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End date: 2023 × End date: 2022 × Start date: 2020 × Publisher: Lausanne : Frontiers Media × WGL Institute: IPHT ×

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    Time-resolved velocity mapping at high magnetic fields: A preclinical comparison between stack‐of‐stars and cartesian 4D-Flow
    (Lausanne : Frontiers Media, 2022) Nahardani, Ali; Krämer, Martin; Ebrahimi, Mahyasadat; Herrmann, Karl-Heinz; Leistikow, Simon; Linsen, Lars; Moradi, Sara; Reichenbach, Jürgen R.; Hoerr, Verena
    Purpose: Prospectively-gated Cartesian 4D-flow (referred to as Cartesian-4D-flow) imaging suffers from long TE and intensified flow-related intravoxel-dephasing especially in preclinical ultra-high field MRI. The ultra-short-echo (UTE) 4D-flow technique can resolve the signal loss in higher-order blood flows; however, the long scan time of the high resolution UTE-4D-flow is considered as a disadvantage for preclinical imaging. To compensate for prolonged acquisitions, an accelerated k0-navigated golden-angle center-out stack-of-stars 4D-flow sequence (referred to as SoS-4D-flow) was implemented at 9.4T and the results were compared to conventional Cartesian-4D-flow mapping in-vitro and in-vivo. Methods: The study was conducted in three steps (A) In-vitro evaluation in a static phantom: to quantify the background velocity bias. (B) In-vitro evaluation in a flowing water phantom: to investigate the effects of polar undersampling (US) on the measured velocities and to compare the spatial velocity profiles between both sequences. (C) In-vivo evaluations: 24 C57BL/6 mice were measured by SoS-4D-flow (n = 14) and Cartesian-4D-flow (n = 10). The peak systolic velocity in the ascending aorta and the background velocity in the anterior chest wall were analyzed for both techniques and were compared to each other. Results: According to the in-vitro analysis, the background velocity bias was significantly lower in SoS-4D-flow than in Cartesian-4D-flow (p < 0.05). Polar US in SoS-4D-flow influenced neither the measured velocity values nor the spatial velocity profiles in comparison to Cartesian-4D-flow. The in-vivo analysis showed significantly higher diastolic velocities in Cartesian-4D-flow than in SoS-4D-flow (p < 0.05). A systemic background bias was observed in the Cartesian velocity maps which influenced their streamline directions and magnitudes. Conclusion: The results of our study showed that at 9.4T SoS-4D-flow provided higher accuracy in slow flow imaging than Cartesian-4D-flow, while the same measurement time could be achieved.
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    The Dissemination and Molecular Characterization of Clonal Complex 361 (CC361) Methicillin-Resistant Staphylococcus aureus (MRSA) in Kuwait Hospitals
    (Lausanne : Frontiers Media, 2021) Sarkhoo, Eiman; Udo, Edet E.; Boswihi, Samar S.; Monecke, Stefan; Mueller, Elke; Ehricht, Ralf
    Methicillin-resistant Staphylococcus aureus (MRSA) belonging to clonal complex 361 (CC361-MRSA) is rare among patients' populations globally. However, CC361-MRSA has been isolated with an increasing trend among patients in Kuwait hospitals since 2010. This study investigated the molecular characteristics of CC361-MRSA isolated from patients in Kuwait hospitals in 2016-2018 to understand their genetic relatedness and virulence determinants. Of 5,223 MRSA isolates investigated by DNA microarray, 182 (3.4%) isolates obtained in 2016 (N = 55), 2017 (N = 56), and 2018 (N = 71) were identified as CC361-MRSA. The CC361-MRSA isolates were analyzed further using antibiogram, spa typing and multi locus sequence typing (MLST). Most of the isolates were resistant to fusidic acid (64.8%), kanamycin (43.4%), erythromycin (36.3%), and clindamycin (14.3%) encoded by fusC, aphA3, and erm(B)/erm(C) respectively. Nine isolates (4.9%) were resistant to linezolid mediated by cfr. The isolates belonged to 22 spa types with t3841 (N = 113), t315 (N = 16), t1309 (N = 14), and t3175 (N = 5) constituting 81.3% of the spa types, four genotypes (strain types), CC361-MRSA-[V/VT + fus] (N = 112), CC361-MRSA-IV, WA MRSA-29 (N = 36), CC361-MRSA-V, WA MRSA-70/110 (N = 33) and CC361-MRSA-[V + fus] variant (N = 1). MLST conducted on 69 representative isolates yielded two sequence types: ST361 (11/69) and ST672 (58/69). All CC361-MRSA isolates were positive for cap8, agr1, and the enterotoxin egc gene cluster (seg, sei, selm, seln, selo, and selu). The tst1 was detected in 19 isolates. The immune evasion cluster (IEC) genes type B (scn, chp, and sak) and type E (scn and sak) were detected in 20 and 152 isolates, respectively. The CC361-MRSA circulating in Kuwait hospitals consisted of two closely related sequence types, ST361 and ST672 with ST672-MRSA [V/VT + fus] as the dominant genotype. The dissemination of these newly emerged clones and the emergence of linezolid resistance limits therapeutic options, as well as present significant challenges for the control of MRSA infections in Kuwait hospitals.