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Biomedical subjects

R D Cox

Publications and source records attributed to R D Cox.

At least 37 records · Page 2Linked to original sources
PubMed1997

Design and implementation of World Wide Web-based tools for image management in computed tomography, magnetic resonance imaging, and ultrasonography.

This article describes our experience in developing and using several web-based tools to facilitate access to and management of images from inside and outside of our department. Having recently eliminated film in ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI), a simple method was required to access imaging from computers already existing throughout the hospital. The success of the World Wide Web (WWW), the familiarity of endusers with web browsers, and the relative ease of developing user interfaces virtually dictated that such an approach be pursued in our case. The resulting web-based tools allow validated users to search our Digital Imaging and Communications in Medicine (DICOM)-compliant archive servers for specific exams; to download image data from a remote site; to request the retrieval of data from long-term storage; to view images, and to perform certain DICOM routing operations. The existing infrastructure of the internet has allowed us to develop a low-cost system capable of being used for teleradiology. Since low-level, machine-specific interface programming was avoided, these tools were developed rapidly and are easily adapted. The familiarity of browser-based interfaces has facilitated user acceptance, and the benefit of platform independence minimizes software portability concerns.

Computer Communication Networks↗
PubMed1997

Implementation of a filmless mini picture archiving and communication system in ultrasonography: experience after one year of use.

This article details our experience in developing and operating an ultrasound mini-picture archiving and communication system (PACS). Using software developed in-house, low-end Macintosh computers (Apple Computer Co. Cupertino, CA) equipped with framegrabbers coordinate the entry of patient demographic information, image acquisition, and viewing on each ultrasound scanner. After each exam, the data are transmitted to a central archive server where they can be accessed from anywhere on the network. The archive server also provides web-based access to the data and manages pre-fetch and other requests for data that may no longer be on-line. Archival is fully automatic and is performed on recordable compact disk (CD) without compression. The system has been filmless now for over 18 months. In the meantime, one film processor has been eliminated and the position of one film clerk has been reallocated. Previously, nine ultrasound machines produced approximately 150 sheets of laser film per day (at 14 images per sheet). The same quantity of data are now archived without compression onto a single CD. Start-up costs were recovered within six months, and the project has been extended to include computed tomography (CT) and magnetic resonance imaging (MRI).

Compact Disks↗
PubMed1997

CD-based image archival and management on a hybrid radiology intranet.

This article describes the design and implementation of a low-cost image archival and management solution on a radiology network consisting of UNIX, IBM personal computer-compatible (IBM, Purchase, NY) and Macintosh (Apple Computer, Cupertino, CA) workstations. The picture archiving and communications system (PACS) is modular, scaleable and conforms to the Digital Imaging and Communications in Medicine (DICOM) 3.0 standard for image transfer, storage and retrieval. Image data is made available on soft-copy reporting workstations by a work-flow management scheme and on desktop computers through a World Wide Web (WWW) interface. Data archival is based on recordable compact disc (CD) technology and is automated. The project has allowed the radiology department to eliminate the use of film in magnetic resonance (MR) imaging, computed tomography (CT) and ultrasonography.

Compact Disks↗
PubMed1997

Identification of nine novel mutations in the hepatocyte nuclear factor 1 alpha gene associated with maturity-onset diabetes of the young (MODY3).

Maturity-onset diabetes of the young (MODY) is a genetically heterogeneous subtype of non-insulin-dependent diabetes mellitus (NIDDM) characterised by early onset, autosomal dominant inheritance and a primary defect in insulin secretion. Recent studies have shown that mutations in the two functionally related transcription factors, hepatocyte nuclear factor 4 alpha (HNF-4alpha) and hepatocyte nuclear factor 1 alpha (HNF-1alpha) are associated with the MODY1 and MODY3 forms of diabetes respectively, whereas mutations in the enzyme glucokinase are the cause of the MODY2 form. We have examined 10 unrelated Caucasian families in which MODY/NIDDM co-segregated with markers for MODY3 for mutations in the HNF-1alpha gene (TCF1). Ten different mutations were observed in these families, all of which co-segregated with diabetes. There were no obvious relationships between the nature of the mutations observed (i.e. frameshift, nonsense, or missense) or their location in the gene with clinical features of diabetes (age at onset, severity) in these families. The mechanisms by which mutations in the HNF-1alpha gene cause diabetes mellitus are unclear but might include abnormal pancreatic islet development during foetal life thereby limiting their later function, as well as impaired transcriptional regulation of genes that play a key role in normal pancreatic beta cell function.

DNA-Binding Proteins↗
PubMed1997

Identification of polygenic disease genes.

I discuss the identification and cloning of genes involved in determining susceptibility to diseases under polygenic control. The process of cloning a susceptibility gene is as follows: identification of new genetic markers in the region by database analysis, isolation of DNA clones in the region and the generation of new genetic markers, refinement of the map position using these markers for linkage disequilibrium analysis, construction of a physical and disequilibrium map, construction of a clone contig across the critical region in yeast artificial chromosomes, PAC, bacterial artificial chromosomes and cosmids, and finally gene identification and etiological mutation detection.

Chromosome Mapping↗
PubMed1996

Mutations in the hepatocyte nuclear factor-1alpha gene in maturity-onset diabetes of the young (MODY3)

The disease non-insulin-dependent (type 2) diabetes mellitus (NIDDM) is characterized by abnormally high blood glucose resulting from a relative deficiency of insulin. It affects about 2% of the world's population and treatment of diabetes and its complications are an increasing health-care burden. Genetic factors are important in the aetiology of NIDDM, and linkage studies are starting to localize some of the genes that influence the development of this disorder. Maturity-onset diabetes of the young (MODY), a single-gene disorder responsible for 2-5% of NIDDM, is characterized by autosomal dominant inheritance and an age of onset of 25 years or younger. MODY genes have been localized to chromosomes 7, 12 and 20 (refs 5, 7, 8) and clinical studies indicate that mutations in these genes are associated with abnormal patterns of glucose-stimulated insulin secretion. The gene on chromosome 7 (MODY2) encodes the glycolytic enzyme glucokinases which plays a key role in generating the metabolic signal for insulin secretion and in integrating hepatic glucose uptake. Here we show that subjects with the MODY3-form of NIDDM have mutations in the gene encoding hepatocyte nuclear factor-1alpha (HNF-1alpha, which is encoded by the gene TCF1). HNF-1alpha is a transcription factor that helps in the tissue-specific regulation of the expression of several liver genes and also functions as a weak transactivator of the rat insulin-I gene.

Animals↗
PubMed1996

Effectiveness of short-term specialized inpatient treatment for war-related posttraumatic stress disorder: a role for adventure-based counseling and psychodrama.

Psychological tests were administered to 24 participants of an inpatient posttraumatic stress disorder (PTSD) treatment program both immediately before and following completion of treatment. Responses were compared to a treatment/wait list comparison group composed of 24 subjects awaiting entry into the program. All treatment/wait list comparison group subjects received weekly PTSD outpatient group therapy. Significant improvements were found in the inpatient treatment group in areas of hopelessness, feelings of guilt and shame, loneliness, and emotional expressiveness. Other indices of psychological functional, including interpersonal skills, gender role stress, anxiety, anger, and PTSD symptomatology did not change significantly in response to treatment. No positive changes in any area of psychological function occurred in the treatment/wait list comparison group. Implications for PTSD and areas of future research are discussed.

Adult↗
PubMed1995

The neuroprotective effect of high-dose methylprednisolone in rat spinal cord hemisection.

Multiple studies support a neuroprotective effect for high-dose methylprednisolone (MP) in acute blunt spinal cord injury. We know of no study that addresses the role of MP in prophylaxis for surgical trauma to the spinal cord or for the treatment of non-missile penetrating injuries to the spinal cord. We examined the neuroprotective effect of MP as measured by the retrograde transport of the fluorescent tracer Fluoro-Gold in 20 rats undergoing C-2 hemisection. Mean cell counts of retrogradely labeled rubrospinal neurons were determined 1 week post-injury. The group receiving MP had a significantly higher (P < 0.0001) number of labeled cells (x = 594) compared to controls (x = 387). The highly significant increase in mean cell counts in rats receiving steroids suggests less secondary axonal injury in the MP group. These findings are the first report of a neuroprotective effect of MP in rat spinal cord hemisection. We suggest that MP may be beneficial as prophylaxis during planned or incidental surgical trauma to the spinal cord and after non-missile penetrating injuries to the spinal cord.

Animals↗
PubMed1994

A 1.2-Mb YAC contig spans the quaking region.

We describe here a 1.2-Mb yeast artificial chromosome (YAC) contig within the region of mouse chromosome 17 between Brachyury (T) and D17Rp17e, and spanning the quaking (qk) region. We describe six new probes distributed across 1.2 Mb: D17Leh502, D17Leh503, D17Leh504, D17Leh505, D17Leh506, and D17Leh507. Probes D17Leh502 and D17Leh507 are at the extreme ends of the YAC contig. With the exception of D17Leh507, all of these probes are within a deletion associated with the quaking(viable) (qkv) allele of quaking. We have positioned these probes on a detailed YAC physical map together with two previously published probes, D17Leh508 and D17Aus119. We show here that D17Leh508 is also within the qkv deletion. Genetic mapping of D17Leh504 and D17Leh507 on two high-resolution genetic crosses carrying qkv and quaking(lethal-1) (qkl-1) alleles shows that these probes do not recombine with quaking and are therefore within 0.04 cM of qkv and 0.05 cM of qkl-1 mutations. The deletion breakpoint contained within the YAC contig has been positioned to within 90 kb by restriction mapping of wildtype and mutant DNA. This contig will form the basis for identification and mapping of expressed sequences and for an investigation of genome organization.

Alleles↗
PubMed1994

Decontamination and management of hazardous materials exposure victims in the emergency department.

Incidents involving releases of hazardous materials are increasing. Providing medical care to patients who may be contaminated with a hazardous material requires advance planning and specialized training and equipment. Failure to adequately prepare for this situation can result in costly contamination of medical facilities and toxic exposures to health care providers. Federal regulations may require hospitals to supply health care providers with training and protective equipment for these situations.

Decontamination↗
PubMed1994

Evaluation of intravenous magnesium sulfate for the treatment of hydrofluoric acid burns.

Hydrofluoric acid exposures to the skin can produce severe, progressive burns. Medical treatment of these burns is aimed at neutralizing the free fluoride ion, which is felt to be responsible for burn progression. Both calcium and magnesium will form complexes with free fluoride and have been used as topical or intradermal treatments in the past. This study evaluated the efficacy of intravenous magnesium sulfate for the treatment of hydrofluoric acid burns and compared this treatment to controls and burns treated with intradermal calcium gluconate in a rabbit model. Both treatments demonstrated a reduction in burn area over time, wound depth, healing time and final scar area compared to controls. The intravenous magnesium treatment showed trends toward improved outcome compared to the intradermal calcium treatment in all parameters evaluated, but these differences did not reach statistical significance. This investigation found intravenous magnesium to be an effective method for treating hydrofluoric acid burns. Intravenous magnesium may have significant utility for treating hydrofluoric acid burns that are not amenable to current therapies.

Animals↗
PubMed1993

Rubrospinal neurons and retrograde transport of fluoro-gold in acute spinal cord injury--a dose-response curve.

Using the fluorescent tracer Fluoro-Gold, we studied the relationship between severity of spinal cord trauma and the number of retrogradely labeled rubrospinal neurons in the rat. We compared the mean cell counts of retrogradely labeled rubrospinal neurons in rats receiving 0, 20, 40, and 60 g/cm concussive spinal cord traumas. For each incremental increase in trauma a significant reduction in mean cell counts took place (P < 0.0001). We demonstrate a dose-response relationship between trauma severity and Fluoro-Gold retrogradely labeled rubrospinal neurons in acute spinal cord injury of the rat. This relationship may be helpful in quickly assessing the efficacy of therapeutic interventions in acute spinal cord injury. Previous studies with HRP failed to demonstrate such a dose-response curve. Fluoro-Gold may be a more sensitive indicator of neuronal survival than HRP in the traumatized rat spinal cord.

Acute Disease↗
PubMed1993

Latex hypersensitivity following exposure to gloves during electromyography.

A case of a 7-year-old boy with myelodysplasia who developed a local acute hypersensitivity reaction after exposure to latex gloves during electromyography is presented. Anaphylaxis from latex gloves has been recently reported, especially in patients with myelodysplasia. Allergens from rubber gloves can be introduced under the skin during EMG and could cause local or systemic acute hypersensitivity reactions. Electromyographers should elicit a history to rule out rubber allergy and use vinyl gloves if suspicion of allergy exists.

Child↗
PubMed1993

Detailed physical and genetic mapping in the region of plasminogen, D17Rp17e, and quaking.

We present here a detailed physical map encompassing over 600 kb of mouse Chromosome (Chr) 17 in the region of plasminogen, D17Rp17e, and quaking. This region is cloned in yeast artificial chromosomes (YACs). We have identified several CpG islands within this region from pulsed field gel mapping of mouse genomic DNA and YAC DNA. Five new DNA probes have been generated. One, D17Leh514, is a minimum of about 90 kb distal to plasminogen. Four, D17Leh513, D17Leh512, D17Leh511, and D17Leh510, are proximal to D17Rp17e, the closest previously described genetic marker to quaking viable and quaking lethal-1 mutations. We have genetically mapped D17Leh511 to within 0.15 cM of these mutations. The genetic distance to D17Rp17e from D17Leh511 is also 0.15 cM; the physical distance of less than 360 kb (minimum 200 kb) is consistent with an approximation of 2 Mbp per cM.

Animals↗