Wireless and Web-based medical monitoring in the home.

A remote medical monitoring system is described, which continuously monitors patients' state of health. The system uses the services provided by intranets and the Internet to allow remote supervision of patients, who may be domiciled in their own home. A hardware/software prototype system has been constructed to demonstrate the use of non-invasive and minimally intrusive sensors attached to patients. Continuous real-time data is acquired, stored and processed. A wireless system or wires connect these monitor devices to the World Wide Web and, on request, information is delivered to authorized medical staff via a web browser or Wireless Application Protocol-enabled mobile telephones. Medical staff may examine real-time data or graphical information and make comparisons with historical data. Parameters may be set to select and control the data acquisition devices. The potential exists for augmentation of patient health by development of novel sensors and low-power electronic circuitry, and this research continues.

Multiple-slice imaging of a tissue-equivalent phantom by use of time-resolved optical tomography.

Following several years of development the construction of a multichannel time-resolved imaging device for medical optical tomography has been completed. Images are reconstructed from time-resolved measurements by use of a scheme that employs a finite-element diffusion-based forward model and an iterative reconstruction solver. Prior to testing on clinical subjects the fully automated instrument and the reconstruction software are evaluated with tissue-equivalent phantoms. We describe our first attempt to generate multiple-slice images of a phantom without uniform properties along the axial direction, while still using a computationally fast two-dimensional reconstruction algorithm. The image quality is improved by the employment of an approximate correction method that uses scaling factors derived from the ratios of finite-element forward simulations in two and three spatial dimensions. The 32-channel system was employed to generate maps of the internal scattering and the absorption properties at 14 different transverse planes across the phantom. The images clearly reveal the locations of small inhomogeneous regions embedded within the phantom. These results were obtained by use of purely temporal data and without resource to reference measurements.

Simultaneous reconstruction of absorption and scattering images by multichannel measurement of purely temporal data.

We present what is believed to be the first simultaneous reconstruction of the internal scattering and absorbing properties of a highly scattering medium by use of purely temporal data. These results are also the first acquired with the multichannel time-resolved imaging system developed at University College London.

A programmable eddy-current compensation system for MRI and localized spectroscopy.

A programmable preemphasis system has been developed for eddy-current compensation in gradient sets with or without active screening. Preemphasis parameters are nonvolatile but can be changed rapidly when working with interchangeable gradient sets. The design allows easy retrofit to existing systems. A method for setting the preemphasis is presented, together with specimen results.

Modified birdcage coils for targeted imaging.

The design of a radiofrequency coil of U-shaped geometry, specifically intended to image individual knuckle joints of the hand, has been investigated. The coil geometry is that of a "split and opened" birdcage coil. The optimum leg positions for such a U-shaped coil have been theoretically predicted using a novel technique that considers both the signal-to-noise ratio and the homogeneity of the field-of-view. Two particular coils of this type have been constructed, each optimum for a different size of image space and assuming a different source of image noise (sample-dominated or coil-dominated). The experimentally determined radiofrequency fields produced by the coils correspond well to theory. Either coil can be used to obtain good-quality, high-resolution (130 microns x 130 microns in-plane) images in vivo of the first, second, or fifth metacarpophalangeal joints of the hand, sites of particular interest in the study of arthritis.

High-resolution magnetic resonance imaging of the interphalangeal joints of the hand.

High-resolution magnetic resonance imaging (MRI) of the interphalangeal joints of the fingers is being employed to study arthritis. To facilitate this research, a clear understanding of the structures visualisable by MRI is necessary. A gradient echo (GE) sequence was developed that produced good contrast between cartilage and other joint structures. These detailed images, with an in-plane resolution of 200 x 100 microns, enable resolution of three cartilage zones which can be interpreted as a superficial layer at the cartilage/cartilage interface, an intermediate layer and calcified cartilage in contact with bone; these correlate well with known anatomy. Further analysis of the images indicates that although a chemical shift artifact causes changes in the images at the field strength used (0.5 T), it does not cause enough distortion to necessitate suppression of the effect. Furthermore, the only detectable susceptibility artifact at these low field strengths was a loss of signal in bone trabeculae at the bone/cartilage interface. There is clearly potential in the study of the articular structures, in particular cartilage, in detail, using high-resolution MRI.

Demonstration of a geode by magnetic resonance imaging: a new light on the cause of juxta-articular bone cysts in rheumatoid arthritis.

The magnetic resonance imaging (MRI) features of a rheumatoid arthritic geode are presented. Development of such a cyst from before x ray diagnosis to its coalescence with the wrist joint is described. The evidence suggests that these juxta-articular cysts are not merely an intrusion of the synovial cavity into the bone marrow but start as isolated structures beneath the subchondral bone.

Formula feeding in the first year of life.

Over 60% of all infants in the United States are completely formula-fed by 2 months of age. A nursing diagnosis framework can aid nurses in supporting and guiding parents who formula-feed their infants.