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R Coxon

Publications and source records attributed to R Coxon.

At least 37 records · Page 2Linked to original sources

Whole-body echo-planar MR imaging at 0.5 T.

The ultra-high-speed echo-planar imaging technique produces instant snapshot magnetic resonance images in exposure times ranging from approximately 10 to 100 msec. A particular variant, the modulus blipped echo-planar single-pulse technique (MBEST), possesses two advantages: First, it makes the technique experimentally more robust; second, it introduces inherent T2 weighting in the images. The authors have used MBEST with an exposure time of 64 msec to explore the potential range of clinical applications in a series of normal volunteers. Applications include evaluation of the heart, renal function, and gastrointestinal tract. All images were obtained with proton resonances at 22 MHz.

Abdomen↗

Gastrointestinal tract: dynamic MR studies with echo-planar imaging.

Gastrointestinal (GI) tract motility was depicted in four human volunteers with the high-speed echo-planar imaging technique: modulus blipped echo-planar single-pulse technique (MBEST). Data acquisition times of 64 and 128 msec obviate image degradation due to motion without the need for gut paralysis and allow imaging of the GI tract in real time. Peristaltic patterns of the gastric antrum and proximal small intestine were depicted for fasting and fed subjects and subjects in whom peristalsis had been pharmacologically stimulated. The potential for quantitative measurements of GI tract motion with this new technique was demonstrated.

Adult↗

Snapshot head imaging at 0.5 T using the echo planar technique.

The echo planar imaging (EPI) method and related variants of this technique can produce complete two-dimensional images from the data collected in a single experiment lasting a fraction of a second. EPI methods are used at 0.5 T to produce snapshot images of the human head with a spatial resolution of less than 2 mm.

Head↗

Development of separation fluoroimmunoassays for bendazac and 5-hydroxy bendazac.

Two distinct separation fluoroimmunoassays were developed to determine serum levels of bendazac and its main metabolite 5-hydroxy bendazac for use in early pharmacokinetic studies and for long-term therapeutic drug monitoring should this prove necessary. In both assays fluorescein-labeled analyte was used as tracer and the antibodies were coupled to magnetizable particles. The use of a magnetizable solid phase enabled a simple and rapid separation step and thus a high sample throughput. There was no crossreactivity between the drug and its metabolite in either assay, indicating that highly specific antibodies had been produced. The results from both assays correlated well with serum levels determined by a high performance liquid chromatography method.

Anti-Inflammatory Agents, Non-Steroidal↗

Evaluation of infants by echo planar imaging after repair of diaphragmatic hernia.

Three infants were studied by echo planar imaging after repair of congenital diaphragmatic hernias. Total lung volume and individual lung volumes were estimated using echo planar imaging. In the two patients with left sided hernias, the right lung was more than twice as large as the left. The patient with a right sided hernia had developed emphysema on the right side, and the right lung was twice as large as the left when estimated by echo planar imaging. Echo planar imaging studies took less than five minutes to perform and no sedation was required.

Female↗

Design of the immunogen and label for use in a fluoroimmunoassay for paracetamol.

The design of immunogens for raising antisera containing antibodies specifically directed against paracetamol is discussed. A derivative of the drug with minimal structural alteration was synthesised, coupled to the carrier protein key-hole limpet haemocyanin, and used to immunise sheep. The evaluation of the resulting antisera is described. Preparation of a fluorescent label with reduced bridge-binding then allowed the development of a polarisation fluoroimmunoassay for paracetamol in buffer, suitable for conversion to a direct serum assay.

Acetaminophen↗

Improvements in snap-shot nuclear magnetic resonance imaging.

New variants of the ultra-high-speed echo-planar imaging technique have been used to obtain snap-shot images of adult patients and volunteers at 0.1 T. Modified pulsed-gradient sequences together with non-linear signal sampling and activity screened gradients have greatly improved the image quality obtainable by single-shot methods. A particular variant, modulus blipped echo-planar single-pulse technique (MBEST), although slightly slower than the blipped echo-planar single-pulse technique (BEST), is experimentally more robust and incorporates intrinsic T2 weighting. An account of these improvements together with some experimental results is presented.

Adult↗

Hemodynamic effects of intermittent transdermal nitroglycerin in chronic congestive heart failure.

The hemodynamic effects of intermittent and continuous treatment with transdermal nitroglycerin, 10 mg/24 hours, were compared in 10 patients with chronic congestive heart failure (CHF). Eight patients responded to initial application with more than a 20% reduction in mean pulmonary artery wedge pressure. Cardiac index increased from a control value of 2.1 +/- 0.5 to 2.4 +/- 0.6 liters/min/m2 at 2 hours (p less than 0.05) and mean pulmonary wedge pressure was reduced from 22 +/- 5 to 16 +/- 6 mm Hg (p less than 0.01). The 2 nonresponders had the largest left ventricular volumes on 2-dimensional echocardiograms. Responders were randomized to intermittent (16 hours/day) or continuous (24 hours/day) treatment for 1 month followed by a month of the alternate treatment. After 1 month of intermittent treatment, the hemodynamic response after reapplication was similar to the initial response. After another month of continuous treatment, hemodynamic values 24 hours after application were similar to initial control values and there was no change after removal and reapplication. Thus, the moderate vasodilator effect of transdermal nitroglycerin in CHF is maintained with intermittent treatment, whereas tolerance develops with continuous treatment.

Administration, Cutaneous↗

Real-time movie imaging from a single cardiac cycle by NMR.

Using a 1-m-bore superconductive magnet at 0.1 T, whole-body transverse images through adult humans have been obtained at repetition times of 57 ms. The techniques used were minor variations of echo-planar imaging (EPI) employing large pulsed gradients to provide complete coverage of the plane in phase space, and low-angle RF excitation sequences allowing rapid repetition of the experiment. In addition active magnetic screening of the gradient coils was implemented to protect the surrounding magnet from the eddy currents induced by the necessarily fast switching of the large gradient fields.

Adult↗

Transdermal nitroglycerin in angina pectoris: efficacy of intermittent application.

Continuous application of transdermal nitroglycerin appears to result in tolerance to the antianginal effect. In a double-blind study the effects of continuous (24 h/day) and intermittent (16 h/day) application of transdermal nitroglycerin in a dosage of 10 mg/day were compared with the effects of placebo in 12 patients with chronic stable angina receiving treatment with beta-adrenergic blocking or calcium channel blocking agents. Exercise performance was assessed 2 to 4 hours after initial application and after 1 week of each treatment given in random order with a 3 day interval between treatments. Exercise time to onset of angina, total exercise duration and time to 1 mm ST segment depression were all significantly increased after initial application during the continuous and intermittent treatment periods. These increases were maintained after 1 week of intermittent but not continuous treatment. Thus the benefit of initial application of transdermal nitroglycerin is maintained with intermittent treatment and a daily nitrate-free interval, whereas tolerance to antianginal effect occurs with continuous treatment.

Administration, Cutaneous↗

Echo planar imaging of normal and abnormal connections of the heart and great arteries.

Echo planar imaging (EPI) is that form of magnetic resonance imaging which provides very short image acquisition times. EPI also provides very rapid sequential imaging. The EPI method is ideal for imaging the heart and thoracic content because images are devoid of cardio-respiratory motion artefact. Previously an analysis of transectional images has been presented. This paper is concerned with the study of the heart by the use of EPI constructions in the sagittal and coronal planes. Defining connections between ventricle and great artery is of cardinal importance in paediatric cardiology. EPI constructions in the normal heart, transposition, truncus arteriosus and right heart hypoplasia are presented and discussed.

Heart Defects, Congenital↗

Transectional echo planar imaging of the heart in cyanotic congenital heart disease.

Echo planar imaging is that form of magnetic resonance imaging which gives very short image acquisition times. The method has been used to produce images of the infant heart which are free of cardiorespiratory motion artefact, despite tachypnoea and tachycardia. EPI transections of the normal heart are compared with transections in truncus arteriosus, tetralogy of Fallot, right heart hypoplasia and transposition of the great arteries. The diagnosis of the cause of cyanosis in these infants was established by the noninvasive EPI method and validation of the findings may be found in transectional postmortem analyses reported in the literature.

Heart Defects, Congenital↗

Enalapril in patients with chronic heart failure: a placebo-controlled, randomized, double-blind study.

A number of studies have shown short-term hemodynamic and symptomatic improvement in patients with congestive heart failure treated with angiotensin converting-enzyme inhibitors. The long-term efficacy of the oral long-acting converting-enzyme inhibitor enalapril remains to be established in controlled studies. We evaluated this drug in 36 patients with New York Heart Association functional class II to III heart failure who were clinically stable on digoxin and diuretic therapy. After baseline assessment of symptoms, exercise capacity, and results of echocardiographic examination and right heart catheterization, patients were randomly assigned to treatment with 5 mg enalapril twice daily (n = 18) or placebo (n = 18) in a double-blind fashion. The two groups had similar clinical, echocardiographic, and hemodynamic characteristics before treatment. After 3 months of treatment, the enalapril group showed a significant improvement as judged by subjective patient impression, functional class, and exercise duration (9.3 +/- 5.7 vs 17.6 +/- 5.6 min; p less than .001). Diuretic dosage was reduced in six patients and increased in one patient, one patient had died and another had been withdrawn from the study. In the placebo group there was no significant change with respect to patient impression, functional class, or exercise duration; diuretic dosage was increased in seven patients and four patients had died. Echocardiographic left ventricular dimensions were significantly reduced and left ventricular shortening fraction significantly increased in the enalapril group but were unchanged in the placebo group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗