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Biomedical subjects

Andrew J Taylor

Publications and source records attributed to Andrew J Taylor.

At least 19 recordsLinked to original sources
PubMed2007

Extracolonic tumors of the gastrointestinal tract detected incidentally at screening CT colonography.

PURPOSE: The aim of this article is to report our experience with incidental detection of extracolonic tumors of the gastrointestinal tract identified prospectively at screening CT colonography. METHODS: A total of 2014 patients (1097 females, 917 males; mean age, 56.9 years) underwent primary CT colonography evaluation at our institution over an 18-month period. Following cathartic preparation and colonic distention, supine and prone multidetector CT scans were obtained with thin-collimation low-dose technique without intravenous contrast. We reviewed our database for lesions of the extracolonic gastrointestinal tract that were detected during the prospective reading. RESULTS: Focal extracolonic gastrointestinal tract lesions were prospectively detected in 10 (0.5 percent) of 2014 patients (8 females; 2 males; mean age, 58.5 years). All patients were asymptomatic. Tumor locations included ileum (n = 3), stomach (n = 3), jejunum (n = 2), and appendix (n = 2). Mean tumor size was 2.2 (range, 0.8-3.4) cm. Lesions in eight patients were subsequently confirmed by conventional or capsule endoscopy and/or by intravenous contrast-enhanced CT. Seven lesions were surgically excised and one was removed at endoscopy; two patients with lipomas did not undergo further evaluation or treatment. Final diagnoses were benign in all cases and included lipoma (n = 3), small-bowel hamartoma (n = 2), appendiceal mucinous cystadenoma (n = 2), gastric leiomyoma (n = 1), small-bowel lymphangioma (n = 1), and gastric fundic gland polyp (n = 1). CONCLUSIONS: Incidental extracolonic tumors of the gastrointestinal tract detected at screening CT colonography were all asymptomatic and benign but often prompted more invasive workup. Although the incidence of these tumors was relatively low, widespread population screening with CT colonography would result in new surgical referrals for these findings.

Aged↗
PubMed2006

Volatile emission by contest losers revealed by real-time chemical analysis.

Animal interactions often involve chemical exchange but simultaneous evaluation of chemistry and behaviour has been problematical. Here we report findings from a novel method, atmospheric pressure chemical ionization-mass spectrometry (APCI-MS) coupled with manipulation of molecular-mass achieved by rearing organisms on deuterium-enhanced nutrients. This allows real-time monitoring of the occurrence and quantity of volatile chemicals released by each of two interacting individuals, in tandem with behavioural observations. We apply these methods to female-female contests in the parasitoid wasp Goniozus legneri. We show that this species emits the spiroacetal 2-methyl-1,7-dioxaspiro[5.5]undecane. Chemical release is most common in more behaviourally aggressive contests, which occur when prior resource owners successfully resist take-over by similar-sized intruder females. Volatiles released during contests are always emitted by the loser. Aggression in contests is reduced after spiroacetal release. We suggest that the spiroacetal functions as a weapon of rearguard action. We anticipate that APCI-MS, which is rapid, non-intrusive and relatively inexpensive to operate, will be widely applied in studies linking chemistry and behaviour.

Aggression↗
PubMed2006

The role of fat in flavor perception: effect of partition and viscosity in model emulsions.

Decreasing the fat content of a food, while maintaining the same aroma content, changes both aroma release (due to partition effects) and the viscosity of the food. To understand the relative contribution of these two factors on flavor perception, a series of flavored emulsions were prepared to control aroma release and viscosity using different aroma, oil, and hydroxypropyl methyl cellulose (HPMC) contents. Samples were formulated to deliver the same aroma-release in vitro and in vivo, and their viscosity was measured using the Kokini oral shear stress parameter. Despite the in vivo aroma release being constant, there were perceptual differences between the samples, and the flavor intensity decreased as in-mouth viscosity increased. For these iso release samples, the Kokini oral shear stress parameter correlated well with the decrease in perception, suggesting that there may be a viscosity stimulus or that the viscosity affects release of tastant and hinders aroma-taste interactions.

Adult↗
PubMed2006

In-mouth amylase activity can reduce perception of saltiness in starch-thickened foods.

Sensory scores for saltiness and thickness obtained for savory liquids thickened with starches or the nonstarch hydrocolloid hydroxypropylmethyl cellulose (HPMC) were correlated with the panelists' amylase activity. Although higher enzyme activities were linked to lower thickness scores for systems thickened by starch, they were also associated with a decreased taste perception, particularly for starches retaining a granular structure after gelatinization (wheat and modified waxy maize). Microscopic evidence showed that the enzyme can disrupt such structures, and this is associated with a decreased mixing efficiency with water and consequently a reduced transport of tastant (sodium) to the saliva (aqueous) phase and to the taste buds. This explains the lower saltiness scores for subjects with higher amylase activity, even if they are associated with a lower perceived thickness.

Adult↗
PubMed2006

Screening for colorectal neoplasia with CT colonography: initial experience from the 1st year of coverage by third-party payers.

PURPOSE: To evaluate our experience in the 1st year of computed tomographic (CT) colonography screening since the initiation of local third-party payer coverage. MATERIALS AND METHODS: This HIPAA-compliant study was approved by the institutional review board, and informed consent was waived. Over a 1-year period that ended on April 27, 2005, 1110 consecutive adults (585 women, 525 men; mean age, 58.1 years) underwent primary CT colonography screening. More than 99% were covered by managed care agreements. CT colonographic interpretation was performed with primary three-dimensional polyp detection, and the final results were issued within 2 hours. Patients with large (> or =10-mm) polyps were referred for same-day optical colonoscopy, and patients with medium-sized (6-9-mm) lesions had the option of immediate optical colonoscopy or short-term CT colonography surveillance. RESULTS: Large colorectal polyps were identified at CT colonography in 43 (3.9%) of 1110 patients. Medium-sized lesions were identified in 77 (6.9%) patients, 31 (40%) of whom chose optical colonoscopy and 46 (60%) of whom chose CT colonography surveillance. Concordant lesions were identified in 65 of 71 patients who underwent subsequent optical colonoscopy (positive predictive value, 91.5%). Sixty-one (86%) of 71 optical colonoscopic procedures were performed on the same day as CT colonography, thereby avoiding the need for repeat bowel preparation. The actual endoscopic referral rate for positive findings at CT colonography was 6.4% (71 of 1110 patients). The demand for CT colonography screening from primary care physicians and their patients increased throughout the study period. CONCLUSION: As a primary colorectal screening tool, CT colonography covered by third-party payers has an acceptably low endoscopic referral rate and a high concordance of positive findings at optical colonoscopy.

Chi-Square Distribution↗
PubMed2006

Elective percutaneous coronary intervention immediately impairs resting microvascular perfusion assessed by cardiac magnetic resonance imaging.

BACKGROUND: Percutaneous coronary intervention (PCI) is known to induce atherosclerotic plaque rupture, which may affect resting distal microvascular perfusion either through distal microvascular spasm or through embolization. We evaluated the effect of PCI on resting microvascular flow. METHODS: We performed cardiovascular magnetic resonance imaging to assess left ventricular systolic function and microvascular perfusion in 15 patients with stable coronary artery disease before and within 24 hours after PCI and in 10 control subjects without obstructive coronary artery disease on a clinical 1.5-T CMR scanner. Microvascular perfusion was evaluated at rest after injecting a bolus of gadolinium-diethylenetriamine pentaacetic acid (0.1 mmol/kg) by calculating the time to 50% maximum myocardial enhancement (T50% max), as well as the relative upslope, of the myocardial signal intensity curve. Regional perfusion and systolic thickening were evaluated using a 16-segment left ventricular model with the slice locations matched anatomically pre-PCI and post-PCI. The relative contrast delay in the region of myocardium subtended by the PCI artery was calculated by subtracting the T50% max of a remote region from the PCI region. RESULTS: In subjects with coronary artery disease, PCI resulted in a regional contrast delay (mean delay 0.6 +/- 0.2 seconds post-PCI vs 0.0 +/- 0.2 seconds pre-PCI, P < .05) and a reduction in the relative upslope (8.6 +/- 0.5 post-PCI vs 10.1 +/- 0.7 pre-PCI, P = .02), consistent with reduced microvascular perfusion. This was unaccompanied by any change in regional systolic thickening (54% +/- 7% pre-PCI vs 53% +/- 5% post-PCI, P = NS). CONCLUSIONS: The data show PCI-induced impairment of resting microvascular perfusion in the area of myocardium subtended by the treated artery after PCI, a likely consequence of iatrogenic atherosclerotic plaque rupture.

Aged↗
PubMed2006

Surface visualization at 3D endoluminal CT colonography: degree of coverage and implications for polyp detection.

BACKGROUND & AIMS: Effective colonoscopic screening for polyps, whether by optical or virtual means, requires adequate visualization of the entire colonic surface. The purpose of this study was to assess prospectively the degree of surface coverage at 3-dimensional (3D) endoluminal computed tomography colonography (CTC) after retrograde fly-through, combined retrograde-antegrade fly-through, and review of remaining missed regions. METHODS: The study group consisted of 223 asymptomatic adults (mean age, 57.8 +/- 7.2 y; 111 men, 112 women) undergoing primary CTC screening. CTC studies were interpreted by experienced readers using a primary 3D approach. The CTC software system that was used continually tracks the percentage of endoluminal surface visualized. The degree of coverage was assessed prospectively after retrograde and combined retrograde-antegrade navigation. The added effect of reviewing missed regions was also assessed prospectively. RESULTS: The mean surface coverage after only retrograde 3D endoluminal fly-through from rectum to cecum was 76.6% +/- 4.8% (range, 63%-92%); coverage was 80% or less in 181 (81.2%) patients. Antegrade navigation back to the rectum increased the overall coverage to 94.1% +/- 2.3% (range, 84%-99%; P < .0001). A review of missed regions 300 mm(2) or larger increased coverage to 97.9% +/- 1.1% (range, 93%-99%; P < .0001) and added 21.4 +/- 11.4 seconds to the interpretation time (range, 3-67 s). CONCLUSIONS: Combined bidirectional retrograde and antegrade 3D navigation, supplemented by rapid review of missed regions, effectively covers the entire evaluable surface at CTC. Unidirectional retrograde 3D fly-through typically excludes 20% or more of the endoluminal surface, which may provide insight into potential limitations at optical colonoscopy.

Aged↗
PubMed2006

Extracolonic findings identified in asymptomatic adults at screening CT colonography.

OBJECTIVE: The purpose of this article is to demonstrate the wide variety of extracolonic findings that may be encountered at screening CT colonography (CTC) in asymptomatic adults as well as to discuss the pertinent issues regarding the detection of potential abnormalities in a healthy population. CONCLUSION: Regardless of whether extracolonic evaluation resulting from CTC screening is viewed as a net benefit or liability, it is an unavoidable responsibility that must be handled with care by the interpreting radiologist. Although many potential abnormalities may be questioned, the pretest probability of clinically relevant disease is quite low in average-risk asymptomatic adults, which may influence subsequent management decisions.

Adult↗
PubMed2006

Patient-controlled room air insufflation versus automated carbon dioxide delivery for CT colonography.

OBJECTIVE: Our objective was to prospectively compare colonic distention and patient comfort at screening CT colonography (CTC) with patient-controlled room air (RA) insufflation versus automated carbon dioxide (CO2) delivery. SUBJECTS AND METHODS: Two hundred eight adults undergoing CTC were randomized to RA or CO2 (104 per method). Colonic distention was prospectively assessed by segment using a 4-point scale (1 = optimal, 2 = adequate, 3 = inadequate, 4 = collapsed). Adequacy of combined supine/prone segmental evaluation was also recorded. Patients provided discomfort ratings on a 0-10 scale (0-1 = none/insignificant, 2-3 = minimal, 4-6 = intermediate, 7-10 = significant) before, during, and after the procedure. RESULTS: No significant differences in segmental distention were observed in the prone position between techniques. In the supine position, CO2 resulted in significantly greater distention in the sigmoid, descending, and transverse segments (p < 0.01). After combined supine/prone assessment, two/104 (1.9%) and three/104 (2.9%) patients were judged to have an inadequately evaluated segment on RA and CO2, respectively (four sigmoid, one transverse). Mean discomfort scores for RA and CO2 were 3.97 and 5.08 during the examination (p < 0.01); 0.91 and 0.42 immediately after (p < 0.01); 0.51 and 0.25 15 min later (p < 0.05); and 0.15 and 0.04 2 hours later (p < 0.01), respectively. During active distention, 19 (18.3%) and 33 (31.7%) patients reported significant transient discomfort with RA and CO2, respectively (p < 0.05). Beyond 15 min, only two (1.9%) patients with RA and no patients with CO2 had a discomfort level higher than 3. CONCLUSION: Although patient-controlled RA insufflation and automated CO2 delivery each resulted in negligible postprocedure discomfort and reliable colonic distention, CO2 was better for both categories.

Air↗
PubMed2006

Polyp volume versus linear size measurements at CT colonography: implications for noninvasive surveillance of unresected colorectal lesions.

OBJECTIVE: Proposed surveillance of unresected medium-sized (6.0-9.9 mm) polyps will require reliable detection of small incremental changes. The purpose of this study was to assess the reproducibility of linear versus volume measurements of polyp size at CT colonography (CTC) and to correlate results with a hemispheric model. MATERIALS AND METHODS: The study group consisted of 30 polyps on supine and prone CTC data sets. Measurements were performed separately by two experienced radiologists using the same CTC system (Vitrea 2), resulting in 120 linear and volume measurements. Linear size was defined as the longest dimension among the 2D multiplanar reconstruction views. Semiautomated volume determination required manual tracing of polyp boundaries on 2D multiplanar reconstruction views. The relative error between reviewers 1 and 2 was defined as 100 x (/D1 - D2/)/D(ave) for linear size (D) and as 100 x (/V1 - V2)/V(ave) for volume (V), where ave is average. RESULTS: The mean relative error for linear size and volume measurement was 10.4% +/- 10.7% and 16.9% +/- 13.2%, respectively. Median linear size and volume of polyps were 9.4 mm and 270 mm3, respectively. CTC-derived volumes for medium-sized polyps closely approximated hemispheric volume (V = (pi/12) x D(b), where b =3.13, r2 = 0.90). Small incremental changes in hemispheric size result in a 3:1 relative change in volume versus diameter, such that a 1-mm diameter change in a medium-sized hemispheric polyp results in a relative change in linear size and volume ranging from approximately 11-18% and 31-53%, respectively. CONCLUSION: Because changes in polyp volume are amplified compared with linear dimension, volume measurement rather than diameter measurement will better allow detection of small incremental changes in polyp size using CTC.

Colonic Polyps↗
PubMed2006

Comparison of colonic transit between polyethylene glycol and water as oral contrast vehicles in the CT evaluation of acute appendicitis.

OBJECTIVE: The objective of our study was to assess the efficacy of a new positive oral contrast agent's ability to reach the colon during CT evaluation of acute appendicitis. SUBJECTS AND METHODS: Eighty adult emergency department patients who underwent abdominal CT to evaluate for appendicitis were studied. Forty patients received the department's standard dose of 1,600 mL of a water-iodinated contrast mixture (ratio of 2 mL of iodinated contrast material to 100 mL of water) with a standard delay time of 2-2.5 hours from the beginning of contrast medium ingestion. Forty patients were given a new oral contrast mixture of 1,000 mL of polyethylene glycol (PEG) mixed with 30 mL of iodinated contrast agent, and the examination was conducted only 1 hour from inception of contrast administration. Examinations were reviewed for the presence of contrast medium in the cecum and the presence of appendicitis or other abdominal abnormality. RESULTS: Thirty-eight of 40 patients in the PEG group had contrast medium in the colon at 1 hour after contrast administration, 20 of whom had surgically confirmed cases of appendicitis. In five other patients in that group, another cause to explain the patient's complaints was identified on imaging. Only 18 of the 40 patients who received the standard oral preparation had contrast material present in the cecum. Eleven patients in that group had confirmed appendicitis, and four others had another abnormal finding detected at CT. There was a significant difference in the success of contrast medium transit to the colon with these two agents (p < 0.0001). CONCLUSION: The use of an oral contrast agent composed of PEG and iodinated contrast material provided a marked improvement in oral agent transit to the colon even in patients with intraabdominal inflammation.

Administration, Oral↗
PubMed2006

Taste-aroma interactions in a ternary system: a model of fruitiness perception in sucrose/acid solutions.

Cross-modal interactions between aroma, sweetness, and acidity were studied. A series of samples was presented to trained panelists who assessed strawberry flavor intensity using magnitude estimation with a reference modulus. The delivery of aroma stimuli from the different solutions was measured by monitoring exhaled breath using atmospheric pressure chemical ionization-mass spectrometry to determine whether there were any physicochemical effects on volatile release; no significant differences were noted. Three-dimensional predictive models were built to describe perceived strawberry flavor intensity as a function of concentrations of sucrose, acid, and volatiles. Analysis of the data identified two groups of panelists with different responses: For Group 1, increasing sucrose and/or acid levels also increased the perceived flavor intensity. For Group 2, changing sucrose concentrations had little effect, but increasing acid and/or volatile levels did. The results show different effects of organic and inorganic acids on perception, as well as clear interactions between the modalities of taste (sugar and acid) and aroma. The clustering of panelists' responses suggests that this phenomenon may depend on prior associations between the fruity flavor and the tastants.

Acids↗
PubMed2005

On-line MS/MS monitoring of acrylamide generation in potato- and cereal-based systems.

An on-line MS/MS technique was used to study the generation of acrylamide in rye-, wheat-, and potato-based systems during cooking. Acrylamide release to the gas phase was monitored continuously and was correlated with the acrylamide content of samples using a calibration based upon the partition of [1,2,3-(13C3)]acrylamide. On-line results at 180 degrees C were compared with data relating to the same systems obtained through GC-MS analysis. Agreement between the two techniques was notable, both in terms of the temporal profiles of acrylamide generation and when comparing the relative magnitudes of results for potato, wheat, and rye determined by each method. The effects of pH (citric acid) and added amino acids (soy protein hydrolysate) on the generation of acrylamide in hydrated potato flake were modeled at 180 degrees C. It was concluded that a combined treatment of low levels of each additive could result in significant reductions in acrylamide, although the effects of such treatments on sensory properties such as color and flavor remain to be evaluated.

Acrylamide↗
PubMed2005

Dynamic headspace analysis of the release of volatile organic compounds from ethanolic systems by direct APCI-MS.

Static equilibrium headspace was diluted with a stream of nitrogen to study the stability of the volatile headspace concentration. The headspace dilution profile of 18 volatile compounds above aqueous and ethanolic solutions was measured in real time using atmospheric pressure chemical ionization-mass spectrometry. Under dynamic conditions the volatiles headspace concentration above water solutions decreased readily upon dilution. The presence of ethanol helped to maintain the volatile headspace concentration when the ethanol solution concentration was above 50 mL/L. This effect was such that under dynamic conditions the absolute volatile concentration above an ethanolic solution was higher than that above an aqueous solution, contrary to results observed in equilibrium studies. The ratio of the headspace concentration of volatiles above ethanolic 120 mL/L and water solutions was correlated to their air/water partition coefficient.

Alcoholic Beverages↗
PubMed2005

Differences in the effect of bolus weight on flavor release into the breath between low-fat and high-fat products.

The maximum intensity of flavor release increased as the weight of food introduced into the mouth (the bolus) was increased for a range of different foods. The relationship was not directly proportional (1:1) but followed a power law function. Low-fat (< or = 1 g/100 g) foods showed a different relationship than high-fat (> or = 5 g/100 g) foods, but all low-fat and all high-fat foods were broadly similar irrespective of food type or flavor molecule chemistry. For low-fat foods the intensity of flavor release increased with increasing bolus weight to a greater extent than high-fat foods. This may be associated with the capacity of fat to selectively adhere to the surfaces of the oral cavity, thereby changing the effective surface area for the release of lipophilic flavors.

Candy↗
PubMed2005

Temporal synchrony and integration of sub-threshold taste and smell signals.

The importance of stimulus timing and location on the perceptual integration of taste and odour was studied based on a sub-threshold methodology. From a panel of 16 people, 12 showed the integration effect previously reported while 4 showed no effect. The experiment was repeated using retronasal and orthonasal delivery of the odour and with tastant present or absent in the mouth. Integration of taste and odour only occurred when both stimuli were present at the same time. Retro- or orthonasal presentation both produced integration providing that tastant delivery was synchronous but the threshold values for the two presentation methods were different. The relevance of these findings to flavour perception under realistic conditions is considered.

Adult↗