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Biomedical subjects

L R Frank

Publications and source records attributed to L R Frank.

49 records · Page 3Linked to original sources

Elimination of oblique flow artifacts in magnetic resonance imaging.

We present an analysis of how flow oblique to the frequency-encoding direction generates displacement artifacts in MR imaging and show that for flow which has constant velocity between the start of the phase encoding and the center of the echo it is possible to eliminate these artifacts by gradient moment nulling in the phase-encoding direction. However, unlike the standard moment nulling calculations for flow compensating the frequency-encode and slice-selection gradients, the phase-encoding first moment must be nulled specifically with respect to the echo center. Limitations of this method imposed by finite gradient strengths are analyzed. In 3D volume acquisitions with two axes phase encoded it is possible to correct for oblique flow in all directions, and this is demonstrated in images of a human volunteer. Correction for oblique flow displacement artifacts may be particularly useful in quantitative flow and angiographic applications.

Artifacts↗

MR gated subtraction angiography: evaluation of lower extremities.

We report the first clinical experience with a new method for projective imaging of blood vessels (angiography) using magnetic resonance. Vascular contrast is produced noninvasively by the phase response of moving protons. Diastolic and systolic gated images produce, respectively, flow signal and flow void; the difference image is a map of the pulsatile flow: an arteriogram. Preliminary studies are presented of the lower extremities of one healthy volunteer and four patients (one each with occlusive disease, soft-tissue tumor, arteriovenous malformation, and venous femoral-popliteal graft). Patient data are compared with accompanying conventional arteriograms, and the new method is discussed.

Adult↗

The policies and practices of American psychiatry are oppressive.

The author argues that psychiatry is not a medical specialty but an instrument for the social control of people whose ideas, actions, values, and life-styles threaten or disrupt established power relationships within families, communities, or society. Psychiatry's instruments for social control are involuntary incarceration and so-called treatment in facilities in which inmates are brutalized, harassed, neglected, and humiliated. The major somatic psychiatric treatments--drugs, electroconvulsive therapy (ECT), and lobotomy--have produced an epidemic of neurological and brain dysfunction, such as tardive dyskinesia, associated with neuroleptic drugs, and memory impairment, associated with ECT. The author condemns the freezing experiments conducted on psychiatric inmates in the United States and on concentration-camp inmates in Germany during the 1940s.

Adult↗

Projective imaging of pulsatile flow with magnetic resonance.

Noninvasive angiography with magnetic resonance is demonstrated. Signal arising in all structures except vessels that carry pulsatile flow is eliminated by means of velocity-dependent phase contrast, electrocardiographic gating, and image subtraction. Background structures become in effect transparent, enabling the three-dimensional vascular tree to be imaged by projection to a two-dimensional image plane. Image acquisition and processing are accomplished with entirely conventional two-dimensional Fourier transform magnetic resonance imaging techniques. When imaged at 0.6 tesla, vessels 1 to 2 millimeters in diameter are routinely detected in a 50-centimeter field of view with data acquisition times less than 15 minutes. Studies of normal and pathologic anatomy are illustrated in human subjects.

Angiography↗

Crescentic glomerulonephritis complicating idiopathic membranous glomerulonephropathy.

We describe the course of a patient with multiple rectal abscesses and progressive renal dysfunction. A renal biopsy demonstrated a membranous glomerulopathy associated with extensive crescent formation. No underlying cause for the glomerulonephritis could be identified and, specifically, the anti-GBM antibody present in other similar cases was not found. There appears to be a subset of patients with membranous glomerulopathy in whom crescents develop with rapid loss of renal function. Anti-GBM antibody is not necessary in the pathogenesis of this lesion.

Abscess↗

Evaluation of nitrobenzimidazoles as hypoxic cell radiosensitizers.

Radiobiological and pharmacokinetic assays were performed to determine the potential of 2-nitrobenzimidazole (NBI) as a hypoxic cell radiosensitizing agent. As judged by comparing survival curve slopes of Serratia marcescens irradiated under aerated and hypoxic conditions, the NBI enhancement ratio (ER) at 2 mM concentration was 2.4 +/- 0.2, compared with an oxygen enhancement ratio of 3.3 +/- 0.3. 2,5-Dinitrobenzimidazole (DNBI) was investigated in vitro; its ER was 3.0 +/- 0.3 at 4 mM concentration. Very poor tissue penetration of DNBI precluded further testing in vivo. Acute toxic signs appeared in C3H/HeJ mice following ip injection of NBI at 100 mg/kg. These would be partly attributable to the stress caused by the high pH of the injection vehicle. The LD50 was estimated to be 125-150 mg/kg. Mammary adenocarcinoma tumors grown in the flanks of these mice exhibited maximum NBI levels at 5 min postinjection (ip). Peak tumor radiosensitization occurred in the interval between 5 and 10 min postinjection. The ER for tumor regrowth delay was 2.1 +/- 0.3 following 50 mg/kg injected into mice 5 min before irradiation. Functional evaluation up to 40 days after treatment revealed no evidence of neurological deficit.

Adenocarcinoma↗

Implementation of quantitative perfusion imaging techniques for functional brain mapping using pulsed arterial spin labeling.

We describe here experimental considerations in the implementation of quantitative perfusion imaging techniques for functional MRI using pulsed arterial spin labeling. Three tagging techniques: EPISTAR, PICORE, and FAIR are found to give very similar perfusion results despite large differences in static tissue contrast. Two major sources of systematic error in the perfusion measurement are identified: the transit delay from the tagging region to the imaging slice; and the inclusion of intravascular tagged signal. A modified technique called QUIPSS II is described that decreases sensitivity to these effects by explicitly controlling the time width of the tag bolus and imaging after the bolus is entirely deposited into the slice. With appropriate saturation pulses the pulse sequence can be arranged so as to allow for simultaneous collection of perfusion and BOLD data that can be cleanly separated. Such perfusion and BOLD signals reveal differences in spatial location and dynamics that may be useful both for functional brain mapping and for study of the BOLD contrast mechanism. The implementation of multislice perfusion imaging introduces additional complications, primarily in the elimination of signal from static tissue. In pulsed ASL, this appears to be related to the slice profile of the inversion tag pulse in the presence of relaxation, rather than magnetization transfer effects as in continuous arterial spin labeling, and can be alleviated with careful adjustment of inversion pulse parameters.

Arteries↗

Pulsatile flow artifacts in two-dimensional time-of-flight MR angiography: initial studies in elastic models of human carotid arteries.

Initial experimental and numerical analysis of artifacts due to pulsatile flow in two-dimensional time-of-flight (2D-TOF) magnetic resonance (MR) angiography are presented. The experimental studies used elastic models of the carotid artery bifurcation cast from fresh cadavers and accurately reproducing the twisting and tapering of the human blood vessels, allowing direct comparison of images with and without flow. Prominent image artifacts, including periodic ghosts and signal loss, were produced by pulsatile flow even though flow-compensated gradient waveforms were used. The dependence of artifacts due to partial saturation on pulse sequence parameters (TR and flip angle) was investigated theoretically for a simple pulsatile velocity profile and compared with experimental results from a model of a normal carotid artery. Signal reduction was observed proximal and distal to the stenosis in a model with a 70% internal carotid artery (ICA) stenosis and a model with 90% stenoses in both the ICA and the external carotid artery. Although this study deals exclusively with 2D-TOF imaging, the methods can also be applied to evaluate other MR angiography techniques.

Artifacts↗

A randomized, controlled trial of two-thumb vs two-finger chest compression in a swine infant model of cardiac arrest [see comment].

BACKGROUND: The American Heart Association (AHA) currently recommends two-finger (TF) chest compression for infants. A previous study demonstrated that two-thumb (TT) with lateral chest wall compression provided significantly higher arterial pressures than did the TF method. Limitations of that study included the lack of an asphyxial model and non-standardized compression forces. OBJECTIVE: To test the hypothesis that TT chest compression generates higher arterial pressures than does the TF method, using an asphyxial model. Also, by standardizing sternal compression force (SCF), the authors sought to show that the increased pressures are the result of thoracic compression. METHOD: The study was a randomized, crossover trial in immature swine weighing 10 kg. Each swine was sedated, anesthetized, paralyzed, intubated, and mechanically ventilated on room air. A femoral arterial catheter was placed. Cardiac arrest was induced by asphyxiation and verified by ECG and pressure tracings. Eleven AHA-certified basic rescuers each randomly performed four 1-minute trials of external chest compressions. Each of the two CPR techniques was performed, with and without feedback of SCF. Compression forces were measured using the Uniforce Sensor System (Force Imaging Technology, Inc., Chicago, IL). During the feedback mode, the rescuers were instructed to maintain sternal pressures at 20-25 psi. During the nonfeedback mode, the rescuers were blinded to the force transducer. All compressions were analyzed for systolic blood pressure (SBP), diastolic blood pressure (DBP), and SCF. Data were analyzed using repeated-measures analysis of variance (RMANOVA) and Tukey multiple comparisons (alpha = 0.05). RESULTS: A total of 2,297 compressions were analyzed. The TT method produced significantly higher SBPs both with (25% increase) and without (57% increase) feedback when compared with the TF. The DBPs were not significantly different. The SCFs were also significantly higher in the two groups with feedback. The SCFs in the TF groups did not reach the standardized value of 20 psi, whereas in the TT groups, both were in the range of 20-25 psi. CONCLUSION: The TT method produced significantly higher SBPs. The authors were unable to demonstrate that the increased SBPs were secondary to the thoracic compression component because the rescuers did not reach the predetermined SCF in the TF groups. In this swine model of infant CPR, TT chest compression is an easier and more effective method.

Animals↗

Tibiofibular syndesmosis: high-resolution MRI using a local gradient coil.

PURPOSE: Our goal was to correlate high-resolution MR images of the tibiofibular syndesmosis with anatomic sections. METHOD: MRI was performed inside a local gradient coil on six cadaveric feet taped in 10-20 degrees dorsiflexion and 40-50 degrees plantar flexion by using axial and coronal T1-weighted SE sequences. After imaging, the specimens were frozen and sectioned into 3-mm-thick slices along the MR planes. Images were correlated with the anatomic sections. RESULTS: MRI depicted the anatomy of the tibiofibular syndesmosis and surrounding structures. With the foot taped in dorsiflexion, axial imaging provided optimum views of the anterior, posterior, interosseous, and transverse tibiofibular ligaments. Coronal images allowed visualization of the entire course of the anterior, posterior, and transverse tibiofibular ligaments. The multifascicular appearance of the anterior tibiofibular ligament was best visualized in coronal sections. With the foot taped in dorsiflexion or in plantar flexion, it was possible to distinguish the posterior tibiofibular ligament and transverse tibiofibular ligament from the posterior talofibular ligament in all specimens. CONCLUSION: High-resolution MRI using a local gradient coil provides excellent delineation of the ligaments of the distal tibiofibular syndesmosis.

Aged↗

Collateral ligaments of the ankle: high-resolution MR imaging with a local gradient coil and anatomic correlation in cadavers.

Findings at high-resolution magnetic resonance (MR) imaging of the lateral and medial collateral ligaments of the ankle were compared with findings in anatomic sections from cadavers. MR imaging of six cadaveric feet was performed with a newly developed local gradient coil and axial and coronal T1-weighted spin-echo sequences. Axial imaging provided optimum views of the anterior and posterior talofibular ligaments, the deep layers of the medial collateral ligament, and the tibionavicular ligament. Coronal imaging allowed complete visualization of the calcaneofibular, posterior talofibular, tibiocalcaneal, and posterior tibiotalar ligaments. In both imaging planes, differentiation of the deep and superficial layers of the medial collateral ligament was possible. Differentiation between the syndesmotic complex and the lateral collateral ligament was accomplished easily; in particular, differentiation of the posterior tibiofibular ligament from the posterior talofibular ligament was not difficult because of the differing insertions of these ligaments. The inhomogeneous appearance of the medial collateral ligament and the posterior talofibular ligament on MR images correlated with areas of fatty tissue on corresponding microscopic sections. High-resolution MR imaging with a newly developed local gradient coil allows excellent visualization of the lateral and medial collateral ligaments of the ankle.

Adipose Tissue↗

Liquid chromatographic determination of lasalocid sodium in chicken skin: interlaboratory study.

The U.S. Food and Drug Administration (FDA) sponsored an interlaboratory study of a liquid chromatographic determinative procedure for lasalocid sodium in chicken skin with adhering fat. Four laboratories analyzed 35 dosed tissue samples and 82 fortified tissue samples containing lasalocid at levels ranging from 0.1 to 0.6 ppm. Samples were homogenized with acetonitrile, washed with hexane, and partitioned into the mobile phase prior to analysis liquid chromatography with fluorescence detection. The results of the interlaboratory study showed good reproducibility for fortified samples. Fortification levels, average recoveries, and interlaboratory percent coefficients of variation were as follows: 0.6 ppm, 0.57 ppm, and 9.7; 0.3 ppm, 0.25 ppm, and 9.1; and 0.15 ppm, 0.14 ppm, and 7.0, respectively. Data for analysis of the dosed tissue also showed good agreement among the laboratories.

Adipose Tissue↗