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Biomedical subjects

F Jolesz

Publications and source records attributed to F Jolesz.

At least 37 records · Page 2Linked to original sources

Lack of association between fibromyalgia syndrome and abnormalities in muscle energy metabolism.

OBJECTIVE: To compare parameters of muscle energy metabolism in patients with fibromyalgia syndrome (FMS) and sedentary controls. METHODS: Thirteen female FMS patients and 13 female sedentary controls underwent a standardized clinical assessment (including dolorimeter measurements of the upper trapezius and tibialis anterior muscles) and a standardized aerobic fitness test including measurement of maximum oxygen uptake (VO2max). Phosphorus (31P) magnetic resonance spectroscopy studies of the upper trapezius and tibialis anterior muscles were then performed in FMS patients and controls, at rest and during and following a muscle-fatiguing exercise protocol. RESULTS: FMS patients and controls had similar levels of VO2max and of maximum voluntary contraction (MVC) of the upper trapezius and tibialis anterior muscles. After controlling for VO2max and MVC, measurements of phosphocreatine (PCr), inorganic phosphate (P(i)), and intracellular pH in these muscles were not significantly different in FMS patients versus sedentary controls either at rest, during exercise, or during recovery. In the patients with FMS, no correlation was found between overall or local pain severity and the principal muscle metabolic parameter, PCr/P(i). Inverse correlations between dolorimeter scores at 2 muscle sites and tibialis anterior PCr/P(i) were found both in patients and in controls. CONCLUSION: This study demonstrates that under the conditions studied, muscle energy metabolism in FMS is no different than that in sedentary controls. These findings do not support the hypothesis that detectable defects in muscle energy metabolism occur in FMS.

Adult↗

Comparison of the precision of two standardized co-ordinate systems for the quantitation of brain anatomy: preliminary results.

We assessed reproducible definition of two standardized co-ordinate systems for intersubject analysis of brain images. The baselines in the two co-ordinate systems were a modification of the canthomeatal (mCM) line and the anterior-posterior commissural (AC-PC) line. Axial spin-echo MR images of four subjects at 1.5T were used. Operator error was computed from the replicate analyses of two operators. The mCM line was determined by the lens of the eye and the internal auditory canal, and the AC-PC line was determined by the intersection of AC and PC with the interhemispheric fissure. Reproducibility of the mCM markers (SD = 0.59 mm) did not differ significantly from that of the AC-PC line (SD = 0.68 mm). The measurement error of the angle of the baseline (delta alpha), however, was more than 7 times as large for the AC-PC line as for the mCM line. An additional error affecting the rostrocaudal rotation of the co-ordinate systems, attributable to the distance between the anatomic markers, was 2.1 and 3.6 degrees (3 mm and 5 mm slice thickness) for the mCM co-ordinate system and 8.2 and 11.0 degrees (3 mm and 5 mm slice thickness) for the AC-PC system. The AC-PC line based co-ordinate system is therefore, less reproducible than the mCM line based system. This could be improved if a combination of axial and sagittal images were used for the definition of the AC-PC line.

Brain↗

Video registration virtual reality for nonlinkage stereotactic surgery.

We have combined three-dimensional (3D) computer-reconstructed neuroimages with a novel video registration technique for virtual reality-based, image-guided surgery of the brain and spine. This technique allows the surgeon to localize cerebral and spinal lesions by superimposing a 3D-reconstructed MR or CT scan on a live video image of the patient. Once the patient's scan has been segmented into the relevant components (e.g., tumor, edema, ventricles, arteries, brain and skin), the surgeon studies the 3D anatomy to determine the optimal surgical approach. The proposed intraoperative surgeon's perspective is displayed in the operating room at the time of surgery using a portable workstation. The patient is then brought to the operating room and positioned according to the planned approach. A video camera is trained on the patient from the proposed intraoperative surgeon's perspective. A video mixer merges the images from the video camera and the 3D computer reconstruction. This video mixer can vary the output intensity of the two input images between 100% of either and 50% of both. This visually superimposes the two images, not unlike a photographic double exposure. The patient's position and the 3D reconstruction are then adjusted until the images on the video mixer's output monitor are identical in terms of scale, position and rotation. This superimposition is facilitated by aligning various surface landmarks such as the external auditory canal, lateral canthus, and nasion. In some cases, such as with spinal tumors, capsules placed on the skin prior to scanning serve as fiducials.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

Temporal lobe regions on magnetic resonance imaging identify patients with early Alzheimer's disease.

OBJECTIVE: The goal of the study was to examine the volume of selected brain regions in a group of mildly impaired patients with Alzheimer's disease (AD). Five regions were selected for analysis, all of which have been reported to show substantial change in the majority of patients with AD at some time in the course of disease. DESIGN: Case-control study with the experimenter "blinded." SETTING: Hospital-based magnetic resonance imaging center. PARTICIPANTS: Fifteen subjects, eight patients with the diagnosis of probable dementia of the Alzheimer type made in concordance with National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association criteria and seven age-matched healthy control subjects. RESULTS: Three of the volumetric measures were significantly different between patients with AD and controls: the hippocampus, the temporal horn of the lateral ventricles, and the temporal lobe. Two of the measures did not significantly differentiate patients with AD and controls: the amygdala and the basal forebrain. A discriminant function analysis demonstrated that a linear combination of the volumes of the hippocampus and the temporal horn of the lateral ventricles differentiated 100% of the patients and controls from one another. CONCLUSIONS: The results suggest that the hippocampus and the temporal horn of the lateral ventricles may be useful as antemortem markers of AD in mildly impaired patients.

Aged↗

Present and future applications of lasers in neurosurgery.

The applications of laser in both adults and pediatric neurosurgery are being steadily refined today. For many routine tumor removals, contemporary lasers do not add to ultrasonic aspiration or suction resection. However, there are some tumors in which one CO2 laser is invaluable; brain stem astrocytomas, skull base tumors, and intraspinal tumors are examples. Similarly, in resections of spinal lipomas they are useful to vaporize lipomas from the roots. Laser welding of vessels is technically possible but has generally not been useful. Perhaps the most exciting application is a combination of laser energy transfer with stereotactic technology. The MRI can be used to visualize structural changes in cerebral tissue. We have used this technology in 40 rats with gliomas and have been able to demonstrate destruction.

Central Nervous System Neoplasms↗

Computer-assisted three-dimensional planning in craniofacial surgery.

Three-dimensional surface reconstruction from computed tomographic (CT) data has been used to plan craniofacial operations. Cephalometric and anthropometric databases were integrated with three-dimensional CT reconstructions to quantitate the skeletal deformity and to assist in the design of the surgical procedure. Interactive techniques were developed to simulate osteotomies and skeletal movements in three dimensions on the computer-generated surface images. The ocular globes were referenced to position the orbital segments; i.e., the osteotomized segments were transposed into normal anatomic relationship with respect to the eyes. The measurements from the computer graphic simulation were used intraoperatively to establish the correct position of the skeletal segments.

Adolescent↗

[Fast spin echo MRI techniques. Contrast characteristics and clinical potentials].

Based on partial RF echo planar principles, Fast Spin Echo techniques (FSE) were implemented on high field systems. These methods produce image quality and contrast which resemble to conventional spin echo (SE) techniques. By reducing acquisition times by factors between 1.4 and 16 over SE methods, FSE allows for several imaging options usually prohibitive with conventional spin echo (SE) sequences. These include fast scans (especially breath-hold acquisitions); improved T2 contrast with longer TR intervals; increased spatial resolution with the use of larger image matrices and/or smaller fields of view; and 3D volume imaging with a 3D multislab FSE technique. Contrast features of FSE techniques are directly comparable to those of multiple echo SE sequences using the same echo spacing than FSE methods. However, essential contrast differences existing between the FSE sequences and their routine asymmetric dual SE counterpart can be identified. Decreased magnetic susceptibility effects and increased fat signal present within T2 weighted images compared to conventional dual SE images are due to the use of shorter echo spacings employed in FSE sequences. Off-resonance irradiation inherent to the use of a large number of radio frequency pulses in shown to results in dramatic magnetization contrast transfer effects in FSE images acquired in a multislice mode.

Abdomen↗

Comparative analysis of computed tomographic and magnetic resonance imaging scans in Alzheimer patients and controls.

Ten patients with Alzheimer's disease underwent computed tomography and magnetic resonance imaging at the same point in time. The mean Mini-Mental State examination score of the patients was 23, indicating that they were mildly impaired. Ten age-equivalent controls also obtained computed tomographic and magnetic resonance imaging scans. A semiautomated computer program analyzed nine comparable regions of interest on each set of scans. When regions of interest from both types of scans were combined in the same discriminant function analysis, the first two variables selected were from the magnetic resonance imaging data set, and they significantly differentiated 95% of the patients and controls.

Aged↗

Marketing CT and MR imaging services in a large urban teaching hospital.

A three-phase marketing program was implemented to increase referrals for examination with computed tomographic (CT) or magnetic resonance (MR) imaging and improve services in an academic radiology department. In the research phase, a data base of 135 referring physicians was developed, and a questionnaire was mailed to 130 physicians. The market research identified three key issues: waiting time to get an appointment, scheduling procedures, and communication of findings. In the implementation phase, additional equipment was installed and a program of expanded appointments, service improvements, and public relations was introduced. In the evaluation phase, 1 year after the completion of phase 2, the effect of the marketing program was measured. The average number of physicians who made referrals per month increased from 609 to 653 (an increase of 7.2% over baseline); the average number of CT and MR examinations performed each month increased by 57.3% and 45.2%, respectively. Referrers' ratings of 10 imaging services improved significantly (P = .02). It is concluded that a well-designed marketing program can boost the productivity of a teaching hospital department.

Appointments and Schedules↗

Rheumatoid arthritis of the cervical spine.

This article discusses the pathologic and radiologic changes in the cervical spine that occur with rheumatoid arthritis. The relevance of radiologic evaluation using radiographs, conventional tomography, myelography, computed tomography, computed tomography-myelography, and magnetic resonance imaging is discussed. Magnetic resonance imaging is the pre-eminent radiologic modality in the examination of cervical rheumatoid arthritis.

Arthritis, Rheumatoid↗

The importance of dopamine in the pathogenesis of experimental prolactinomas.

The factors responsible for the production of prolactin-secreting tumors are obscure. One hypothesis, that chronic loss of dopamine control from the hypothalamus may be associated with prolactinoma formation, was tested. Female adult Fischer 344 rats were subjected to ovariectomy and were then given subcutaneous implants of diethylstilbestrol (DES) Silastic capsules to produce lactotrophic hyperplasia. Sequential studies assessed the neuronal activity of the tuberoinfundibular dopaminergic neurons of the arcuate nucleus of the hypothalamus (A12) during and after this estrogen-induced pituitary growth. Immunocytochemical staining for tyrosine hydroxylase was used as a marker for dopamine synthesis, plasma radioimmunoassay provided plasma prolactin levels, and magnetic resonance imaging and histological studies were performed to examine the structural changes occurring in the pituitary gland. Animals were sacrificed from 3 to 67 days after DES implantation. To determine the reversibility of the estrogen-induced changes, rats were also sacrificed at different time intervals after the removal of 30-, 40-, or 60-day DES implants. After 30 days of DES treatment, plasma prolactin levels increased 40-fold and pituitary weight increased more than threefold. Tyrosine hydroxylase immunoreactivity diminished gradually and was almost completely depleted at 30 days. Pituitary histology revealed marked prolactin cell hyperplasia. These changes were completely reversible; removal of the capsule after 30 days resulted in eventual normalization of plasma prolactin levels and pituitary size and in restoration of tyrosine hydroxylase immunoreactivity in the A12 region. Sixty days of DES treatment produced large hemorrhagic tumors with sustained high plasma prolactin levels and an irreversibly distorted A12 area. These observations suggest that in these animals loss of dopamine regulation secondary to estrogen stimulation initially produces prolactin hyperplasia but that prolonged loss leads to adenoma formation.

Animals↗

CT assessment of thoracic extension and of concomitant lesions in syringohydromyelia.

Computed tomographic (CT) myelography, when used with metrizamide, permits a reliable demonstration of syringohydromyelic cavities in the cervical spinal cord. We report 6 cases of cervical syrinx demonstrated by high-resolution CT 4 h after metrizamide myelography; these cavities, which were not suspected clinically, extended into the thoracic cord. In addition 4 cases were associated with Chiari Type 1 malformation and 1 case was associated with both Chiari Type 1 malformation and infratentorial arachnoid cyst. We recommend that CT evaluation of cervical syringohydromyelia routinely include the thoracic spine, in order to demonstrate possible thoracic extension of the cavity. Scans of the foramen magnum are also recommended, because of the possibility of concomitant lesions, especially Chiari Type 1 malformation.

Adult↗

MRI evaluation of thermal ablation of tumors with focused ultrasound.

MRI was used to target and evaluate the tissue effects of focused ultrasound ablation on tumors implanted in the skeletal muscle of rabbits in vivo. First, MRI was used to localize the tumors and plan the ultrasound therapy. Second, temperature-sensitive phase-difference images were acquired to monitor the location of the ultrasound focus and to estimate the effects of temperature rise. After the treatment, the spatial and temporal temperature profiles for defining boundaries of tissue coagulation were calculated. Finally, these boundaries were compared to T2-weighted and contrast-enhanced T1-weighted images obtained immediately after therapy. The results indicate that using MRI for planning and evaluating focused ultrasound surgery is feasible. We showed a linear relationship between applied power and shifts in the proton resonant frequency. Fluctuations in the location of the focus about the target location were on the order of the resolution of the MR images. The temperature rise and lesion size varied significantly. Regions of tissue coagulation calculated from MR data correlated well with post-therapy imaging.

Animals↗

Functional MRI of the lumbar spine in erect position in a superconducting open-configuration MR system: preliminary results.

The purpose of this study was to determine the feasibility of obtaining, and findings in, functional MRI of the lumbar spine in an erect position and with flexion and extension. Thirty subjects (including 5 volunteers) were imaged in a sitting position and while performing flexion and extension. The alternations in posterior disk margin, size of neural foramina, and central canal were evaluated. In addition, routine supine imaging was accomplished in 15 of these subjects. The foraminal size and posterior disk margins did not change appreciably from supine to upright position. With extension, there was an increased disk bulge in 27% of disks (40% of those with desiccation). Central canal size (50%) and foraminal size (27%) decreased with extension, especially at levels with disk desiccation. Images obtained with our open-configuration MR unit were diagnostically adequate, although of inferior quality compared with those obtained with a conventional unit. Our preliminary results show the feasibility of obtaining diagnostic images of the erect lumbar spine with flexion and extension. The results are in agreement with those obtained with cadaveric studies. The utility of this method in diagnostic imaging of patients with low back pain remains to be determined.

Adult↗