Biomedical subjects
Publications and source records attributed to M J Peters.
The influence of parameters describing the head on the localization of two simultaneous active dipoles is studied. The head is described by a set of five concentric anisotropic spheres. The uncertainties in the conductivity parameters and their effects on the dipole parameters are discussed. Finally the applicability of EEG and MEG is compared.
A previously well 27-year-old Caucasian woman presented with five episodes of alcohol-induced abdominal pain over two years culminating in severe acute pancreatitis. Chest x-ray showed bilateral hilar lymphadenopathy and nodular pulmonary infiltrates. In hospital she developed a unilateral facial nerve palsy and other features of sarcoidosis, which was confirmed by biopsy of a pretracheal lymph node. No previous case is reported of sarcoidosis presenting with recurrent pancreatitis apparently induced on each occasion by moderate alcohol consumption and in the absence of other risk factors. Pancreatic involvement as part of sarcoidosis is uncommon but is treatable if recognized and has a good prognosis.
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The numerical accuracy of the boundary element (BE) method used to solve the volume conduction problem of nested compartments, each having a homogeneous conductivity, is studied. The following techniques for improving this accuracy are discussed: the handling of the auto solid angle element omega ii, the overall refinement of the level of discreteness, the use of a locally refined discrete grid, the isolated problem approach, and an adaptive refined computation of the discrete surface integrals involved in the BE method. The effects of these techniques on the numerical accuracy of the computed electrical potentials are illustrated by taking a volume conductor consisting of four concentric spheres representing the head since for this model an analytical (exact) solution is available. The techniques are of importance for numerically computed electroencephalograms (EEG's) since the numerically computed surface EEG's are severely affected by the relatively low conductivity of the compartment representing the skull.
Short TI inversion recovery (STIR) produces both fat suppression and the additive effect of T1 and T2 mechanisms on tissue brightening, in contrast to the subtractive effect of these two mechanisms on spin-echo sequences. In order to compare STIR and spin-echo imaging, we reviewed 90 lesions detected in 76 consecutive MR studies of the chest, liver, or pelvis performed at 1.5 T with both STIR and double-echo spin-echo techniques. Images were compared for the number of individual lesions detected. Lesion conspicuity was scored by using a subjective scale for each sequence. Lesion size was measured with hand-held calipers, and volume was calculated assuming a prolate ellipse. Because of inherent error in such calculations, lesions were judged to be similar in size (within 20%) or dissimilar (more than 20% difference). The presence of a lesion was proved by direct biopsy in 36 (40%), by tissue pathology from some other focus plus follow-up of the lesion in 37 (41%), or by other imaging plus follow-up in 12 (13%). STIR images detected five (6%) more lesions than spin echo and did not miss any of the lesions detected by spin echo. Conspicuity was greater on STIR images than on spin-echo images in 82 (91%) of the lesions. Twenty-six (29%) of the lesions appeared larger on STIR images than on spin-echo images. For these reasons, STIR may be a useful adjunct to spin echo for body MR in some cases. However, STIR images typically display lower signal-to-noise than spin-echo images do, and all abnormalities (tumor or edema) may appear equally bright on STIR.
N-Formyl-methionyl-leucyl-phenylalanine (FMLP), an acylated tripeptide bacterial neutrophil chemotactic factor, has been shown to be a bronchoconstrictor by inhalation in man in vivo. It thus has a putative role in the generation of bronchoconstriction associated with bacterial bronchial infection. We have investigated the effect of pretreatment with the anticholinergic agent, ipratropium bromide (IB), and the beta 2-agonist, fenoterol (F), on FMLP-induced bronchoconstriction. Ten non-asthmatic subjects aged 21-28 yrs performed dose-response curves to nebulized FMLP on 3 study days after pretreatment with saline, F or IB. Amongst the 8 subjects who bronchoconstricted by 20% to FMLP there was a significant increase in the provocative concentration causing a 20% fall in forced expiratory volume in one second (FEV1) (PC20FMLP) after both IB and F. F was significantly better than IB. When comparison was made using absolute fall in FEV1 and including all 10 subjects the same results were found. Partial inhibition of FMLP-induced bronchoconstriction by IB suggests that part of the effect of FMLP is vagally mediated. We suggest that F is acting via modulation of FMLP-induced rises in intracellular free calcium.
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Formyl-methionyl-leucyl-phenylalanine (FMLP), a synthetic, acylated tripeptide analogous to bacterial chemotactic factors, has been shown to cause bronchoconstriction in guinea pig, rabbit, and human airways in vitro. To determine whether FMLP causes bronchoconstriction in man in vivo, a preliminary study was undertaken in which five non-smokers (mean age 35 years, FEV1 94% (SEM 5%) predicted) and five smokers (mean age 34 years, FEV1 93% (6%) predicted) inhaled aerosols of FMLP. None of the subjects showed airway hyperresponsiveness to histamine (the provocative concentrations of histamine causing a fall of greater than or equal to 20% in FEV1 (PC20) were over 8 mg/ml). FMLP dissolved in 50% dimethylsulphoxide and 50% saline in concentrations of 0, 0.06, 0.12, 0.25, 0.5, 1.0, 2.0, and 4.0 mg/ml was administered to the subjects by means of a French-Rosenthal dosimeter, FEV1 being recorded after inhalation of each concentration. Dose dependent falls in FEV1 occurred in five non-smokers (geometric mean 1.76, 95% confidence limits 0.87-3.53 mg/ml) and three smokers (0.23, 0.07-0.78 mg/ml), with two smokers not responding by 20% to the highest concentration of FMLP. On a separate day the FMLP dose-response curves were repeated after nebulisation of 500 micrograms of ipratropium bromide. The PC20 FMLP in the responders more than doubled. In six additional normal subjects a histamine inhalation test was performed before and four and 24 hours after inhalation of FMLP. All subjects remained unresponsive to histamine. These results show that FMLP is a potent bronchoconstrictor in some non-asthmatic individuals in vivo and this may be important in bronchoconstriction related to infection in patients with chronic obstructive lung disease.
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The magnetic field distribution around the head is simulated using a realistically shaped compartment model of the head. The model is based on magnetic resonance images. The 3 compartments describe the brain, the skull and the scalp. The source is represented by a current dipole situated in the visual cortex. The magnetic field distribution due to the source and that due to the volume currents are calculated separately. The simulations are carried out in order to ascertain which matrix of grid points is suitable as a measuring grid. The possibilities studied are grid points situated in a plane, in a surface which follows the contours of the head and in a sphere. This sphere is taken concentric to the sphere which is the best possible fit for the head. Taking into account the relative contribution of the volume currents and the possible accuracy in the positioning of the magnetic field detector, it can be concluded that the best choice is to measure the normal component of the magnetic field at points which are situated in the spherical surface. The results of this study also show that the magnetic field distribution based on a realistically shaped compartment model differs from that based on a compartment model consisting of concentric spheres. In the spherical model of the head no contribution of the volume currents to the component of the field normal to the sphere can be expected. The difference between the results obtained with these two volume conductor models increases with source depth.
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An inverse solution computer program, using a single current dipole in a selected volume conductor, calculates an equivalent dipole from a magneto- or electroencephalographic distribution. The program is used to evaluate several volume conductor models of the head by using one model when generating the distribution and another when calculating the equivalent dipole. Sources of errors in the equivalent dipole, namely uncertainties in the model parameters (e.g. conductivities) and noise in the MEG or EEG distribution, are investigated in the same way. A realistically shaped model of the head is introduced to investigate the extent to which sphere-shaped models can be used.
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The source of both the measured visual evoked potentials and the measured visual evoked magnetic fields was estimated by means of an inverse procedure. The model used consisted of a single current dipole positioned in a volume conductor consisting of four concentric spheres. Comparison of the results showed that the estimations did not always match. In order to reveal a possible cause of this mismatch a realistically shaped multicompartment model of the head was constructed. From forward simulations it followed that the influence of the realistic shape was apparent, especially when the dipole was positioned deep within the brains.
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With the routine use of sonography in the evaluation of suspected gallbladder disease, the familiarity of gallbladder duplication and its differential considerations are essential. Three cases are presented: one surgically proven duplication of the gallbladder, one case in which the sonographic findings were compatible with duplication of the gallbladder, and one surgically proven intraperitoneal fibrous band mimicking a gallbladder duplication. Gallstones were present in all cases and were confined to only one of the two lobes identified in each case. The gallstones did not communicate between individual gallbladder lobes despite multiple patient positions. Contraction of the non-stone-containing lobe was present in one nonfasting patient, which is probably the best indirect sign of a double gallbladder.