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Biomedical subjects

J R Mallard

Publications and source records attributed to J R Mallard.

At least 19 recordsLinked to original sources

Pattern of 2-deoxy-2-[18F]-fluro-D-glucose accumulation in liver tumours: primary, metastatic and after chemotherapy.

Eight patients with liver metastases from adenocarcinoma of the colon or rectum, two with suspected hepatic metastases and one with primary hepatoma were studied with 2-deoxy-2-[18F]-fluro-D-glucose (18F-FDG) using positron emission tomography (PET). In five of the patients with metastatic tumour a second examination was performed four weeks after treatment with recombinant interleukin-2 (rIL2) and fluorouracil (5FU). In all tumours (one primary and eight metastatic) the radioactivity was seen to accumulate in a rim around each tumour with a large central area showing no uptake. In the five cases imaged after treatment with rIL2, the appearance of the tumour uptake was the same as before treatment. In the two cases of suspected but not proven metastases, no abnormal accumulation of 18F-FDG was seen.

Adenocarcinoma

Measurement of blood flow in tibial fracture patients using positron emission tomography.

The quantification of local bone blood flow in man has not previously been possible, despite its importance in the study of normal and pathological bone. We report the use of positron emission tomography, using 15O-labelled water, to measure bone blood flow in patients with closed unilateral fractures of the tibia. We compared fractured and unfractured limbs; alterations in blood flow paralleled those found in animal models. There was increased tibial blood flow at the fracture site as early as 24 hours after fracture, reaching up to 14 times that in the normal limb at two weeks. Blood flow increase was less in displaced than in undisplaced fractures. The muscle to bone ratios of blood flow were similar to those in previous animal work using other techniques. Positron emission tomography will allow study of human bone blood flow in vivo in a wide variety of pathological conditions.

Adult

Study of tissue compression in breast phantoms: possible implications for the use of X-ray mammography as a method of imaging breast carcinoma.

A method is described of constructing a simple phantom breast containing an idealised tumour with elastic properties. The transparent tissues are compressed and evidence is adduced to show that with tissue compression the tumour boundary is subjected to a degree of strain the magnitude of which is dependent on the degree of deformation. Excessive compression can lead to fracture of the tumour. A literature survey reveals that malignant tissues are more delicate than normal tissues. The study underlines the need for care when using X-ray mammography with compression to image a cancer bearing breast, in order to avoid disseminating cancer cells via the circulation.

Breast Neoplasms

AURA: a new respiratory monitor and apnoea alarm for spontaneously breathing patients.

Previous attempts to introduce non-invasive monitoring of ventilation of spontaneously breathing patients into routine practice have been unsuccessful. The Aberdeen University Respiratory Alarm (AURA) allows such monitoring by utilizing the pyroelectric property of polarized polyvinylidine fluoride sensors to detect temperature changes that occur during breathing into an oxygen delivery face mask. A quartz crystal oscillator generates pulses that allow measurement of interexpiratory time and ventilatory frequency. The system incorporates LED digital displays, a bargraph and audiovisual alarms. An analog output permits display and analysis of the sensed signals. AURA performed satisfactorily in both volunteer studies and six patients in the clinical setting. AURA may be an appropriate respiratory transducer in those patients requiring oxygen therapy.

Adult

Theoretical considerations in relation to the treatment of brain tumours by means of local hyperthermia generated by ultrasound fields.

Brain tumours comprise a significant fraction of all tumours in the human body. Despite the development of technology in clinical oncology, these tumours still present a difficult challenge. The margin between destruction of tumour and damage to normal tissue is narrow in the brain. The price paid for producing tissue damage outside the tumour is high in terms of quality of survival. Results of many experiments with ultrasound hyperthermia show that this new technique is successful for treating certain types of malignant tumours. In the case of brain tumours, applying focused fields should have the advantage of selectively destroying the tumour and leaving surrounding tissues intact. Previous attempts at applying ultrasound to the field of neurosurgery are reviewed. Those factors which have effects on the generation of thermal fields in brain tissues are considered in relation to the possible treatment of human brain tumours. Calculated thermal fields in a 2-D brain model generated by an applicator built in our laboratory are also presented.

Brain

Some of the factors involved in the Sarvazyan method for recording ultrasound field distributions with special reference to the application of ultrasound in physiotherapy.

The mapping of ultrasound fields using the dye paper method is described. The mode of action by which the dye concentration is increased has been investigated. Microbubbles on the paper surface and microstreaming of dye solution seem to be essential features of the mapping method. The streaming is thought to inhibit the formation of a dye depletion layer near the paper to an extent dependent on local sound intensity A linear relation between streaming velocity and intensity is derived.

Coloring Agents

Impedance imaging in upper arm fractures.

We used the Aberdeen impedance imaging system to drive a constant current of 1 mA on a 10 kHz sine wave into the upper arm encircled by an elastic belt of 16 equi-spaced strip electrodes. The system was used to examine a normal upper arm, an upper arm with a recent humeral fracture and an upper arm with a clinically united fracture. We approximated the human upper arm to a circular cylinder and assumed bilateral symmetry of normal human limbs. We measured transverse limb resistivity ratios and reconstructed static two-dimensional images of the spatial distribution of log(resistivity) by the equipotential back projection technique using a homogeneous muscle equivalent saline reference. Our results indicate that impedance osteography provides unique information about the changing electrical characteristics at the fracture site. This information could prove a useful adjunct to clinical and radiological tests for fracture union.

Calibration

AURA: a new respiratory monitor.

The Aberdeen University Respiratory Alarm (AURA) is designed to monitor the respiratory rate and the inter- expiratory period (respiratory gap) in the spontaneously breathing patient using polarised polyvinylidene fluoride sensors incorporated in the Oxygen delivery mask. The monitor is composed of three modules--the sensor module includes a pair of polyvinylidene film strips mounted on the inner surface of the Oxygen mask. The difference in temperature between the ambient Oxygen enriched air and the warmer expired air allows the pyroelectric property of the sensors to be harnessed. The sensor arrangement allows a differential signal to develop between them which is amplified, filtered and rectified prior to triggering a counter. The timing module is based on a 32,768 Hz crystal oscillator that generates pulses allowing the period between expirations to be measured and compared to the maximum allowable period set by the user. The respiratory rate is also measured and compared to the minimum set by the user using EPROMS and comparators. The display module consists of a bar-graph display of the level of the sensed signal with each breath with a soft audible click. Eight segment LEDs are used to provide a digital display of the respiratory rate and the respiratory gap. Audiovisual alarms are triggered when the rate falls short of the set rate and/or when the gap exceeds the set gap. The need for continuous respiratory monitoring of the spontaneously breathing adult in hospital practice led us to develop this prototype with sensors whose design and configuration can be considerably improved.

Adult

The Aberdeen Impedance Imaging System.

The Aberdeen Impedance Imaging System is designed to reconstruct 2 dimensional images of the average distribution of the amplitude and phase of the complex impedance within a 3 dimensional region. The system uses the four electrode technique in a 16 electrode split-array. The system hardware consists of task-orientated electronic modules for: driving a constant current, multiplexing the current drive, demultiplexing peripheral voltages, differential amplification, phase sensitive detection and low-pass filtration, digitisation with a 14 bit analog to digital converter (ADC), and -control logic for the ADC and multiplexors. A BBC microprocessor (Master series), initiates a controlled sequence for the collection of a number of data sets which are averaged and stored on disk. Image reconstruction is by a process of convolution-backprojection similar to the fan-beam reconstruction of computerised tomography and is also known as Equipotential Backprojection. In imaging impedance changes associated with fracture healing the changes may be large enough to allow retrieval of both the amplitude and phase of the complex impedance. Sequential imaging of these changes would necessitate monitoring electronic and electrode drift by imaging an equivalent region of the contralateral limb. Differential images could be retrieved when the image of the normal limb is the image template. Better characterisation of tissues would necessitate a cleaner retrieval of the quadrature signal.

Adult

The Wellcome Foundation lecture, 1984. Nuclear magnetic resonance imaging in medicine: medical and biological applications and problems.

From early biological work and the first T1 nuclear magnetic resonance (n.m.r.) animal image in 1974, whole-body patient images, by using a two-dimensional Fourier transform method were achieved in Aberdeen in 1980 with a 0.04 T vertical resistive magnet. Different pulse sequences produce images dependent by different amounts on proton density, T1 and T2, and for clinical work it is advantageous to use more than one pulse sequence to image pathology. The slow improvement of spatial resolution with increasing standing magnetic field strength is discussed and information on the T1 and T2 contrast dependence is reviewed: it suggests that the gains from high fields may be less than believed hitherto. Electrocardiogram gating can be used to produce moving images of the beating heart; blood flow can be imaged and surface radiofrequency coils are used for improved detail. N.m.r. imaging has considerable potential for studying response to therapy; mental states and dementia; tissue generation; discriminating body fat and body fluids. Other nuclei such as 23Na can be imaged and the potential to image fluorine-labelled pharmaceuticals could be very exciting; n.m.r. contrast agents are now being developed. Images formed from T1 values measured for each pixel are very useful for diagnosis, but the numerical values themselves are less valuable for distinctive pathological identification. With 15 companies manufacturing n.m.r. imagers and over 200 in use in hospitals, the technique is rapidly becoming established in diagnostic clinical practice and some typical uses are presented.

Adenocarcinoma

Particulate oral NMR contrast agents.

Insoluble paramagnetic compounds in suspension can be used to achieve visualization of the gastrointestinal system on magnetic resonance imaging (NMR). Particulate preparations of these agents decrease the T1 and T2 of solutions to which they are added. Gadolinium oxalate, a prototype of these particulate agents, was evaluated in vitro and in vivo (in rabbits) by NMR imaging. The effect of this compound upon T1 and T2 in vitro was also quantitated by NMR spectroscopy. Opacification of the upper gastrointestinal tract was achieved with gadolinium oxalate following oral administration. The colon was visualized following rectal administration.

Administration, Oral

Nuclear magnetic resonance pulse sequence and discrimination of high- and low-fat tissues.

Signal size compared to independently measured T1 is described for various pulse sequences on the Aberdeen Mk II nuclear magnetic resonance imager. The ability of these sequences to discriminate between certain tissue types, and in particular between adipose tissue and muscle, is discussed. Inversion recovery, with a t interval of 200 ms, gives the best discrimination for this purpose, with a contrast ratio of 6 between fat and muscle. Other image types, and especially T1, give better contrast for low-lipid soft tissue such as liver and spleen.

Adipose Tissue

Contrast enhancement of magnetic resonance images by chromium EDTA: an experimental study.

Chromium EDTA was evaluated as an intravenous contrast agent for magnetic resonance (MR) imaging in vitro and in vivo in rabbits and rats. The effect of Cr EDTA on T1 and T2 values in vitro was first quantitated by spectroscopy at 2.5 MHz, followed by animal trials in which the effects of intravenous injection of Cr EDTA on calculated T1 MR images (obtained by the spin- warp technique at 1.7 MHz) were determined. Following administration of chromium EDTA, differences in T1 values between normal and abnormal kidneys were noted, renal hydronephrosis and renal ischemia were readily identified by the pattern of change in T1, and changes were observed in the normal rabbit brain and in tumors implanted in rats. It is concluded that the use of stable paramagnetic metal ion chelates, such as Cr EDTA, as intravenous contrast agents in MR imaging is feasible and that such agents would make possible the observation of tissue vascularity, breakdown of the blood-brain barrier, and renal function.

Animals

Fetal imaging by nuclear magnetic resonance: a study in goats. Work in progress.

Nuclear magnetic resonance proton imaging was used to obtain images of goat fetuses in utero. The long T1 relaxation time of amniotic fluid makes it appear black on proton density images when examined using the Aberdeen imager, and so allows very good discrimination of the position and structure of the fetus. Some fetal internal tissues can be seen on T1 images. These findings suggest that NMR imaging has great potential in pregnancy studies.

Animals