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D L Rubin

Publications and source records attributed to D L Rubin.

At least 37 records · Page 2Linked to original sources
PubMed1998

Terrorism. Part 1: Calibrating your risks and response.

Emergency service organizations are "in combat" every day. Yet with the experience and education we have amassed over the years, we remain ill-prepared to deal with the full effects of a terrorist attack. Terrorism has many definitions. For this article we choose this one: Terrorism: The use of violence, threats, intimidation or information manipulation for revenge, politics, support of a cause or the furthering of a criminal enterprise.

Biological Warfare↗
PubMed1997

Differentiation of liver hemangiomas from metastases and hepatocellular carcinoma at MR imaging enhanced with blood-pool contrast agent Code-7227.

PURPOSE: To evaluate differentiation of liver lesions at magnetic resonance (MR) imaging enhanced with Code-7227. MATERIALS AND METHODS: Thirty-five patients with 38 proved liver lesions (15 hemangiomas, 17 metastases, six hepatocellular carcinomas [HCCs]) underwent T1-weighted gradient-echo and T2-weighted fast-spin-echo MR imaging at 1.5 T before and after intravenous administration of Code-7227 (1.1 mg iron per kilogram of body weight). RESULTS: In hemangiomas, the mean contrast-to-noise ratio on precontrast and postcontrast images, respectively, increased from -4.51 +/- 4.7 (standard deviation) to 5.19 +/- 6.3 on T1-weighted images and decreased from 14.73 +/- 7.4 to 0.64 +/- 5.1 on T2-weighted images. In comparison, metastases remained hypointense to liver on T1-weighted images (from -5.77 +/- 5.9 to -7.8 +/- 6.8) and hyperintense on T2-weighted images (from 8.73 +/- 5.4 to 12.61 +/- 6.1). Although HCC enhanced more than metastases, they also remained hypointense to liver on T1-weighted images (from -4.87 +/- 6.1 to -1.79 +/- 5.7) and hyperintense on T2-weighted images (from 10.12 +/- 7.9 to 8.7 +/- 6.4). The degree of enhancement on T1-weighted images and of signal intensity drop on T2-weighted images were significantly lower in malignant liver masses than in hemangiomas (P < .001). CONCLUSION: Distinctly different enhancement patterns with Code-7227 helped accurate differentiation of liver lesions.

Adult↗
PubMed1995

Influence of viscosity on WIN 39996 as a contrast agent for gastrointestinal magnetic resonance imaging.

RATIONALE AND OBJECTIVES: The authors discuss the influence of viscosity on the imaging properties of WIN 39996 suspension. WIN 39996 suspension is a magnetically susceptible iron ferrite that provides negative (darkening) contrast enhancement in magnetic resonance imaging of the gastrointestinal tract. METHODS: The viscosity of WIN 39996 suspension was altered by various stress conditions (1 week to 4.5 months storage at temperatures of 5 degrees to 70 degrees C) or by various amounts of xanthan gum. Magnetic resonance imaging was performed in vitro on phantoms and in vivo on the gastrointestinal tract of anesthetized dogs. RESULTS: The results indicated that in vitro and in vivo imaging efficacies of WIN 39996 suspension depended on the viscosity, irrespective of the means by which the viscosity was altered. Specifically, the imaging quality was suitable at viscosities > or = 36.6 cp for in vitro imaging, and > 25 cp for in vivo imaging. The lower in vivo viscosity limit for magnetic resonance imaging compared with the in vitro limit may be due to gastrointestinal peristaltic activities continuously mixing the WIN 39996 suspension to prevent gravitational settling, and the enhancement of signal blackening by intraluminal WIN 39996 that was above and below the plane of image. CONCLUSIONS: It is speculated that the imaging quality of WIN 39996 suspension depends on the degree of dispersion of the magnetically susceptible iron ferrite in the WIN 39996 suspension, and that a minimum viscosity is needed to ensure such dispersion.

Animals↗
PubMed1995

Adrenal gland enhancement at MR imaging with Mn-DPDP.

PURPOSE: To determine adrenal gland enhancement with manganese (II) N,N' dipyridoxylethylenediamine-N,N'-diacetate 5,5'bis(phosphate) (DPDP) at magnetic resonance imaging. MATERIALS AND METHODS: After phase III trials, fat-suppressed, motion-compensated, T1-weighted spin-echo images (repetition time, 500 msec; echo time, 12 msec) of 13 consecutive patients were obtained at 1.5 T at one site, prior to and approximately 30 minutes after intravenous administration of 5 mumol/kg Mn-DPDP. Images were analyzed visually and by means of region-of-interest measurements, normalized to spleen. With data added from three more sites, enhancement of three adrenal adenomas and two metastases was analyzed. RESULTS: Twenty-five of 26 adrenal glands were depicted on MR images, and all showed enhancement. Mean adrenal enhancement (38%) was comparable to mean enhancement of liver (46%), pancreas (25%), and renal cortex (58%). Adrenal cortex and medulla could not be distinguished in nonenhanced or enhanced images. All three adrenal adenomas enhanced by more than 40%, but the metastases did not enhance. CONCLUSION: Functioning adrenal tissue (glands and at least some adenomas) are enhanced with Mn-DPDP.

Adenoma↗
PubMed1994

Optimization of an oral magnetic particle formulation as a gastrointestinal contrast agent for magnetic resonance imaging.

RATIONALE AND OBJECTIVES: Magnetically susceptible iron oxide (MSIO) contrast agents for magnetic resonance imaging (MRI) of the gastrointestinal (GI) tract are limited because they produce magnetic susceptibility artifacts. To determine whether oral magnetic particles (WIN 39996) can be an effective MRI contrast agent without producing induced image artifacts, we optimized a liquid formulation of WIN 39996. METHODS: A range of concentrations (25-250 micrograms iron/mL) and viscosities (1-600 cP) was imaged in a phantom at 1.5 T using conventional spin-echo and gradient-recalled echo pulse sequences. Some formulations also contained titanium. RESULTS: All concentrations of WIN 39996 at 1 cP produced susceptibility artifacts. For formulations in the 150 to 600 cP range, the 125 to 150 micrograms/mL concentrations produced signal blackening and magnetic susceptibility image distortion comparable to an air control. Concentrations greater than 150 micrograms/mL were unacceptable because they produced significant susceptibility artifacts, while concentrations less than 125 micrograms/mL were undesirable because they produced insufficient signal blackening. CONCLUSIONS: These preliminary in-vitro studies suggest that an optimized liquid formulation of WIN 39996 can be produced that yields excellent negative contrast without producing image artifacts.

Artifacts↗
PubMed1992

Formulation of radiographically detectable gastrointestinal contrast agents for magnetic resonance imaging: effects of a barium sulfate additive on MR contrast agent effectiveness.

Complete and homogeneous distribution of gastrointestinal (GI) contrast media are important factors for their effective use in computed tomography as well as in magnetic resonance (MR) imaging. A radiographic method (using fluoroscopy or spot films) could be effective for monitoring intestinal filling with GI contrast agents for MR imaging (GICMR), but it would require the addition of a radiopaque agent to most GICMR. This study was conducted to determine the minimum amount of barium additive necessary to be radiographically visible and to evaluate whether this additive influences the signal characteristics of the GICMR. A variety of barium sulfate preparations (3-12% wt/vol) were tested in dogs to determine the minimum quantity needed to make the administered agent visible during fluoroscopy and on abdominal radiographs. Solutions of 10 different potential GI contrast agents (Gd-DTPA, ferric ammonium citrate, Mn-DPDP, chromium-EDTA, gadolinium-oxalate, ferrite particles, water, mineral oil, lipid emulsion, and methylcellulose) were prepared without ("nondoped") and with ("doped") the barium sulfate additive. MR images of the solutions in tubes were obtained at 0.38 T using 10 different spin-echo pulse sequences. Region of interest (ROI) measurements of contrast agent signal intensity (SI) were made. In addition, for the paramagnetic contrast media, the longitudinal and transverse relaxivity (R1 and R2) were measured. A 6% wt/vol suspension of barium was the smallest concentration yielding adequate radiopacity in the GI tract. Except for gadolinium-oxalate, there was no statistically significant difference in SI for doped and non-doped solutions with most pulse sequences used. In addition, the doped and nondoped solutions yielded R1 and R2 values which were comparable. We conclude that barium sulfate 6% wt/vol added to MR contrast agents produces a suspension with sufficient radiodensity to be viewed radiographically, and it does not cause significant alteration in the MR signal appearance of most GICMR. These formulations can be useful for achieving optimal filling of the gastrointestinal tract prior to MRI.

Animals↗
PubMed1992

The Dyggve-Melchior-Clausen syndrome in Indian siblings.

The clinical and radiographic features of a brother and sister with the Dyggve-Melchior-Clausen syndrome are presented. These features differentiate this syndrome from other bone dysplasias causing short trunk dwarfism. In addition to the vertebral, pelvic and proximal limb defects typical of this syndrome, both these patients have more severe distal limb involvement than has been described previously. Their parents are first cousins and have four other unaffected children, which supports an autosomal recessive mode of inheritance for this syndrome. The ancestors of this kindred emigrated to South Africa from India in the 19th century.

Adolescent↗
PubMed1991

Methods for the systematic investigation of gastrointestinal contrast media for MRI: evaluation of intestinal distribution by radiographic monitoring.

Comparison of the effectiveness of various gastrointestinal (GI) contrast agents for magnetic resonance (MR) imaging is often complicated by varying amounts intraluminal filling with the orally administered agents. To achieve more uniform and reproducible imaging results with GI contrast agents for MR imaging (GICMR), we evaluated a radiographic method for monitoring intraluminal filling and distribution. Solutions of Mn-DPDP (2 mM), to which a small amount of barium sulfate (6 wt/vol%) was added, were administered orally to dogs. Gastric emptying and small bowel transit were monitored fluoroscopically. MR imaging was performed either 1) at a fixed time after administration of the contrast agent or 2) at a variable interval when the contrast agent was observed fluoroscopically to be in the terminal ileum. When initiation of MR imaging was guided by fluoroscopic monitoring of intestinal contrast distribution, uniform and reproducible intestinal contrast enhancement by GICMR was achieved. However, when MR imaging was performed at a fixed time interval after oral administration, non-uniform and variable GI visualization was obtained, and this corresponded to the variable intestinal distribution observed fluoroscopically. We conclude that reproducible intestinal filling with orally administered contrast agents can be accomplished with a radiographic monitoring technique, and this promotes more consistent GI visualization on MR images. Such standardized and reproducible methods are necessary for studies in which the effectiveness of GI contrast media for MR imaging is evaluated and compared.

Administration, Oral↗
PubMed1990

Detection of hepatic malignancies using Mn-DPDP (manganese dipyridoxal diphosphate) hepatobiliary MRI contrast agent.

A new hepatobiliary contrast agent (Mn-DPDP) was used in the detection of liver metastases in six rabbits with seven hepatic V2 carcinomas. This contrast agent is derived from pyridoxyl-5-phosphate which is biomimetically designed to be secreted by the hepatocyte. After Mn-DPDP administration, a 105% increase in liver signal to noise was obtained using a 200/20 (TR/TE) pulsing sequence, and a 62% decrease in intensity was observed using a 1200/60 pulsing sequence. Liver V2 carcinoma contrast enhancement increased 427% using the 200/20 pulsing sequence and 176% using the 1200/60 pulsing sequence. Four of seven V2 carcinomas were not detectable prior to the administration of Mn-DPDP (50 mumol/kg). Two neoplasms were only detectable in retrospect (after Mn-DPDP) on the 1200/60 sequence. The smallest neoplasms detected in this study were 1-4 mm. Mn-DPDP appears to be a promising MRI contrast agent.

Animals↗
PubMed1990

The prevalence of diffuse idiopathic skeletal hyperostosis in African blacks.

The prevalence of diffuse idiopathic skeletal hyperostosis (DISH) was studied in a hospital based population of African Blacks over the age of 40 years. The study was based on an analysis of the lateral chest radiographs of 1000 patients in a retrospective study and 500 consecutive medical admissions in a prospective study. The overall prevalence of DISH was 3.9% (males 3.8% and females 4.2%). There was a rise in the prevalence of DISH with increasing age from 1% in the 40-49 year age group to 13.6% in those over 70 years. The prevalence of diabetes was 52.4% in the 21 patients with DISH who were seen in the prospective analysis. Ankylosing spondylitis, which is associated with HLA-B27, is rare in African Blacks. However, DISH is not uncommon but its prevalence is lower than in a similar hospital based study of Jews in Israel.

Adult↗
PubMed1990

Magnetic susceptibility effects and their application in the development of new ferromagnetic catheters for magnetic resonance imaging.

Newly developed ferromagnetic catheters (Fe-Caths) are more conspicuous than conventional radiographic catheters (Rad-Caths) on magnetic resonance (MR) images because they produce recognizable ferromagnetic signal patterns (FSPs). To determine how MRI parameters influence these patterns, the imaging characteristics of nine Fe-Caths (ferromagnetic concentration 0.01 to 1.0 weight/weight %) were studied systematically and compared with three Rad-Caths. All catheters were studied in stationary and moving phantoms at mid-field (0.38 T) and high-field (1.5 T) strength using spin-echo and gradient-echo pulse sequences. Rad-Caths always produced a signal void. Fe-Caths produced FSPs, the size of which depended on the orientation of the catheter with respect to the main magnetic field, the concentration of ferromagnetic agent in the catheter, and the direction and strength of the frequency encoding gradient. When Fe-Caths were positioned perpendicular to the main magnetic field, they produced FSPs; however, when they were parallel to the main magnetic field, Fe-Caths produced no FSP, thus having a similar appearance to the Rad-Caths. Ferromagnetic catheters produce conspicuous patterns on MR images that depend on catheter orientation in the main magnetic field and vary predictably with the MRI parameters.

Animals↗
PubMed1988

Cervical spine fracture in diffuse idiopathic skeletal hyperostosis.

The occurrence of spinal fractures in ankylosing spondylitis is well documented but fractures are uncommon in patients with diffuse idiopathic skeletal hyperostosis (DISH). We report a 58-year-old Black male with DISH who developed quadriplegia after fracture dislocation of the cervical spine.

Cervical Vertebrae↗
PubMed1985

Rapid pulmonary dissemination in mycosis fungoides simulating pneumonia. A case report and review of the literature.

Mycosis fungoides is a neoplastic disease with extranodal dissemination most frequently to the lung. The roentgenographic and clinical manifestations in these patients may simulate pneumonia and delay appropriate treatment. Disseminated disease is thought to occur in the setting of involvement of the peripheral blood with the neoplastic cells. A case of rapid pulmonary involvement with mycosis fungoides which simulated pneumonia is presented in which there was no peripheral blood manifestation of the disease.

Adult↗