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Biomedical subjects

B S Hu

Publications and source records attributed to B S Hu.

At least 55 records · Page 3Linked to original sources

Coronary angiography with magnetization-prepared T2 contrast.

A magnetization-prepared, T2-weighted sequence (T2 Prep) is used to suppress muscle and venous structures. When combined with lipid suppression, this technique improves the visualization of the coronary arteries. T2 Prep was designed to be rebust in the presence of flow as well as B0 and B1 inhomogeneities and may be combined with virtually any imaging technique. Here, it is implemented with both a single-slice spiral acquisition and a multi-slice spiral method that acquires up to 15 slices in a single breath-holding interval.

Arteries↗

The diminishing variance algorithm for real-time reduction of motion artifacts in MRI.

A technique has been developed whereby motion can be detected in real time during the acquisition of data. This enables the implementation of several algorithms to reduce or eliminate motion effects from an image as it is being acquired. One such algorithm previously described is the acceptance/rejection method. This paper deals with another real-time algorithm called the diminishing variance algorithm (DVA). With this method, a complete set of preliminary data is acquired along with information about the relative motion position of each frame of data. After all the preliminary data are acquired, the position information is used to determine which data frames are most corrupted by motion. Frames of data are then reacquired, starting with the most corrupted one. The position information is continually updated in an iterative process; therefore, each subsequent reacquisition is always done on the worst frame of data. The algorithm has been implemented on several different types of sequences. Preliminary in vivo studies indicate that motion artifacts are dramatically reduced.

Algorithms↗

DNA fingerprinting of Pseudomonas aeruginosa serotype O11 by enterobacterial repetitive intergenic consensus-polymerase chain reaction and pulsed-field gel electrophoresis.

We report the use of pulsed-field gel electrophoresis (PFGE) and enterobacterial repetitive intergenic consensus (ERIC)-based polymerase chain reaction (PCR) to characterize clinical isolates of Pseudomonas aeruginosa serotype O11 collected from an incident of hospital-acquired infection. Both typing techniques differentiated 20 different strain types among seven epidemiologically related isolates and 22 epidemiologically unrelated isolates. There was complete concordance between these two techniques. Our results indicate that the ERIC-based PCR technique represents a rapid and simple means for typing P. aeruginosa serotype O11 with a level of discrimination equivalent to that of PFGE.

Base Sequence↗

Comparison of susceptibility to extended-spectrum beta-lactam antibiotics and ciprofloxacin among gram-negative bacilli isolated from intensive care units.

The in vitro activities of extended-spectrum beta-lactam antibiotics (including piperacillin, cefotaxime, ceftriaxone, ceftazidime, cefepime, imipenem, and meropenems) were assessed and compared with the activity of ciprofloxacin against 366 clinical Gram-negative bacilli isolates from the intensive care units of Taichung Veterans General Hospital. The most prevalent species isolated were Pseudomonas aeruginosa and Acinetobacter baumannii. The activities of ceftazidime, cefepime, imipenem, and meropenem against these isolates were comparable to that of ciprofloxacin. Meropenem was found to be the most potent extended-spectrum beta-lactam antibiotic tested and the MIC50s and MIC90s for most of these multiresistant strains were lower than those of imipenem, ceftazidime, and cefepime, except for Stenotrophomonas maltophilia. The extended-spectrum beta-lactam antibiotics that were still active against S. maltophilia were piperacillin and ceftazidime. More than 50% of Enterobacter spp. were resistant to third-generation cephalosporins and piperacillin, but they remained susceptible to carbapenems and cefepime.

Anti-Bacterial Agents↗

Comparison of different PCR approaches for characterization of Burkholderia (Pseudomonas) cepacia isolates.

In this study, we evaluated three PCR methods for epidemiological typing of Burkholderia (Pseudomonas) cepacia--PCR-ribotyping, arbitrarily primed PCR (AP-PCR) and enterobacterial repetitive intergenic consensus sequence PCR (ERIC-PCR)--and compared them with pulsed-field gel electrophoresis. The analysis was performed with 31 isolates of B. cepacia, comprising 23 epidemiologically unrelated isolates and 8 isolates collected from the same patient during two episodes of bacteremia. Pulsed-field gel electrophoresis, ERIC-PCR, and AP-PCR identified 23 distinct types among the 23 unrelated isolates, while PCR-ribotyping only identified 12 strain types, even after AluI digestion of the amplification products. Among the eight isolates collected from the same patient, all typing techniques revealed two clones of strains. The day-to-day reproducibilities of PCR-ribotyping and ERIC-PCR were good, while greater day-to-day variations were noted in the fingerprints obtained by AP-PCR. We conclude that all three PCR techniques are useful for rapid epidemiological typing of B. cepacia, but ERIC-PCR seems to be more reproducible and discriminative.

Base Sequence↗

Analysis of clonal relationships among isolates of Shigella sonnei by different molecular typing methods.

Shigella sonnei is a major cause of diarrheal disease in developed as well as in developing countries. Epidemiologic studies of this organism have been limited by the lack of a simple and effective method for comparing strains. In this study, we have compared different molecular typing methods, i.e., plasmid profile analysis, restriction endonuclease analysis of plasmids, rRNA gene restriction analysis (ribotyping), pulsed-field gel electrophoresis (PFGE), and enterobacterial repetitive intergenic consensus (ERIC) sequence-based PCR (ERIC-PCR) for typing 20 clinical isolates of S. sonnei collected from six incidents of infection. PFGE and ERIC-PCR fingerprintings had the highest discriminatory power for discrimination of epidemiologically related isolates from epidemiologically unrelated strains of S. sonnei, and both gave seven distinct strain types among these isolates and the type strain of the species. Plasmid study and ribotyping produced only six and typing techniques demonstrated two distinct patterns, respectively, among these strains. All of these molecular an identical fingerprint for eight temporally related sporadic isolates. It is possible that these temporally related isolates belonged to a single bacterial clone and circulated obscurely through the community. Our results indicate that the ERIC-PCR technique represents a rapid and simple means for typing S. sonnei with a level of discrimination equivalent to that of PFGE but greater than those of plasmid profile analysis, restriction endonuclease analysis of plasmids, and ribotyping.

Bacterial Typing Techniques↗

Real-time motion detection in spiral MRI using navigators.

A technique has been developed whereby motion can be detected in real time during the acquisition of data. This enables the implementation of an algorithm to accept or reject and reacquire data during a scan. Frames of data with motion are rejected and reacquired on the fly so that by the end of the scan, a complete motion-free data set has been acquired. The algorithm has been implemented on several different types of sequences. Preliminary in vivo studies indicate that motion artifacts are dramatically reduced.

Abdomen↗

Use of PCR to study epidemiology of Serratia marcescens isolates in nosocomial infection.

A method to characterize strains of Serratia marcescens based on the PCR amplification of enterobacterial repetitive intergenic consensus sequences has been developed. The PCR fingerprints were generated from boiled supernatants prepared directly from bacterial colonies without the need for DNA extraction. The technique was applied to isolates obtained during an outbreak of pneumonia from seven mechanically ventilated patients, and its result indicated that the outbreak was due to the spread of two epidemic strains. This technique was validated by comparison with rRNA gene restriction analysis. There was complete concordance between these two techniques in discriminating the outbreak-related strains from epidemiologically unrelated isolates. Typing with both biochemical profile and antibiogram profile, though simple, was found to be less reliable than genotyping. The results show that this enterobacterial repetitive intergenic consensus PCR provides a rapid and simple means of typing S. marcescens isolates for epidemiologic studies.

Bacterial Typing Techniques↗

Rapid diagnosis of tuberculous meningitis by a simplified nested amplification protocol.

We have developed a simplified protocol based on nested polymerase chain reaction (PCR) for early diagnosis of tuberculous meningitis. Using this protocol, we detected the Mycobacterium tuberculosis genome within 24 hours in the CSF of 19 of 21 patients (90%) with clinically suspected tuberculous meningitis. The PCR results were negative in all 79 nontuberculous meningitis controls.

Adult↗

A three-dimensional spin-echo or inversion pulse.

In theory, multidimensional pulses can be designed to be selective in any number of dimensions. In practice, available gradient power has enforced a limit to two dimensions. We show here that three-dimensional pi pulses are feasible on commercial imaging machines provided that the range of off-resonance frequencies are limited.

Image Processing, Computer-Assisted↗

Spatially resolved and localized real-time velocity distribution.

A technique is presented for collecting the spin velocity distribution as a function of position and time. It uses a multidimensional excitation pulse to select a cylinder, giving localization in two dimensions. Resolution in the third spatial dimension is achieved in the readout. During readout, an oscillating gradient encodes the acquired data in both one spatial dimension (x) and one velocity dimension (v). Two acquisitions (42 ms each) are needed to get a complete coverage of kx--kv space, which makes this technique real-time. The data is interpolated from the nonuniformly sampled kx--kv space to a Cartesian frame with a gridding scheme to take advantage of the Fast Fourier Transform. The technique was successfully applied to phantoms and normal volunteers, giving reasonable real-time measurements of velocity.

Blood Flow Velocity↗

Localized real-time velocity spectra determination.

The accurate measurement of flow velocity has long been a subject of NMR research. In the field of medical imaging, a variety of techniques primarily based on the principle of Fourier encoding have been described. Due to time constraints, necessary trade-offs exist between spatial versus velocity spectral resolution. In general, either the average velocity of individual pixels is displayed or velocity spectral determinations are made at the cost of spatial localization. The recent development of multidimensional excitation pulses makes spatial localization possible during the excitation phase of the pulse sequences. This approach, coupled with time varying gradient readout, can be used to obtain single-shot localized velocity spectra. Using these concepts, we have obtained in vivo real-time measurements of localized velocity spectra on our clinical imager.

Aorta↗

[Clinical efficacy of cefmetazole in intraabdominal infection].

A number of different organisms can be isolated from intraabdominal infection. The most common are aerobic Gram-negative bacilli. Anaerobes are not unusual. From June 1989 to January 1990, Cefmetazole was administered to 23 patients with intraabdominal infection at Veterans General Hospital-Taipei. There were six patients with spontaneous bacterial peritonitis, five biliary tract infection, five liver abscesses, five with pelvic inflammatory disease, one acute ruptured appendicitis and another intraabdominal abscess. In addition, ten patients had sepsis. Clinical response was satisfactory in 21 (91.3%) of 23 patients, and the microbiological eradication rate was 90% (36/40). One patient with Streptococcus and Bacteroides oralis liver abscess relapsed after organism eradication. Therapy failed in a case with Pseudomonas aeruginosa and Bacteroides fragilis infection. This study showed Cefmetazole to be an effective and safe antibiotic for treatment of intraabdominal infection.

Adolescent↗

Magnetization transfer time-of-flight magnetic resonance angiography.

Time-of-flight (TOF) angiography based on inflow enhancement is limited by the steady-state signal differences between blood and the surrounding stationary tissues. We present a new TOF sequence in which magnetization transfer contrast is used to supplement wash-in effects. Angiograms demonstrating the superior performance of this technique are presented.

Blood Vessels↗

Pulsed saturation transfer contrast.

In vivo 1H conventional NMR image contrast generation usually relies on the macroscopic T1 and T2 relaxation parameters of the tissues of interest. Recently cross-relaxation related image contrast has been reported by Wolff and Balaban in animal models. Due primarily to the broad lineshape of the intended saturation spin pool and the use of off-resonance irradiation, high specific absorption rate and an auxiliary RF amplifier have been necessary to produce these images. The relatively long spin-lattice relaxation property of this spin pool, however, suggests the use of pulse methods to achieve saturation. In this paper, we show that short-T2 spin pools can be selectively saturated with short intense RF pulses. Cross-relaxation time constants can be measured using the technique of saturation recovery. In vivo magnetization-transfer-weighted images can be produced using pulses on commercial whole-body imagers without additional hardware.

Adipose Tissue↗

Fast spiral coronary artery imaging.

A flow-independent method for imaging the coronary arteries within a breath-hold on a standard whole-body MR imager was developed. The technique is based on interleaved spiral k-space scanning and forms a cardiac-gated image in 20 heartbeats. The spiral readouts have good flow properties and generate minimal flow artifacts. The oblique slices are positioned so that the arteries are in the plane and so that the chamber blood does not obscure the arteries. Fat suppression by a spectral-spatial pulse improves the visualization of the arteries.

Adipose Tissue↗

Coronary angiography using fast selective inversion recovery.

Using a fast version of selective inversion recovery, we have obtained coronary angiograms of normal volunteers showing the proximal portions of the left coronary artery. Blood is tagged in the aortic root at end systole using a 2D inversion pulse. After a wash-in time of 300-600 ms, the coronary vessels are imaged with a 2- to 3-cm-thick slab in either axial or oblique projection. The scan is completed within a breathhold in 24 heartbeats.

Coronary Vessels↗

Overview of viridans streptococcal endocarditis: clinical analysis of 99 cases.

A total of 99 cases of viridans streptococcal endocarditis encountered during the period of 1973 and 1990 at the Veterans General Hospital-Taipei were reviewed to evaluate its prognostic factors. Applying strict clinical and laboratory criteria, 24 cases were categorized as definite, 44 probable, 23 possible and 8 likely. The symptoms were frequently subtle and atypical but initial laboratory tests gave useful indications: 69.1% with leukocytosis, 78% with anemia, 58.5% with elevation of LDH level, 88.9% with elevation of ESR value and 100% with elevation of CRP level. Furthermore, 32.4% of the cases demonstrated proteinuria and 67.4% microscopic hematuria. Seventy-three of the subjects had a history of underlying heart disease, predominantly rheumatic heart disease. Histological examination and echocardiography revealed that 51 patients suffered from vegetative endocarditis, 7 (13.7%) of whom were found to have anatomically confirmed vegetations without initial echocardiographic evidence, Vascular events were seen in 61 cases (61.6%): peripheral stigmata (32 cases), cerebral vascular accidents (17 cases), pulmonary embolism (10 cases) and others (2 cases). The overall mortality rate was 18.2%. Congestive heart failure with embolization was the most common cause of death in this group. The presence of vegetation was not well correlated with embolic events. There was no statistically significant association between the mortality and the following characteristics: age, sex, underlying heart disease, evidence of echocardiographically detected vegetations, major surgical intervention and recurrent cases except for embolic events (p less than 0.01). In conclusion, viridans streptococcal endocarditis complicated embolic events usually presented with a fulminant course and a grave outcome.

Adolescent↗