Search PubMed⌕ Search

Biomedical subjects

W A Murphy

Publications and source records attributed to W A Murphy.

At least 109 records · Page 6Linked to original sources
PubMed1986

Soft-tissue tumors: MR imaging.

We evaluated the suspected soft-tissue masses of 33 patients using magnetic resonance (MR) imaging. Thirty-two masses were defined, of which ten were malignant and 22 were benign. Specific characteristics that would allow us to distinguish the benign lesions from the malignant ones could not be identified on MR imaging. Lesions located within muscles or in the intramuscular septa were best seen with T2-weighted imaging sequences; those located within the subcutaneous fat were best outlined with T1-weighted imaging sequences. Both imaging sequences were necessary to provide the complete representation of the extent of the mass. We performed comparison studies using computed tomography (CT) in 24 of the cases. Of 92 possible comparisons and in four categories MR imaging yielded results that were superior to those obtained by CT scanning in 30 instances, equaled the results obtained by CT scanning in 62 instances, but never yielded results inferior to those obtained by CT scanning. However, MR imaging failed to demonstrate soft-tissue calcification and soft-tissue gas in one case each.

Adult↗
PubMed1986

Carpal avascular necrosis: MR imaging.

The authors evaluated the use of magnetic resonance (MR) imaging in diagnosis of avascular necrosis (AVN) of carpal bones by examining 21 patients with wrist pain and two healthy volunteers. MR images were compared with conventional radiographs in every case and with bone scintigrams in 18 cases. MR imaging was slightly less sensitive than bone scintigraphy in depicting AVN, but in patients who were imaged with long repetition time (TR)/long echo time (TE) sequences in addition to short TR/short TE sequences, MR imaging was found to be more specific. While the authors believe that bone scintigraphy remains the screening test of choice for patients with wrist pain and normal plain radiographs, MR imaging promises to add significant diagnostic information in cases in which bone scans are abnormal.

Adult↗
PubMed1986

Pitfalls of rotator cuff sonography.

Experience with rotator cuff sonography in 106 patients was analyzed to identify the causes of scan misinterpretation. Possible interpretive errors may be classified into four categories: those from failure to recognize normal anatomy, those caused by soft-tissue abnormalities, those caused by bony abnormalities, and those caused by technical limitations of the study. Errors in recognition of normal anatomy are easily overcome by experience and comparison to the normal, contralateral rotator cuff. Errors resulting from soft-tissue abnormalities were seen in two patients with calcific tendinitis simulating rotator cuff tears. Problems in interpretation resulting from fractures in two patients and inferior glenohumeral subluxation in two other patients could have been avoided by review of the plain films before performing sonography. The major technical limitation of the study arises from the inability to image the rotator cuff beneath the acromion. Fortunately, rotator cuff tears are rarely isolated in this location, and passive maneuvers often allow otherwise hidden parts of the cuff to be imaged.

Adolescent↗
PubMed1986

MRI of normal and pathologic skeletal muscle.

Lower extremity skeletal muscle of 22 individuals (five normal volunteers and 17 patients with muscular or neuromuscular diseases) was studied with magnetic resonance imaging. Axial images generated with spin-echo pulse sequences using short repetition times (500-900 msec TR) and short echo times (30-60 msec TE) provided excellent contrast between fat (high signal intensity) and muscle (intermediate signal intensity). Seventeen patients with clinically verified muscle disorders were evaluated in a manner similar to the normal volunteers. Conditions studied include Duchenne muscular dystrophy (three patients), limb-girdle muscular dystrophy (five), facioscapulohumeral dystrophy (three), and spinal muscular atrophy, amyotrophic lateral sclerosis, hereditary sensorimotor neuropathy, cerebral palsy, poliomyelitis, and Kearn-Sayre mitochondrial muscle disease (one each). General patterns of muscle abnormality were common among the diseases and included decreased or increased muscle size and a spectrum of muscle replacement by fat. Variable patterns were observed within disease groups and for each patient. Much phosphorus-31 spectroscopy has been performed in a blind fashion with no proton map of normal/abnormal muscle distribution to guide the spectroscopist. This study emphasizes the worth of having a muscle proton map of patients with muscle dysfunction to assure that meaningful phosphorus spectroscopic information is obtained from a volume of tissue limited to an appropriate muscle.

Adult↗
PubMed1986

Musculoskeletal magnetic resonance imaging.

In the short time that MRI has been available, it has become apparent that one of the more important nonneurologic applications is in imaging the musculoskeletal system. MRI is effective at providing high-contrast images with acceptable spatial resolution for a variety of bone marrow disorders, soft tissue masses, osseous tumors, and muscle diseases. The multiplanar aspect of the method is a great advantage and promises to be a major reason why MRI will be selected instead of CT for many examinations. Currently, it appears that MRI is a leading method of detecting ischemic necrosis of the femoral head and determining the extent of soft tissue masses and bone tumors. Surface coil technology promises better resolution of small parts such as the wrist and temporomandibular joint. Phosphorous spectroscopy should make important contributions to our basic understanding of normal and altered muscle energy metabolism as well as providing a safe method of following the course and therapy of muscle diseases. It is anticipated that MRI will have an important position among the variety of imaging tests for musculoskeletal diseases.

Bone Diseases↗
PubMed1986

Ultrasonographic evaluation of the rotator cuff and biceps tendon.

Ultrasonography of the rotator cuff and biceps tendon was investigated in 106 patients who had been referred for arthrography of the shoulder. Both the sensitivity and the specificity of ultrasound in detecting a tear of the rotator cuff were 91 per cent. The predictive value of a negative sonogram was 95 per cent and the predictive value of a positive sonogram was 84 per cent. Ultrasonography proved to be superior to arthrography in the examination of the normal and abnormal biceps tendon. Sonographically detectable effusions from the tendon sheath of the biceps were present in 19 per cent of this population of patients. This finding was statistically highly associated (90 per cent) with rotator cuff tears and other soft-tissue abnormalities of the shoulder. Based on these results, it appears that ultrasonography can be used as the initial imaging test for many patients with suspected abnormalities of the rotator cuff or biceps tendon.

Adolescent↗
PubMed1986

Management of femoral fractures and pseudofractures in adult hypophosphatasia.

Ten pseudofractures and six complete fractures occurred in five patients with adult hypophosphatasia. The four pseudofractures that were treated non-operatively progressed to complete fracture. The six pseudofractures and six complete fractures that were treated by internal fixation united. New fractures occurred in four patients after the removal of the internal fixation. We recommend that complete fractures, symptomatic pseudofractures, and progressive asymptomatic pseudofractures in patients with adult hypophosphatasia be treated with load-sharing internal-fixation devices, such as rigid intramedullary nails. These should not be removed unless it is absolutely essential. If removal is necessary, however, they should be replaced, preferably during the same anesthetic session. In our opinion, the guidelines developed from this study may be applied reasonably to patients with osteomalacia from causes other than hypophosphatasia, especially if medical therapy has been unsuccessful.

Adult↗
PubMed1985

Octapeptide analogs of somatostatin exhibiting greatly enhanced in vivo and in vitro inhibition of growth hormone secretion in the rat.

Analogs of a superactive somatostatin (SRIF) octapeptide (code named SMS 201-995 (1)) were synthesized using solid-phase synthetic methodology and assayed for their ability to inhibit growth hormone release from cultured rat anterior pituitary cells and in sodium pentobarbital-anesthetized rats. One analog: (Formula: see text) exhibited greatly enhanced in vitro inhibitory activity (greater than 1,000x) relative to both the parent octapeptide molecule and to the 14 amino acid SRIF molecule. This analog which was also very potent in vivo contains a tyrosine residue and, given its high in vitro activity, may be of investigative importance as a radioiodinated ligand in receptor assays. An octapeptide retro-inverso analog also exhibited significant SRIF-like activity. Several very low activity octapeptide analogs were synthesized and were found to be devoid of SRIF-antagonist activity. A dodecapeptide analog previously shown to be superactive in vivo also demonstrated high in vitro activity.

Animals↗
PubMed1985

Evaluation of factors associated with glucocorticoid-induced osteopenia in patients with rheumatic diseases.

In 161 ambulatory rheumatic disease patients receiving long-term prednisone therapy, diaphyseal mass (DM) and metaphyseal mass (MM) of the forearm were measured by single photon absorptiometry, and bone radiographs were reviewed when available. Multivariate analysis of treatment and patient characteristics demonstrated that glucocorticoid-induced osteopenia (defined as an elevated DM:MM ratio) and bone fractures occurred with similar frequency in patients of each sex, in whites and blacks, in patients with various rheumatic diseases, and in patients receiving different regimens of prednisone therapy. However, large cumulative doses of prednisone were associated with elevated DM:MM ratios as well as with bone fractures, and menopause or age greater than or equal to 50 years (males or females) was associated with bone fractures. We conclude that long-term therapy with various prednisone regimens results in glucocorticoid-induced osteopenia and fractures. This affect is cumulative, occurs in all patient groups, and results in more bone fractures in certain groups.

Bone and Bones↗
PubMed1985

Osteolytic Paget's bone disease in a young man. Rapid healing with human calcitonin therapy.

Paget's bone disease is rare in young adults. Severe osteolytic Paget's bone disease in a 28-year-old man was found to respond, clinically, biochemically, and radiographically, within one month to daily subcutaneous injections of 0.5 mg of synthetic human calcitonin. After two years of therapy, he remains asymptomatic and has no biochemical evidence of Paget's bone disease while receiving injections three times a week. Despite aggressive disease, young patients may rapidly demonstrate the same beneficial response to synthetic human calcitonin therapy as has been observed in middle-aged or elderly patients with Paget's bone disease.

Adult↗
PubMed1985

Structure-activity studies on the N-terminal region of growth hormone releasing factor.

In previous reports illustrating the effects of conformational restriction of the N-terminal region of human pancreatic growth hormone releasing factor, we demonstrated that D-amino acid substitutions in either of positions 1, 2, or 3 resulted in greatly increased growth hormone releasing activity both in vivo and in vitro. The most active compound, [D-Ala-2]GRF(1-29)NH2, was 51 times more active than the parent 29 amino acid peptide in the sodium pentobarbital anesthetized rat. These observations have now been extended to analogues containing multiple D-amino acid replacements in these three positions. Once again, peptides with superagonist potencies ranging from 1200% to 3800% were obtained after solid-phase synthesis and purification by medium-pressure reverse-phase liquid chromatography. In addition, it was found that [D-Asn-8]- and [D-Ala-4]GRF(1-29)NH2 were, respectively, 2.43 and 1.1 times more active than GRF(1-29)NH2 itself. In contrast, [D-Phe-6] and [D-Thr-7] analogues were virtually inactive. Chou-Fasman structural predictions suggest that the first three residues of the peptide assume no fixed type of conformation but that a reverse turn could be present between residues 6 and 10. Attempts are made to rationalize the biological results with these calculations. The effects of other side chains on the D-amino acid in position 2 were also investigated. Both the Ac-[D-Phe-2]- and Ac-[D-Arg-2]peptides had very low activity. Several of the inactive peptides were tested as possible antagonists of GRF; however, none was able to block the stimulatory effects of GRF(1-29)NH2 after combined administration.

Amino Acid Sequence↗
PubMed1985

Magnetic resonance imaging using gadolinium labeled monoclonal antibody.

Gadolinium was attached to antibodies and tested in vitro and in vivo for its effect on proton relaxation enhancement. Using the cyclic anhydride method, diethylenetriaminepentaacetic acid (DTPA) was attached to albumin, IgG and anti-CEA monoclonal antibody. Gadolinium (Gd) was then chelated to the protein complexes forming protein-DTPA-Gd complex. With this technique approximately 9 atoms of Gd could be attached to each albumin molecule, 4 to each IgG molecule and 1.5 to each monoclonal antibody molecule. The minimal in vitro concentration of Gd in the form of IgG-DTPA-Gd necessary to produce proton relaxation enhancement at 0.35 tesla was 10(-1) mM. An in vivo experiment using anticarcinoembryonic antigen (CEA) monoclonal antibody-DTPA-Gd in hamsters implanted with human colon carcinoma resulted in a tumor concentration of Gd of less than 10(-4) mM. No enhancement of the tumors was detected at that concentration. For monoclonal antibodies to function as selective MR contrast agents, substantial advances in technology must occur.

Animals↗
PubMed1985

Multispectral analysis of magnetic resonance images.

Magnetic resonance (MR) imaging systems produce spatial distribution estimates of proton density, relaxation time, and flow, in a two dimensional matrix form that is analogous to that of the image data obtained from multispectral imaging satellites. Advanced NASA satellite image processing offers sophisticated multispectral analysis of MR images. Spin echo and inversion recovery pulse sequence images were entered in a digital format compatible with satellite images and accurately registered pixel by pixel. Signatures of each tissue class were automatically determined using both supervised and unsupervised classification. Overall tissue classification was obtained in the form of a theme map. In MR images of the brain, for example, the classes included CSF, gray matter, white matter, subcutaneous fat, muscle, and bone. These methods provide an efficient means of identifying subtle relationships in a multi-image MR study.

Basal Ganglia Diseases↗
PubMed1985

Oblique views of the heart by magnetic resonance imaging.

We describe a simple method that uses patient positioning to obtain oblique views of the human heart by magnetic resonance (MR) imaging. These views provide MR images that directly correlate with conventional anterior or posterior oblique radiography.

Heart↗
PubMed1985

Pressure erosions of bone in rheumatoid arthritis: a subject review.

Pressure, or compressive, erosions of bone in various locations in patients with rheumatoid arthritis are described. Possible pathophysiologic mechanisms that account for the appearance and distribution of these erosions include osteopenia, soft-tissue laxity, soft-tissue pressure on bone, bone pressure on bone, and muscular forces.

Acetabulum↗
PubMed1985

Radiation fibrosis: differentiation from recurrent tumor by MR imaging.

Magnetic resonance (MR) images of 21 patients who had undergone radiation therapy were analyzed and compared with those of 15 patients who had untreated tumors. T2-weighted images (TR = 1,500 msec, TE = 90 msec) were most helpful in distinguishing recurrent tumor from radiation fibrosis. Radiation fibrosis, like muscle, usually remained low in signal intensity on T2-weighted images, while tumor demonstrated higher signal intensity. In no patient was the signal intensity of tumor the same or less than muscle on the T2-weighted images. However, relatively high signal intensity on T2-weighted images is not specific for tumor recurrence and may be seen in acute radiation pneumonitis, infection, hemorrhage, and even pulmonary radiation fibrosis.

Adult↗