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Biomedical subjects

I D McLean

Publications and source records attributed to I D McLean.

9 recordsLinked to original sources

Comparative evaluation of an II based and a flat panel based cardiovascular fluoroscopy system within a clinical environment.

The image quality and dose parameters from a 2004 Siemens Axiom Artis dBC cardiac biplane with flat panel detector were evaluated and compared to similar parameters evaluated for a 1977 Toshiba DPF 2000A biplane cardiac unit with a conventional image intensifier. Image quality assessment was performed with the Westmead test object; using solid water as a patient equivalent absorber. The patient dose comparison of the two systems is based on dose area product meter readings for 1512 patient cases recorded over 6 months following installation of the Siemens flat panel digital unit. The image quality results indicate that: (a) high contrast resolution was better with the digital flat panel unit, (b) low contrast resolution is similar between systems, and (c) the threshold contrast of the flat panel system is the same or inferior to that of the image intensifier system. Input dose to the surface of the flat panel detector showed a strong dependence on field size, similar to the behaviour of image intensifier system. For the most common clinical procedure--Left Heart Study via Judkins--the average total dose area product reading was 64.0 Gy-cm2 against 67.7 Gy-cm2 for the digital and conventional units respectively (p = 0.27) indicating no significant difference in dose performance between the two x-ray machines.

Equipment Failure Analysis↗

Recommendations for a mammography quality assurance program.

In 1989 the ACPSEM published a position paper entitled "A Quality Assurance Programme for Mass Screening in Mammography". This paper described test parameters and performance specifications for the equipment related aspects of a mammography quality assurance program. Advice on test equipment selection was also provided. In the intervening period of time there have been considerable advances in mammography technology creating a need to review a number of the paper's recommendations. There have also been considerable developments in the mammography quality assurance (QA) field, not the least of which includes the American College of Radiology Mammography Accreditation Program (ACR-MAP) and the similarly structured Royal Australian and New Zealand College of Radiologists' Mammography Accreditation Program (RANZCR-MAP). In light of these developments it was decided by the Radiology Interest Group to review the ACPSEM position on those aspects of mammography QA that fall within the medical physicist's area of expertise. This document represents the outcome of those deliberations.

Australia↗

Long-term study of the biochemistry and biomechanics of anterior cruciate ligament-patellar tendon autografts in goats.

This study examined the change in type-III collagen concentration and hydroxypyridinium crosslink density of anterior cruciate ligament-patellar tendon autografts and their correlations with Young's modulus of the anterior cruciate autografts and anterior cruciate controls for as long as 3 years after surgery. Fifteen adult female goats (two control and 13 experimental) were tested. Each experimental animal received an anterior cruciate ligament-patellar tendon autograft to the right knee. These animals were tested at 0 (n = 2), 6 (n = 2), 12 (n = 2), and 24 (n = 1) weeks and 1 (n = 3) and 3 (n = 3) years after surgery. After mechanical testing, the anterior cruciate autograft and control tissues were analysed for type-III collagen concentration and hydroxypyridinium crosslink density. The results of sodium dodecyl sulfate gel electrophoresis showed a trend of initial increase in the percentage of type-III collagen in the anterior cruciate ligament autografts and a subsequent decrease after 24 weeks following surgery. There was a nonsignificant (p > 0.05) negative correlation between type-III collagen concentration and Young's modulus. The hydroxypyridinium crosslink density was highest at 1 year after surgery. There was a significant (p < 0.05) positive correlation between hydroxypyridinium crosslink density and Young's modulus in the anterior cruciate autografts and controls. This suggests that hydroxypyridinium crosslink density has a good linear relationship with the material strength of the anterior cruciate ligament autograft and hence could be used as an objective guide for rehabilitation with anterior cruciate autografts.

Animals↗

Biomechanics of patellar tendon autograft for reconstruction of the anterior cruciate ligament in the goat: three-year study.

This study examined the biomechanics of anterior cruciate ligament-patellar tendon autografts for as long as 3 years after surgery. Twenty-seven adult female goats were tested; four served as controls and the others received an autograft to the right knee with each left knee serving as an additional control. The animals with grafts were tested at 0 week (n = 4), 6 weeks (n = 4), 12 weeks (n = 4), 24 weeks (n = 3), 1 year (n = 5), and 3 years (n = 3) after surgery. The anteroposterior laxity of the knee joint, load-relaxation, and structural and material properties of the graft were tested. The anteroposterior laxity was significantly greater than that of the controls for all groups except at 3 years. Load-relaxation was greater than that of the control anterior cruciate ligaments, but in the 1 and 3-year grafts load-relaxation was less than that of the patellar tendons with 5 minutes of sustained loading. Between 12 and 52 weeks, the stiffness and modulus of the grafts increased 3-fold, but the improvement was slow afterward. At 3 years, the strength and stiffness of the grafts were 44 and 49% those of the control ligaments, respectively; the modulus was 37 and 46% that of the control anterior cruciate ligaments and patellar tendons, respectively. The persistent inferior mechanical performance at 3 years suggests that anterior cruciate ligament grafts may never attain normal strength.

Animals↗

Some DSA testing methods and an evaluation of eight available units.

Eight DSA units in the Sydney region were evaluated by a set of simple performance tests. Low contrast resolution and iodine sensitivity tests exhibited the most variation between the six fully tested units. A range of performance levels was measured. Four of the eight units required adjustment by the manufacturers' service engineer after testing. The evaluation of those units considered satisfactory by both the manufacturers and the operators indicated that the fully interfaced, integral units gave better results than the earlier 'add on' units.

Angiography, Digital Subtraction↗

Swimmers' injuries.

Swimming is an excellent sport for people of all age groups but can produce overuse injuries. Early diagnosis is essential before the resistant stage is reached: a swimmer with shoulder pain cannot 'swim it out'. Swimmers have different tolerances to high levels of activity but injuries can be reduced if attention is paid to technique, preliminary warm up and stretching exercises. Training errors and faulty technique cause problems but psychological stress in the teenage group should not be overlooked.

Adolescent↗

Osteochondritis dissecans of the patellofemoral joint.

Osteochondritis dissecans of the patellofemoral joint is an uncommon condition that may be the cause of anterior knee pain or crepitus. We present the clinical features of 37 patients with osteochondritis dissecans lesions of the patellofemoral joint (24 on the patella, 13 on the trochlear groove), including two patients with medial trochlear groove lesions, which have not, to our knowledge, been previously reported. The osteochondral lesions involved the convex articular surfaces. The median age of patients when first examined was 15 years, and 54% of patients had open epiphyses. These lesions were more common in male patients than in female patients (four-to-one ratio). Osteochondritis dissecans of the patellofemoral joint can be overlooked unless quality radiographs are viewed with care and, at arthroscopy, both the patella and trochlear groove are assessed. Treatment depends on the symptoms, site, and nature of the lesion and the patient's age. Nonoperative management includes patellar taping and vastus medialis obliquus muscle exercises. Operative intervention is indicated for patients with mechanical symptoms and includes arthroscopy, consisting of chondroplasty and removal of loose bodies, and lateral retinacular release. In this study treatment generally improved the symptoms, but patients with articular cartilage loss had persistent patellofemoral crepitus and discomfort.

Adolescent↗

The long-term biomechanical and viscoelastic performance of repairing anterior cruciate ligament after hemitransection injury in a goat model.

To test the healing of the partially torn anterior cruciate ligament, we transected the posterolateral bundle in 11 adult female goats and tested the ligaments at 12, 24, and 52 weeks and 3 years after surgery. As early as 12 weeks after surgery translucent fibrous tissue covered the wound. The differences in anteroposterior laxity between right and left knees measured at 45 degrees and 90 degrees of flexion were not significantly different at each period. Results of Instron testing of the posterolateral bundle revealed the normalized changes in load-relaxation and Young's modulus were not significantly different at each period, but the ultimate tensile strength and stiffness at 3 years were significantly higher than at 12 weeks (P < 0.05) Failure started at the repair site for the 12-week group, but at 24 and 52 weeks the failure occurred throughout the ligament. At 3 years, the specimens failed with bony avulsion, indicating the repaired tissue was not the weakest link of the bone-ligament-bone complex. This study shows that under favorable conditions, partial anterior cruciate ligament injuries are capable of repair. What is more important, the high ultimate tensile strength and stiffness of the 3-year repaired tissue indicate full structural repair of such an artificial transection injury may be possible.

Animals↗