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Biomedical subjects

R W Gill

Publications and source records attributed to R W Gill.

15 recordsLinked to original sources

Specific cytogenetic abnormalities and k-ras mutation in two new human colorectal-adenoma-derived cell lines.

Two new human epithelial cell lines from sporadic colorectal adenomas designated S/RR and S/BR are reported. Both cell lines have extended growth capacities in vitro, reaching passages 38 and 40 respectively and show no sign of senescence. S/RR and S/BR cell lines have retained the ability to differentiate in vitro, as shown by mucin production from goblet-like cells. S/BR was derived from a large colonic tubular villous adenoma (3 to 4 cm), whereas S/RR was derived from a small rectal adenoma (< 1 cm), and may represent a relatively early-stage adenoma. The parent S/RR cell line has given rise to a clonogenic variant, designated S/RR/Cl, which also has shown no sign of senescence and has currently reached passage 43. Both the S/BR and the S/RR cell lines had mutations in codon 12 of the K-ras gene, while retaining one normal allele. The presence of this mutation, particularly in the cell line S/RR derived from a small adenoma, is consistent with ras mutation being a relatively early event in colorectal carcinogenesis and is perhaps involved in the ability of the adenoma cells to progress and to give rise to an immortal cell line in vitro. The clonal derivatives of the S/RR cells have an isochromosome 1q and abnormalities of chromosome 13 which include an isochromosome 13q. The S/BR cells have a deletion on the short arm of chromosome 1 and trisomy 7. The common abnormality for S/RR and S/BR cells involves chromosome 1. The involvement of different chromosomes in the 2 cell lines also suggests different pathways for malignant progression of the premalignant adenoma cells.

Adenoma

Automatic vessel tracking and measurement for Doppler studies.

In this initial report, an imaging technique is described for automatically recognising the walls of a blood vessel during Doppler measurements, and hence automatically adjusting the position of the sample volume. The method reduces the inherently two-dimensional edge detection problem to a one-dimensional one, and iterates over several imaging frames to optimise the information. The orientation and diameter of the vessel are also measured. The technique has been clinically tested off-line and is particularly applicable to Doppler volumetric flow studies.

Algorithms

New class of pulsed Doppler US ambiguity at short ranges.

A form of range ambiguity in Doppler ultrasound has been identified. It occurs when a high pulse repetition frequency (prf) is used with a superficial range gate. "Phantom" range gates are then generated at depths beyond the desired range gate, and these may produce artifactual signals. Extremely high prf values should not normally be used, and duplex machines should be programmed to display phantom range gates wherever they fall within the displayed field of view.

Humans

Transvaginal pulsed Doppler ultrasound assessment of blood flow to the corpus luteum in IVF patients following embryo transfer.

The waveforms of vessels supplying the ovaries of women on an in-vitro fertilization (IVF) programme were studied using transvaginal B-mode and Doppler ultrasound. There were 125 scans recorded in 65 women at weekly intervals from 3 days after embryo transfer or 5 days after gamete intrafallopian transfer (GIFT) until confirmation of pregnancy or onset of menses. At each examination the signals obtained from vessels supplying the ovaries were recorded and quantified using a resistance index (RI). Fifteen patients became pregnant of whom one has subsequently miscarried. There was a highly significant difference in the RI values between patients who became pregnant and those who did not; no patient who became pregnant had a RI greater than 0.5. Oestrogen to progesterone ratios were calculated in the subgroup of non-pregnant patients and there was no correlation between these values and the RI values. This new technique enables prediction of IVF treatment failure earlier than has been reported previously and may reflect the inadequacy of the corpus luteum.

Corpus Luteum

Splenic blood flow measurements by Doppler ultrasound: a preliminary report.

Splenic blood flow and splenic volume were measured by Doppler and cross sectional ultrasound in 72 human subjects consisting of 61 patients with splenomegaly and 11 normal subjects. This non-invasive and relatively simple method yielded satisfactory results in 76% of the subjects studied; failures were due to obesity, debility, distorted vascular anatomy, and excessive gas in the stomach. These preliminary results suggest that the Doppler ultrasound technique is a practical clinical method for measuring splenic blood flow.

Adult

Quantitative sonography.

The review presents a perspective on ultrasonic techniques which place numerical values on properties of tissue or physiological function. Two distinct approaches to tissue characterisation are identified and the various techniques employed are reviewed. The range of Doppler techniques currently in use or under development are described. The potential roles of the various techniques are discussed, using clinical results from the Ultrasonics Institute as a basis. Attenuation measurements show a considerable spread in results, but sound speed appears to correlate closely with the degree of fibrosis in liver and spleen. Other methods have been found useful in specialised areas. The use of pulsed Doppler with a resolution cell sufficiently large to encompass the entire vessel, in conjunction with B-mode imaging to determine geometry, permits volumetric flow measurements to be made in deep vessels and reveals previously inaccessible physiological data. The use of analysis techniques to provide quantitative information in the physiological state or function of tissue promises to add a new dimension to diagnostic ultrasound.

Doppler Effect

Microtelemetry--the use of integrated circuits in biotelemetry.

Integrated circuits are now in widespread use in such equipment as computers and consumer electronics, where their low cost, high reliability and small size are their principal advantages. In biotelemetry, small size is of particular importance. Here the use of integrated circuits allows systems of considerable complexity to be produced with high reliability in small packages. Commercial integrated circuits with the low power consumption and low voltage operation needed for biotelemetry are now becoming available; some such applications are briefly reviewed. In addition, examples of the use of custom integrated circuits in biotelemetry, and of the use of integrated circuit technology to build unique transducers and assemblies, are described.

Forecasting

Percutaneous control of a portacaval H-graft: description of a new device and its initial clinical application.

A percutaneously-controlled inflatable cuff which can change the diameter of a portacaval H-graft has been developed and used in 10 patients. When inflated, the cuff narrows the H-graft to increase portal pressure and reduce shunting. Use of the cuff has been of clinical significance in 3 of 7 long-term surviving patients. Narrowing the shunt improved the clinical state in 2 patients with encephalopathy, and reopening a closed shunt improved ascites in the third patient. Duplex ultrasound and deep Doppler have demonstrated an alteration of hepatic portal blood flow following inflation of the cuff after 6 months. It is concluded that further development of this controlled portacaval H-graft is warranted.

Adult

Measurement of blood flow by ultrasound: accuracy and sources of error.

Doppler ultrasound has now developed to the point where the rate of flow of blood in a given vessel can be measured with appropriate instrumentation. The theoretical basis of Doppler flow measurement is reviewed in this paper, with particular emphasis on the potential and actual sources of error. Three distinct approaches are identified, and the strengths and weaknesses of each discussed. The separate errors involved in estimating the vessel cross-sectional area, the angle of approach, and the Doppler shift are analyzed, together with the question of the uniformity of scattering from the blood. In vivo and in vitro tests of the accuracy obtained using a number of Doppler flow measuring instruments are then reviewed. It is concluded that the Doppler methods are capable of good absolute accuracy when suitably designed equipment is used in appropriate situations, with systematic errors of 6% of less. There are, however, considerable random errors, attributable primarily to errors in measuring the cross-sectional area and the angle of approach. Repeating the measurement of flow several times and averaging the results can reduce these random errors to an acceptable level.

Blood Flow Velocity