further experience with and improvement of the navigator echo technique we used is necessary for reliable assessment of coronary artery stenosis.

Adult↗

Navigator echo-based respiratory gating for three-dimensional MR coronary angiography: reduction of scan time using a slice interpolation technique.

PURPOSE: The aim of the study was to compare a conventional respiratory-gated 3D MR coronary angiographic technique (conventional MRCA) with a respiratory-gated 3D MR coronary angiographic technique that includes a slice interpolation technique (slice interpolation MRCA). Both MRCA techniques were compared based on the quality of visualization of the coronary arteries and the diagnostic accuracy in identifying hemodynamically significant coronary artery stenoses. METHOD: Forty patients with known proximal coronary artery stenosis after conventional CA were examined on a 1.5 T scanner, that is, 20 patients with each sequence. A 6 point grading system (0 = worst quality, 5 = best quality) was used to evaluate and compare the image quality. The length and proximal diameter of the depicted coronary arteries were measured. Detection of coronary artery stenoses was compared with that obtained by conventional CA by two blinded readers. RESULTS: With the slice interpolation technique, the average scan time of the entire heart was reduced by approximately 40%. With use of conventional MRCA, 69% of all proximal and middle coronary artery segments were visualized with a sufficient image quality; with the slice interpolation technique, 79% of these segments were depicted adequately. For the assessment of stenoses, sensitivity was 71% and specificity was 53% for conventional MRCA and 72 and 60% for slice interpolation MRCA, respectively. These differences in sensitivity and specificity were statistically not significant. CONCLUSION: The application of a slice interpolation technique reduces the scan time, maintains a comparable sensitivity and specificity for the assessment of coronary artery stenoses, and increases the number of completely identified coronary artery segments compared with the conventional technique.

Aged↗