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Biomedical subjects

R Coxon

Publications and source records attributed to R Coxon.

At least 19 recordsLinked to original sources

Active acoustic control in gradient coils for MRI.

The new principles of active acoustic control in gradient coil design recently introduced by Mansfield and Haywood (MAGMA 1999;8(Suppl 1):55) are further developed theoretically for the far-field acoustic output for a single sector of a coil system comprising four or more flat rectangular coil sectors. Each sector consists of a split plate arrangement in which are embedded two windings, an outer primary winding and a narrow inner re-entrant loop control winding immediately adjacent to and surrounding the split or air gap. The wire spacing of the control winding is made small so as not to affect substantially the magnetic field created by the primary winding. Experimental results are presented for two sectors each made of a different readily available plastic material and tested over a range of frequencies. They both show substantial average reductions in acoustic output over the full output when the control winding is appropriately driven. New theoretical expressions are derived for particular frequencies based on normal mode expansions for the plate. This new approach is better able to explain the acoustic output difference between the full and reduced output modes. Empirical expressions are also developed which include longitudinal as well as transverse plate characteristics and used to fit the experimental acoustic output data as a function of frequency and indicate good agreement with regard to both the form and amplitude of the acoustic output response.

Acoustics↗

Liver transplantation for citrullinaemia improves intellectual function.

BACKGROUND: Arginosuccinic acid synthetase (ASA) (EC 6.3.4.5) deficiency (citrullinaemia) (McKusick 215700) is a well-recognized cause of neonatal hyperammonaemic coma with poor long-term intellectual function, despite good medical management. METHODS: Cadaveric hepatic transplantation was performed in a 12-year-old boy with citrullinaemia under poor biochemical control. Subsequent development of fulminant hepatic failure necessitated a second cadaveric transplant. Psychometric assessments before and after transplantation were performed using a variety of age-appropriate tests. RESULTS: Normalization of plasma ammonium in our patient post transplantation has resulted in dramatic improvement in mental functioning and well-being and he now enjoys a normal diet. Psychometric assessment confirmed decline in his abilities prior to transplantation with particular post-transplantation improvement in perceptual organization and visuospatial abilities; these did not, however, return to normal. His family report considerable reduction in stress associated with the unpredictable nature of previous hyperammonaemic crises and recurrent hospitalization. CONCLUSIONS: Liver transplantation should be considered as an early therapeutic option in children with citrullinaemia to prevent ongoing cerebral insult associated with hyperammonaemia.

Amino Acid Metabolism, Inborn Errors↗

Functional magnetic resonance imaging of single motor events reveals human presupplementary motor area.

Conventional functional imaging paradigms use periods of repetitive task performance to generate sustained functional signal changes. We have developed a technique of imaging the small, transient signal changes that occur after single cognitive events. The technique uses echo-planar imaging at 3 T to generate functional images of the whole brain with a temporal resolution of 3 seconds. It uses a signal averaging technique to create time sweeps of functional activity. After a single cognitive event, widely distributed patterns of brain activation can be detected and their time course measured. This technique enables the individual cognitive tasks that constitute a paradigm to be analyzed separately and compared. We describe the application of this new technique to separate the cognitive elements in a simple "go/no-go" motor paradigm. Comparison of activation patterns during "go" and "no-go" responses reveals hierarchical subdivision of the medial premotor cortex into an anterior region (presupplementary motor area) involved in movement decision making and a posterior region (supplementary motor area proper) directly involved in motor execution.

Adult↗

Active acoustic screening: reduction of noise in gradient coils by Lorentz force balancing.

We have designed and constructed a quiet gradient set with restricted access for the combined purposes of evaluating the principles of active acoustic screening, recently introduced by Mansfield, Glover, and Bowtell, and for EPI studies of the head at 3.0 T. The design utilizes the return paths of the conductors in a closed arc loop arrangement to eliminate net Lorentz forces thereby attenuating acoustic noise especially at low frequency. This design should significantly reduce the dangers to patients of high noise levels, especially in high field magnetic resonance imaging systems.

Acoustics↗

Anti-tumor necrosis factor-alpha prevents decreased ventricular contractility in endotoxemic pigs.

It is not known how the decrease in left ventricular contractility following endotoxin exposure is mediated, or whether this decrease is preventable by antibodies to tumor necrosis factor-alpha (TNF alpha). Four groups of six anesthetized and instrumented pigs were pretreated with ovine polyclonal antibody to human TNF alpha (anti-TNF alpha), nonspecific IgG, or saline, and then treated with either endotoxin or saline. We measured hemodynamics and left ventricular pressures (Millar catheter) and volumes (conductance catheter). Left ventricular contractility was assessed using the slope (Emax) of the end-systolic pressure-volume relationship. Four hours after the start of endotoxin infusion in the nonspecific IgG pretreated group, Emax had decreased by 44 +/- 6% (p < 0.05), mean arterial pressure had decreased from 115 +/- 7 mm Hg to 70 +/- 10 mm Hg (p < 0.05), and cardiac output was rapidly decreasing after an initial increase (p < 0.05). Anti-TNF alpha significantly reduced the decrease in Emax (11 +/- 9%, p < 0.05), and the systemic hypotension (108 +/- 15 mm Hg to 99 +/- 6 mm Hg, p < 0.05), at 4 h, and prevented the late decrease in cardiac output. This suggests that TNF alpha is an important early mediator in sepsis leading to decreased left ventricular contractility.

Animals↗

Prolonged monitoring of the upper gastrointestinal tract using echo planar magnetic resonance imaging.

Upper gastrointestinal motility and transit has been studied in five human volunteers with the ultra high speed, magnetic resonance imaging (MRI) technique MBEST (Modulus Blipped Echo-planar Single pulse Technique), a variant of echo planar imaging. Snapshot images requiring a data acquisition time of only 64-128 msec allowed visualisation of peristalsis in the antrum and duodenum in real time, without motional image degradation, as would normally be seen using conventional MRI. Gastroduodenal flow of the luminal contents was visualised using water as a contrast medium, with appropriate adjustment of the time constant (T2) weighting of the system. Rapid (0.3 Hz) imaging of gastroduodenal motility in both transverse and coronal planes was achieved by respiratory gating to the imaging frequency, allowing repetition rates of up to 20 frames per minute for 2-3 hours. Fast replay of stored images, to produce a 'movie loop', allowed identification of fasting motility patterns of the gastric antrum and proximal small intestine, with depiction of the phases of the migrating motor complex. Images of the fed patterns after the ingestion of a test meal showed good separation of solid and liquid particulate matter and mixing waves in the gastric body. The potential for quantitative measurements with this new imaging modality of the gastrointestinal tract is under development, which will allow us to measure transit and correlate this with motility data.

Adult↗

Observation of cerebrospinal fluid flow with echo-planar magnetic resonance imaging.

Using echo-planar (EP) magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) flow patterns have been demonstrated in the normal subject and patients with pathological conditions including communicating hydrocephalus, aqueduct stenosis and syringohydromyelia. Snap-shot imaging times of 128 ms allow detailed demonstration of transient intraventricular CSF flow patterns, which is not possible with conventional MRI. The potential of EPI as a method for qualitative and quantitative assessment of CSF dynamics is illustrated.

Cerebral Aqueduct↗

Echo-planar imaging of the human fetus in utero.

We have demonstrated that echo-planar imaging can be used to produce high-quality snapshot images of the human fetus in utero in a fraction of a second. These images are free of motional artifact or blurring and allow detailed depiction of fetal structures in normal and pathological pregnancies.

Fetal Heart↗

Inversion-recovery echo-planar imaging (IR-EPI) at 0.5 T.

Echo-planar imaging is used in combination with a spin preparation phase to produce a T1-weighted image. The small additional time penalty in this procedure does not detract significantly from the ultrahigh-speed imaging capability of EPI, allowing a rapid real-time optimization of tissue parameters in the image display. Results obtained on a head demonstrate this technique.

Electron Spin Resonance Spectroscopy↗

Echo planar imaging of an infant with pectus excavatum.

Echo planar imaging has enabled us to image safely and without sedation the thorax of an infant with pectus excavatum deformity. The heart was displaced into the left side of the thorax, and the right lung was calculated to be 1.6 times larger than the left lung.

Funnel Chest↗

Estimation of lung volume in infants by echo planar imaging and total body plethysmography.

Echo planar imaging (an extremely fast method of magnetic resonance imaging) was used to measure lung volume in a group of nine infants, all of whom had had respiratory problems. The mean echo planar imaging estimate of total lung volume was 44 +/- 9 ml/kg. In each case the right lung was larger than the left (ratio 52.8:47.2%). The mean thoracic gas volume was 36 +/- 8 ml/kg. The entire sequence of images of the thorax (about 400) takes five minutes to complete, infants require no sedation, and there are no side effects.

Female↗

Ultrafast magnetic resonance scanning of the liver with echo-planar imaging.

Echo-planar imaging (EPI) is a magnetic resonance imaging (MRI) technique which provides MR images in, typically, 50-100 ms. The potential of EPI as an imaging modality for the liver has been investigated in volunteers and patients with liver disease. Images with improved quality are presented. Obtained at a field strength of 0.52 Tesla, these true unaveraged snap-shot images have larger data arrays, comprising 128 X 128 pixels.

Aged↗

Echo planar imaging of the human fetus in utero at 0.5 T.

The snap-shot capability of the echo-planar imaging technique is used to freeze motion effectively in human fetal studies in utero. These first results obtained at 0.5 T demonstrate diagnostic quality images without the need for averaging. Although averaging improves the image signal to noise ratio, it is shown that significant image blurring is produced even when only eight separate images are averaged over a period of a few seconds. Results are presented showing anatomical detail of the internal organs of the fetus. Some pathology is also demonstrated. These results were obtained using the modulus blipped echo-planar single-pulse technique (MBEST). Running at 10 frames/second, the modulus version of the fast low-angle excitation echo-planar technique (FLEET) is used to produce ungated fetal cardiac movies.

Female↗

Effect of reducing atrial pressure on atrial natriuretic factor and vasoactive hormones in congestive heart failure secondary to ischemic and nonischemic dilated cardiomyopathy.

The effect of an acute and sustained reduction in atrial pressure on atrial natriuretic factor (ANF) and vasoactive hormone secretion was studied in 9 patients with congestive heart failure (CHF). Intravenous nitroglycerin was titrated to reduce the pulmonary artery wedge pressure by 30 to 50% and maintain this reduction for 4 hours. After 60 minutes of nitroglycerin administration, the mean decrement in wedge pressure was 10.0 +/- 1.7 (standard error) mm Hg (35%) and plasma ANF was 65.3 +/- 13.9 pmol/liter (35%). The initial decrease, sustained reduction and later increase in plasma ANF levels closely paralleled the changes in pulmonary arterial wedge (r = 0.94, p less than 0.0001) and right atrial pressures (r = 0.91, p less than 0.0001) during and immediately after the nitroglycerin infusion. Plasma aldosterone and cortisol levels increased during the first 2 hours of the nitroglycerin infusion, but there was little change in plasma norepinephrine or plasma renin activity. Although levels were elevated in CHF, plasma ANF still responded rapidly to changes in atrial pressure. A sustained reduction in pressure produced a sustained reduction in ANF levels. These findings provide further support for a regulatory role of ANF, even in chronic CHF.

Aged↗

Snapshot imaging at 0.5 T using echo-planar techniques.

Echo-planar imaging using a magnetic field strength of 0.5 T has resulted in an improvement in image quality compared with recent images published at 0.1 T. The sensitivity of the technique to main magnetic field inhomogeneity and transient eddy currents has necessitated innovations in gradient and radiofrequency coil design. These improvements are described, and new variations in the echo-planar pulse sequence which provide better contrast and allow separate imaging of water and fat distributions are presented.

Abdomen↗