Biomedical subjects
Publications and source records attributed to J S Orr.
Nuclear magnetic resonance (NMR) has begun to be applied to a variety of clinical situations. The present status of the technology and some current patient data are discussed and reviewed.
Possible effects of adrenaline, noradrenaline, vasopressin, and angiotensin II to increase 14CO2 production from [1-14C]oleate were examined in hepatocytes from fed L-triiodothyronine (T3)-treated or control rats. Rates of 14CO2 production were decreased and rates of ketogenesis increased in hepatocytes from T3-treated rats. These changes were accompanied by a marked shift of the 3-hydroxybutyrate:acetoacetate concentration ratio towards acetoacetate. Rates of glucose and lactate release were decreased. Whereas the Ca2+-mobilizing hormones increased 14CO2 production from [1-14C]oleate by 64-84% with hepatocytes from control rats, they increased 14CO2 production from [1-14C]oleate by on 24-32% with hepatocytes from T3-treated rats. The magnitude of the response to the Ca2+-mobilizing hormones in hepatocytes from T3-treated rats was increased by the addition of 3-mercaptopicolinate, an inhibitor of phosphoenolpyruvate carboxykinase, to the incubation medium (increases of 52-88%). In the presence of 3-mercaptopicolinate, the 3-hydroxybutyrate:acetoacetate concentration ratio in hepatocytes from fed, T3-treated rats was similar to that in hepatocytes from control rats in the absence of 3-mercaptopicolinate. The results demonstrate that hyperthyroidism per se does not lead to a loss of sensitivity, in terms of oleate oxidation, either to the catecholamines or to vasopressin and angiotensin II. The impaired ability of hepatocytes from T3-treated rats to respond to these hormones is a consequence of decreased net glycolytic flux or a more oxidized mitochondrial redox state.
The results of nuclear magnetic resonance (NMR) examinations in 26 patients with histologic (15 cases) or clinical (11 cases) diagnoses of tumors within the posterior fossa were reviewed and compared with x-ray computed tomography (CT). Most tumors displayed an increase in T1 and T2 relative to brain. All seven benign tumors were seen with both CT and NMR, although one of these cases initially was misdiagnosed on the basis of the CT findings. The extent of these tumors was equally well shown with CT and NMR in three cases but was demonstrated better by NMR in four. Calcification was seen with CT but not with NMR in two of these patients. All 19 malignant tumors were demonstrated with NMR. Two of these were not seen with CT. In 12 patients minimal changes consisting of a poorly defined low-attenuation are or minor displacement of the fourth ventricle were noted with CT, although much more extensive changes were seen with NMR. In three patients the changes were equally well shown with both techniques. In the remaining two cases, the extent of the tumor was defined more accurately with contrast-enhanced CT, where the margin between tumor and surrounding edema was better seen than with NMR. Mass effects were better demonstrated with NMR in 13 patients and equally well shown in six. Bony erosion was better demonstrated with CT in two cases. Hydrocephalus with periventricular edema was seen in five patients; in each it was more clearly demonstrated with NMR. The NMR diagnosis of tumors is discussed and relevant new developments are summarized.
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A nuclear magnetic resonance (NMR) imaging system is described, and preliminary results from its clinical use are presented. The properties and detection of the magnetisation due to hydrogen protons are outlined, and a rotating frame is introduced to describe the motion of the magnetisation. Radiofrequency (RF) pulses are used to rotate the magnetisation, and slice selection is achieved using a 90 degree RF pulse and a magnetic field gradient. Data acquisition and image reconstruction are explained. Three scanning sequences are described: repeated free induction decay (FID), inversion - recovery, and spin-echo. These sequences produce images whose pixel values have different dependencies on hydrogen proton density, T1 and T2. Inversion-recovery images show striking differentiation between grey and white matter in the brain. The absence of bone artifact is a significant advantage over X-ray computed tomography in the posterior fossa, where rapid repeated FID sequences can also be used to demonstrate flow effects. The considerable soft tissue contrast available with NMR is of value in demonstrating disease within the liver where T1 appears to be sensitive but relatively nonspecific diagnostic parameter. High resolution scans are of value in demonstrating the adrenal gland and spinal cord.
A nuclear magnetic resonance (NMR) machine constructed by Thorn-EMI Ltd was used to produce tomographic images of the brain in eight volunteers and fourteen patients. The use of an inversion recovery technique designed to emphasise variations in the spin-lattice time constant (T1) resulted in remarkable differentiation between grey and white matter in all subjects examined. White matter was seen both centrally and peripherally to subcortical level and the basal ganglia were clearly demarcated by the surrounding white matter and ventricular system. The posterior fossa was visualised with substantially less artefact than with X-ray computed tomography (CT) and both the brainstem and middle cerebellar peduncle were clearly shown. Pathological appearances in patients with glioblastoma multiforme, cerebral infarction, and cerebral aneurysm were demonstrated and compared with those seen with CT. The technique will require thorough clinical evaluation but appears to have considerable potential in the diagnosis of neurological disease.
Cell-survival data were collected to determine the survival response of asynchronous CHO cells subjects to radiation and hyperthermia. The irradiation was at room temperature 100 minutes before exposure to hyperthermia at 42 degrees C. The survival response to the combination of these two agents is expressed by means of a survival surface, a three-dimensional concept relating cell survival to heat dose and radiation dose. The survival surface could be approximately described by a survival model comprising three components of cell killing: the unperturbed radiation component, the unperturbed hyperthermia component, and the interaction component. The dependence of the radiation component and the interaction component on radiation quality were investigated by irradiating with either 60Co gamma rays, 250 kV X rays or 14.7 MeV neutrons. An analysis suggests that the interaction component and the radiation component exhibit similar dependencies on radiation quality both for the deposition of damage and the repair or accumulation of that damage.
Posterior fossa scans were performed on five healthy volunteers using a nuclear magnetic resonance (NMR) machine constructed by Thorn-EMI Ltd. Three different NMR scanning sequences were used. In the first, a type of saturation-recovery technique was used to produce images strongly dependent on the density of hydrogen nuclei, but with some dependence on the spin-lattice relaxation time (T1). In the second, an inversion-recovery technique was used to produce images with a stronger dependence on the spin-lattice relaxation time. In the third, a spin-echo technique was used to obtain images with a dependence on the spin-spin relaxation time (T2). All three types of NMR image were unaffected by bone artifact. Visualization of brain adjacent to the skull base was obtained without loss of detail due to partial-volume effect from bone. The saturation-recovery images highlighted arteries and veins that were clearly visible without the use of contrast agents. The inversion-recovery images showed remarkable gray-white matter differentiation enabling internal structure to be seen within the brainstem and cerebellum. The trigeminal nerve and ganglion were also seen outside the brain. Experience with the spin-echo technique is limited, but the images at the base of the brain show considerable soft-tissue detail. The NMR images of the posterior fossa in this study were comparable in quality to those obtained from a new rotate-rotate x-ray computed tomography machine and were superior in several respects.
The blood levels of thyrotrophin (TSH), thyroxine (T4), triiodothyronine (T3), and reverse triiodothyronine (rT3) were measured in a group of patients undergoing cholecystectomy and receiving 2000 kcal of glucose daily throughout the study. TSH changes suggested a peroperative peak followed by a fall and subsequent rise. T4 showed no significant changes. T3 fell and rT3 rose postoperatively, with a highly significant fall in the T3/rT3 ratio (p less than 0.001). Surgery and carbohydrate deprivation separately result in similar changes. However, the demonstration of the changes after injury despite adequate carbohydrate intake strongly suggests that they are a primary response to surgery and not a secondary response to the normal consequential fall in caloric and carbohydrate intake. The changes could be an appropriate adaptation to the changed metabolic requirements.
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The effects of a single whole-body dose of X-rays on the serum levels and kinetics of thyroid hormones in rats were studied. The influence of radiation-induced anorexia was monitored by using pair fed control groups. A dose of 800 rad caused a reduction in T4 levels and 750 rad had a similar effect on T3; in each case the control group showed a smaller reduction. The kinetic results indicated that, in the control groups, the early reduction in hormone concentrations was caused, by a change in the distribution of the hormone; however, the continuing reduction in hormone levels in the irradiated rats appeared to results from decreased production. The results suggest that the thyroid system may play an active part in the early metabolic changes which follow whole-body irradiation.
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The theory of image formation by simple summation of an object's projections, without further processing, is considered. Calculations are presented of the resultant image from a point, a rectangle, an annulus, and three rotationally symmetric objects. The general features of these images are discussed and it is postulated that for many objects of interest a limited compensation for edge unsharpening would suffice to produce recognition of the objects.
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Results for 180 patients with carcinoma of the larynx treated by radiotherapy at Belvidere Hospital in Glasgow between 1958 and 1968 are presented. The policy of treatment was primary radiotherapy with surgery for recurrences. All the patients have been followed up for more than five years. Overall crude five-year survival is 57%. For stages I and II it is 70%. Surgical rescue was successful in 50% of fit patients.