Biomedical subjects

Thomas Boehm

Publications and source records attributed to Thomas Boehm.

At least 19 recordsLinked to original sources

PubMed2006

Visualization of congenital thoracic vascular anomalies using multi-detector row computed tomography and two- and three-dimensional post-processing.

Anomalies of the vascular system are caused by false embryogenesis and are therefore present from birth. Single-detector row spiral computed tomography angiography (CTA) and multi-detector row computed tomography angiography (MDCTA) have gained increasing importance in the non-invasive assessment of vascular pathologies and replace conventional angiography in many cases. High-resolution volumetric datasets that are acquired during a single breath-hold give the possibility of two- (2D) and three-dimensional (3D)-post-processing. Due to post-processing, even complex vascular malformations are visualized in an understandable way. Furthermore, CTA, in contrast to conventional angiography, depicts not only the vascular structures but also allows assessment of the surrounding anatomical structures. We present cases of rare congenital anomalies of the thoracic vessels using MDCT with special respect to 2D- and 3D-post-processing.

Algorithms↗

PubMed2006

Noninvasive coronary angiography with 64-section CT: effect of average heart rate and heart rate variability on image quality.

PURPOSE: To evaluate prospectively the effect of average heart rate and heart rate variability on image quality at 64-section computed tomographic (CT) coronary angiography. MATERIALS AND METHODS: The study protocol had local ethics committee approval; written informed consent was obtained. There were 125 patients (45 women, 80 men; mean age, 59.9 years +/- 12.9 [standard deviation]; 79 receiving beta-blockers) who underwent 64-section CT coronary angiography with retrospective electrocardiographic gating. Data sets were reconstructed in 5% steps from 20% to 80% of R-R interval. Heart rate variability was calculated as 1 standard deviation from mean rate during scanning. Two observers rated image quality of each coronary segment at least 1.5-mm diameter (1 = no motion artifacts, 5 = not evaluative). Repeated analysis of variance measurements were performed to evaluate quantitative parameters. Pearson correlation analysis was performed to compare image quality in each patient with average heart rate and heart rate variability. RESULTS: Average heart rate was 63.3 beats per minute +/- 13.1, with variability of 3.2 beats per minute +/- 2.1. Diagnostic image quality (score < or = 3) was attained in 1821 of 1836 segments at the best reconstruction interval. There was no correlation between mean heart rate and image quality for all segments of the right coronary and left anterior descending arteries, but there was a significant correlation for left circumflex artery (r = 0.33, P < .05). Heart rate variability was correlated with image quality overall (r = 0.75, P < .001) and for each coronary artery. Heart rate was less variable and image quality was better (P < .05) in patients receiving beta-blockers. Best image quality was obtained in diastole with heart rate less than 80 beats per minute and in systole with faster heart rate. CONCLUSION: Coronary angiography with 64-section CT provides diagnostic image quality within a wide range of heart rates. Reducing average heart rate and heart rate variability is beneficial for reducing artifacts.

Adult↗

PubMed2006

Thymus-homing precursors and the thymic microenvironment.

T cells develop in the thymus from precursors that are generated in the bone marrow and continuously seed the thymus through the blood. During evolution, 'outsourcing' the development of one blood lineage, namely the T-cell lineage, to an anatomically distinct hematopoietic organ required the generation of migratory precursors in the bone marrow, their homing to specialized, precursor-retaining thymic niches and their subsequent differentiation. Niche building and precursor homing are therefore intricately linked and should be viewed in context. In this review, we discuss recent findings on the developmental and genetic events that prepare the thymic epithelial microenvironment for its complex tasks, and highlight recent progress in the definition of the thymus-settling cells and the homing process that leads them into the thymus.

Animals↗

PubMed2006

Conserved functions of Ikaros in vertebrate lymphocyte development: genetic evidence for distinct larval and adult phases of T cell development and two lineages of B cells in zebrafish.

Zebrafish has been advocated as an alternative animal model to study lymphocyte development, although the similarities in the genetic requirements of lymphopoiesis between fish and mammals have not yet been investigated. In this study, we examine the role of the transcription factor Ikaros in zebrafish lymphopoiesis. In fish larvae homozygous for an ikaros allele predicted to lack the C-terminal zinc fingers, T lymphopoiesis is absent; the presence of V(H)DmuJmu rearrangements in adolescent fish is delayed in mutants. In adolescent mutant fish, T cells expressing tcrb and tcrd and B cells expressing igm are formed with low efficiency and display an oligoclonal Ag receptor repertoire. By contrast, B cells expressing the igz isotype do not develop, providing genetic evidence for two separate B cell lineages in zebrafish. Thus, Ikaros appears to play similar roles in fish and mammalian lymphopoiesis.

Alleles↗

PubMed2006

Formation of a functional thymus initiated by a postnatal epithelial progenitor cell.

The thymus is essential for the generation of self-tolerant effector and regulatory T cells. Intrathymic T-cell development requires an intact stromal microenvironment, of which thymic epithelial cells (TECs) constitute a major part. For instance, cell-autonomous genetic defects of forkhead box N1 (Foxn1) and autoimmune regulator (Aire) in thymic epithelial cells cause primary immunodeficiency and autoimmunity, respectively. During development, the thymic epithelial rudiment gives rise to two major compartments, the cortex and medulla. Cortical TECs positively select T cells, whereas medullary TECs are involved in negative selection of potentially autoreactive T cells. It has long been unclear whether these two morphologically and functionally distinct types of epithelial cells arise from a common bi-potent progenitor cell and whether such progenitors are still present in the postnatal period. Here, using in vivo cell lineage analysis in mice, we demonstrate the presence of a common progenitor of cortical and medullary TECs after birth. To probe the function of postnatal progenitors, a conditional mutant allele of Foxn1 was reverted to wild-type function in single epithelial cells in vivo. This led to the formation of small thymic lobules containing both cortical and medullary areas that supported normal thymopoiesis. Thus, single epithelial progenitor cells can give rise to a complete and functional thymic microenvironment, suggesting that cell-based therapies could be developed for thymus disorders.

Animals↗

PubMed2006

Quality control in self/nonself discrimination.

Unicellular eukaryotes primarily employ self/nonself discrimination to avoid self-mating, whereas multicellular organisms also use self/nonself discrimination in immune defense. Recent advances in understanding self/nonself discrimination in eukaryotes shed new light on the emergence of the most sophisticated self/nonself discrimination system known, the antigen receptors employed in the adaptive immune system.

Animals↗

PubMed2006

Aortic stenosis: comparative evaluation of 16-detector row CT and echocardiography.

PURPOSE: To prospectively evaluate whether planimetric measurements of aortic valve area (AVA) with 16-detector row computed tomography (CT) allow classification of aortic stenosis (AS). MATERIALS AND METHODS: The study had institutional review board approval; patients gave informed consent. Twenty patients (11 men, nine women; mean age, 63 years) with AS and 20 patients (10 men, 10 women; mean age, 65 years) without underwent transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), and retrospectively electrocardiographically gated 16-detector row CT. Twenty CT data sets were reconstructed in 5% steps of R-R interval; data analysis was performed with four-dimensional software. Maximum AVA in systole planimetrically measured with CT (AVA(CT)) was compared with AVA planimetrically measured with TEE (AVA(TEE)), AVA calculated with the continuity equation and TTE (AVA(TTE)), and transvalvular pressure gradients determined with the Bernoulli equation and TTE. Correlations among AVA(CT), AVA(TTE), AVA(TEE), and transvalvular pressure gradients were tested with bivariate regression analysis; agreement between methods was assessed with the Bland-Altman method. RESULTS: In patients without AS, mean AVA(CT) was 3.56 cm2 +/- 0.66 and mean AVA(TEE) was 3.43 cm2 +/- 0.69. In patients with AS, mean AVA(CT) was 0.89 cm2 +/- 0.35; mean AVA(TEE), 0.86 cm2 +/- 0.35; and mean AVA(TTE), 0.83 cm2 +/- 0.33. Mean transvalvular pressure gradient was 51 mm Hg +/- 22. Significant correlations were present between AVA(CT) and AVA(TEE) (r = 0.99, P < .001), AVA(CT) and AVA(TTE) (r = 0.95, P < .001), and AVA(CT) and transvalvular pressure gradients (r = -0.74, P < .01). Mean differences were -0.08 cm2 (limits of agreement: -0.32, 0.16) for AVA(CT) versus AVA(TEE) and 0.06 cm2 (limits of agreement: -0.15, 0.26) for AVA(CT) versus AVA(TTE). CONCLUSION: Planimetric measurements of AVA with retrospectively electrocardiographically gated 16-detector row CT allow classification of AS that is similar to that achieved with measurements by using echocardiographic methods.

Aged↗

PubMed2006

Optimal image reconstruction intervals for non-invasive coronary angiography with 64-slice CT.

The reconstruction intervals providing best image quality for non-invasive coronary angiography with 64-slice computed tomography (CT) were evaluated. Contrast-enhanced, retrospectively electrocardiography (ECG)-gated 64-slice CT coronary angiography was performed in 80 patients (47 male, 33 female; mean age 62.1+/-10.6 years). Thirteen data sets were reconstructed in 5% increments from 20 to 80% of the R-R interval. Depending on the average heart rate during scanning, patients were grouped as < 65 bpm (n = 49) and > or = 65 bpm (n = 31). Two blinded and independent readers assessed the image quality of each coronary segment with a diameter > or = 1.5 mm using the following scores: 1, no motion artifacts; 2, minor artifacts; 3, moderate artifacts; 4, severe artifacts; and 5, not evaluative. The average heart rate was 63.3 +/- 13.1 bpm (range 38-102). Acceptable image quality (scores 1-3) was achieved in 99.1% of all coronary segments (1,162/1,172; mean image quality score 1.55 +/- 0.77) in the best reconstruction interval. Best image quality was found at 60% and 65% of the R-R interval for all patients and for each heart rate subgroup, whereas motion artifacts occurred significantly more often (P < 0.01) at other reconstruction intervals. At heart rates < 65 bpm, acceptable image quality was found in all coronary segments at 60%. At heart rates > or = 65 bpm, the whole coronary artery tree could be visualized with acceptable image quality in 87% (27/31) of the patients at 60%, while ten segments in four patients were rated as non-diagnostic (scores 4-5) at any reconstruction interval. In conclusion, 64-slice CT coronary angiography provides best overall image quality in mid-diastole. At heart rates < 65 bpm, diagnostic image quality of all coronary segments can be obtained at a single reconstruction interval of 60%.

Adult↗

PubMed2006

Evidence for a functional second thymus in mice.

The thymus organ supports the development of T cells and is located in the thorax. Here, we report the existence of a second thymus in the mouse neck, which develops after birth and grows to the size of a small lymph node. The cervical thymus had a typical medulla-cortex structure, was found to support T cell development, and could correct T cell deficiency in athymic nude mice upon transplantation. The identification of a regular second thymus in the mouse may provide evolutionary links to thymus organogenesis in other vertebrates and suggests a need to reconsider the effect of thoracic thymectomy on de novo T cell production.

Animals↗

PubMed2006

Essential role of the main olfactory system in social recognition of major histocompatibility complex peptide ligands.

Genes of the major histocompatibility complex (MHC), which play a critical role in immune recognition, influence mating preference and other social behaviors in fish, mice, and humans via chemical signals. The cellular and molecular mechanisms by which this occurs and the nature of these chemosignals remain unclear. In contrast to the widely held view that olfactory sensory neurons (OSNs) in the main olfactory epithelium (MOE) are stimulated by volatile chemosignals only, we show here that nonvolatile immune system molecules function as olfactory cues in the mammalian MOE. Using mice with targeted deletions in selected signal transduction genes (CNGA2, CNGA4), we used a combination of dye tracing, electrophysiological, Ca2+ imaging, and behavioral approaches to demonstrate that nonvolatile MHC class I peptides activate subsets of OSNs at subnanomolar concentrations in vitro and affect social preference of male mice in vivo. Both effects depend on the cyclic nucleotide-gated (CNG) channel gene CNGA2, the function of which in the nose is unique to the main population of OSNs. Disruption of the modulatory CNGA4 channel subunit reveals a profound defect in adaptation of peptide-evoked potentials in the MOE. Because sensory neurons in the vomeronasal organ (VNO) also respond to MHC peptides but do not express CNGA2, distinct mechanisms are used by the mammalian main and accessory olfactory systems for the detection of MHC peptide ligands. These results suggest a general role for MHC peptides in chemical communication even in those vertebrates that lack a functional VNO.

Animals↗

PubMed2006

Influence of cardiac hemodynamic parameters on coronary artery opacification with 64-slice computed tomography.

The purpose of this study was to evaluate the influence of ejection fraction (EF), stroke volume (SV), heart rate, and cardiac output (CO) on coronary artery opacification with 64-slice computed tomography (CT). Sixty patients underwent, retrospectively, electrocardiography-gated 64-slice CT coronary angiography. Left ventricular EF, SV, and CO were calculated with semi-automated software. Attenuation values were measured and contrast-to-noise ratios (CNRs) were calculated in the proximal right coronary artery (RCA) and left main artery (LMA). Mean EF during scanning was 61.5+/-12.4%, SV was 63.2+/-15.6 ml, heart rate was 62.5+/-11.8 beats per minute (bpm), and CO was 3.88+/-1.06 l/min. There was no significant correlation between the EF and heart rate and the attenuation and CNR in either coronary artery. A significant negative correlation was found in both arteries between SV and attenuation (RCA r=-0.26, P<0.05; LMA r=-0.34, P<0.01) and between SV and CNR (RCA r=-0.26, P<0.05; LMA r=-0.26, P<0.05). Similarly, a significant negative correlation was found between the CO and attenuation (RCA r=-0.42, P<0.05; LMA r=-0.56, P<0.001) and between the CO and CNR (RCA r=-0.39, P<0.05; LMA r=-0.44, P<0.001). The actual hemodynamic status of the patient influences the coronary artery opacification with 64-slice CT, in that vessel opacification decreases as SV and CO increase.

Adult↗

PubMed2006

CT angiography of peripheral arterial bypass grafts: Accuracy and time-effectiveness of quantitative image analysis with an automated software tool.

RATIONALE AND OBJECTIVES: Qualitative analysis of computed tomography (CT) angiography data often is limited by intra- and interobserver variability. The purpose of this study was to evaluate the time-effectiveness and accuracy of a quantitative CT angiography data analysis using automated software in comparison with qualitative axial and coronal CT image reading in patients with peripheral bypass grafts. MATERIALS AND METHODS: Twenty-eight patients with 33 saphenous bypass grafts underwent 4-channel (n = 21) and 16-channel (n = 7) CT angiography. Two readers evaluated in consensus the CT data qualitatively on axial and coronal reconstructions and with the software regarding the presence of graft stenoses, aneurysmal changes, and arteriovenous fistulas. The time for data analysis was taken and the accuracy was compared with the results from digital subtraction angiography (DSA). RESULTS: No significant difference was present between data analysis time using axial and coronal CT images (4.9 +/- 1.5 minutes) and when using the software tool (5.5 +/- 1.4 minutes). Good (kappa = 0.652) to excellent (kappa = 1.000) intermodality agreement was present between qualitative and quantitative CT analysis regarding graft-related abnormalities. Sensitivity and specificity for diagnosing stenoses, aneurysms, and fistula did not differ significantly (P > .025) between qualitative CT image reading and the automated software tool. CONCLUSIONS: CT angiography analysis of peripheral bypass grafts using an automated software tool is similar regarding time-effectiveness and accuracy when compared with qualitative CT data analysis on axial and coronal images. It may assist in determining the significance of an abnormality and can yield objective morphometric data of vessel calibers.

Algorithms↗

PubMed2006

Co-evolution of a primordial peptide-presentation system and cellular immunity.

How did early vertebrates survive when their lymphocytes began to use antigen receptors with random specificities, despite their potential for extensive self-reactivity? Here, I propose that the quality-control mechanisms that tame self-reactivity in the adaptive immune system were derived, at least in part, from an ancient mechanism that guided sexual selection on the basis of evaluating genetic relatedness.

Animals↗

PubMed2005

Mitral regurgitation: quantification with 16-detector row CT--initial experience.

PURPOSE: To prospectively determine if retrospectively electrocardiographic (ECG)-gated multi-detector row computed tomography (CT) with a 16-detector row CT scanner can depict mitral regurgitation and enable quantification of the severity of the disease. MATERIALS AND METHODS: The study had institutional review board approval, and patients gave informed consent. Nineteen patients with mitral regurgitation (10 men, nine women; mean age, 66 years +/- 9 [standard deviation]; range, 41-83 years) and 25 patients without mitral regurgitation (14 men, 11 women; mean age, 68 years +/- 9; range, 43-83 years) as determined with transesophageal color Doppler echocardiography and ventriculography underwent retrospectively ECG-gated 16-detector row CT. Twenty CT data sets covering the entire mitral valve apparatus were reconstructed in 5% steps of the R-R interval for each patient, and data analysis was performed with four-dimensional software. Using planimetry, two readers measured in consensus the area of the regurgitant orifice during systole. These measurements were compared with semiquantitative data from transesophageal echocardiography and ventriculography by using Spearman rank order correlation coefficients. RESULTS: In the 25 patients without mitral regurgitation, no regurgitant orifice during systole could be detected with multi-detector row CT. In the 19 patients with mitral regurgitation, a regurgitant orifice could be visualized in all cases. The mean regurgitant orifice area at CT-45 mm(2) +/- 34 (range, 10-148 mm(2))-correlated significantly with the results at transesophageal echocardiography (r = 0.807, P < .001) and ventriculography (r = 0.922, P < .001). CONCLUSION: Planimetric measurements of the regurgitant orifice area at retrospectively ECG-gated 16-detector row CT enable quantification of mitral regurgitation.

Adult↗

PubMed2005

MHC peptides and the sensory evaluation of genotype.

Social interactions, such as finding and identifying a mate, often rely on the ability to sense molecular cues carrying information about genetic relationship and individuality. We summarize recent evidence for an unexpected mechanistic link between the immune and olfactory systems in enabling this identification process. In addition to their established role in the immune response, peptide ligands of major histocompatibility complex (MHC) molecules constitute a previously unknown family of social recognition signals detected by specific subsets of sensory neurons in the mammalian nose. This sensing of MHC peptides can be viewed as a form of functional genome analysis by the nose. Behavioral studies in mice and fish show that MHC peptides are accepted as olfactory cues that influence mate choice decisions and selective pregnancy failure. These findings provide a molecular mechanism by which an individual can sense the composition and compatibility of vital immune system molecules of a conspecific, with direct consequences for social behavior.

Animals↗

PubMed2005

Coronal thick CT reconstruction: an alternative for initial chest radiography in trauma patients.

It has been proposed that the imaging workup of trauma patients be accelerated by omitting the initial chest radiography (CR) and directly performing a computed tomography (CT); however, the baseline CR is then lacking. The purpose of this study was to assess if coronal thick reconstructions generated from chest CT could present an adequate alternative for CR. Sixty trauma patients underwent bedside CR and multidetector row chest CT in the emergency room. The image quality of thoracic anatomical structures, the diagnostic accuracy for chest pathology, and the depiction of indwelling devices were assessed on both modalities. Main pulmonary arteries and perihilar bronchi were equally visualized with both modalities. Central bronchi, retrocardial lung parenchyma, diaphragm, descending aorta, and vertebral pedicles were better visualized on thick CT reconstructions, whereas peripheral lung vessels were better depicted on CR (p<0.05). The accuracy to delineate various pathological findings did not differ between both modalities, except for a higher sensitivity to diagnose bronchial cuffing on CR (p<0.05). The location of indwelling devices was similarly and correctly depicted with both modalities. Coronal thick CT reconstructions provide a similar image quality and diagnostic accuracy compared with CR. These reconstructions may serve as an equivalent baseline image in trauma patients in whom emergency radiological evaluation has to be accelerated.

Adolescent↗

PubMed2005

Comparison of retrospectively ECG-gated and nongated MDCT of the chest in an emergency setting regarding workflow, image quality, and diagnostic certainty.

PURPOSE: This study aims to assess the influence of ECG-gated acquisition on workflow and to compare image quality and diagnostic certainty for retrospectively ECG-gated and nongated multidetector computed tomography of the chest in the emergency suite. MATERIALS AND METHODS: Thirty-two consecutive patients were referred for both an ECG-gated and a nongated CT to rule out traumatic thoracic injury (n=15) or acute aortic dissection (n=17). The time from the start of the transportation from the emergency suite to the CT room until the start of the CT scan was recorded. Using a scoring system, the image quality of axial images and multiplanar reformats, the presence of disease, and the subjective diagnostic certainty were assessed with regard to the vascular structures, the bone structures, and the lung parenchyma. RESULTS: The time needed for transportation and patient preparation was 12.1+/-1.7 min (8.1-14.5 min). The motion artifacts of the thoracic aorta and the supra-aortic vessels were significantly reduced in the ECG-gated data acquisition compared with the nongated technique (P<0.001). Subjective diagnostic certainty for assessment of the aorta was significantly better using ECG gating. The image quality of the lung parenchyma (P<0.005), the spine (P<0.005), and the ribs (P<0.002) was inferior in the ECG-gated data sets but did not compromise the detection rate of traumatic lesions and fractures. CONCLUSION: Performing ECG gating in the emergency room did not slow down the diagnostic workup. ECG-gated acquisition performed better in the assessment of the aorta, but image quality for lung and bone structures was slightly reduced. Further studies are required to assess the influence of the imaging technique on the diagnostic outcome.

Aorta, Thoracic↗

PubMed2005

BMP signaling is required for normal thymus development.

The microenvironment of the thymus fosters the generation of a diverse and self-tolerant T cell repertoire from a pool of essentially random specificities. Epithelial as well as mesenchymal cells contribute to the thymic stroma, but little is known about the factors that allow for communication between the two cells types that shape the thymic microenvironment. In this study, we investigated the role of bone morphogenetic protein (BMP) signaling in thymus development. Transgenic expression of the BMP antagonist Noggin in thymic epithelial cells under the control of a Foxn1 promoter in the mouse leads to dysplastic thymic lobes of drastically reduced size that are ectopically located in the neck at the level of the hyoid bone. Interestingly, the small number of thymocytes in these thymic lobes develops with normal kinetics and shows a wild-type phenotype. Organ initiation of the embryonic thymic anlage in these Noggin transgenic mice occurs as in wild-type mice, but the tight temporal and spatial regulation of BMP4 expression is abrogated in subsequent differentiation stages. We show that transgenic Noggin blocks BMP signaling in epithelial as well as mesenchymal cells of the thymic anlage. Our data demonstrate that BMP signaling is crucial for thymus development and that it is the thymic stroma rather than developing thymocytes that depends on BMP signals.

Animals↗