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At least 217 records · Page 12Linked to original sources
PubMed1998

Prospective evaluation of systematic sextant transition zone biopsies in large prostates for cancer detection.

OBJECTIVES: A prospective evaluation was performed to define the role of systematic transition zone (TZ) biopsies in prostates larger than 50 cc. METHODS: From August 1994 to July 1997, 213 consecutive patients referred because of an abnormal digital rectal examination or prostate-specific antigen greater than 4.0 ng/mL had a calculated prostate size greater than 50 cc by transrectal ultrasound (TRUS) measurement. These patients underwent TRUS-guided sextant biopsies of the peripheral zone (PZ) and TZ. RESULTS: The median calculated prostate size was 70 cc with a TZ size of 39 cc. Fifty-five cases of carcinoma of the prostate were found, giving a 26% detection rate. The TZ biopsies detected cancer in 30 of the 55 patients (55% sensitivity) compared with the 47 patients detected by the PZ biopsies (85% sensitivity). Seven cancers (13%) were detected only by the additional TZ biopsies. TZ biopsies revealed bilateral tumors when the PZ biopsies had shown unilateral disease in 2 cases. In 6 cases the TZ biopsies showed higher Gleason grade tumors than was found in the PZ. In the 30 cases with positive TZ biopsy, concordance between the PZ and TZ biopsies occurred in 74% (133 of 180) of the sectors. The PZ biopsy detected cancer in 43 of 66 corresponding sectors that had positive TZ biopsies, giving a sensitivity of 65% and a negative predictive value of 80%. CONCLUSIONS: Routine PZ biopsies missed detecting 13% of the cancers found with the addition of sextant TZ biopsies in patients with large prostates (greater than 50 cc). In addition, 14% of the patients with cancer had upgrading or detection of bilateral tumor with the added biopsies. Routine systematic sextant TZ biopsies should be considered in patients with prostates greater than 50 cc in size.

Aged↗
PubMed2002

Ultraviolet-excited (308 nm) autofluorescence for bladder cancer detection.

OBJECTIVES: To assess the ability of ultraviolet laser-induced autofluorescence for the diagnosis of transitional cell carcinoma of the bladder. METHODS: We studied 43 patients undergoing transurethral resection with recurrent transitional cell carcinoma of the bladder. Guided through 5-aminolevulinic acid-induced fluorescence endoscopy, the autofluorescence of the red fluorescing areas and the adjacent tissue and inconspicuous-appearing mucosa were measured spectroscopically. The autofluorescence excitation was carried out with a xenon chloride excimer laser operating at 308 nm (AF308). For the evaluation of the autofluorescence spectra, an intensity ratio (335/430 nm) was calculated and correlated with the histologic results of the biopsies taken. RESULTS: We analyzed the AF308 spectra of 114 biopsies (21 malignant, 93 benign). The autofluorescence intensity ratios for the benign lesions were a factor of 2 to 7 higher than carcinoma in situ and neoplastic tissue. Therefore, 20 of 21 neoplastic lesions were detected as true positive by AF308. A sensitivity and specificity for AF308 of 95% and 77%, respectively, could be calculated. The sensitivity and specificity for 5-aminolevulinic acid-induced fluorescence endoscopy was 90% and 61%, respectively. By combining the two methods, we calculated a sensitivity of 90% and a specificity of 84%. CONCLUSIONS: The combination of a sensitive imaging technique such as 5-aminolevulinic acid-induced fluorescence endoscopy and a more specific spectral fluorescence probe technique with autofluorescence at 308 nm is a very efficient procedure in the detection of transitional cell carcinoma of the bladder.

Aged↗
PubMed2001

[Determination of roxithromycin in serum by high-performance liquid chromatography with ultraviolet detection].

OBJECTIVE: To make better the RP-HPLC method for the determination of roxithromycin(RM) in human serum. METHODS: RM and clarithromycin (internal standard) were extracted from alkalinized serum sample (500 microliters) with methylene chloride. After evaporation of the organic layer, the residue was dissolved in 100 microliters of acetonitrile-ammonium phosphate (1:1, pH 6.0) and washed with n-hexane, then 20 microliters was injected onto a column (5 microns, 15 cm x 4.6 mm) of Penomenex luna C18. The mobile phase was acetonitrile-0.05 mol/L phosphoric acid (39:19:42, adjusted to pH 7.2 with ammonia water) pumped at 1.2 ml/min through the column. The variable wavelength UV detector operated at 0.01 aufs and the wavelength was set at 210 nm. RESULTS: The retention times for RM and clarithromycin were 4.4 min and 5.0 min, respectively. Standard curve was linear in the concentration range of 0.25 to 32 mg/L. The detection limit in serum was 0.06 mg/L; the average method recovery 97.4%; the inter-day RSD less than 3.0%. CONCLUSION: This method was found to be simple, rapid, sensitive and accurate for determination of RM in human serum.

Chromatography, High Pressure Liquid↗
PubMed2004

[Determination of phenylalanine and tyrosine in serum by high-performance liquid chromatography with fluorescent detection].

OBJECTIVE: To determine phenylalanine and tyrosine in serum by high-performance liquid chromatography (HPLC) method. METHODS: Serum precipitated with perchloric acid was isocratically eluted using a base-deactivated C8 column with 10% acetonitrile in water as the mobile phase. The flow rate was 1.0 ml/min. Fluorescent detector worked at an excitation wavelength of 210 nm and emission wavelength of 303 nm. RESULTS: Good linearity was observed in the range of 12.2 approximately 1 220.0 micromol/L for phenylalanine, the intra- and inter-assay coefficients of variation (CV) were 4.07% and 7.17% respectively, and the average recovery was 102.5%. There also was a good linearity in the range of 5.5 approximately 550.0 micromoL/L for tyrosine. The intra- and inter-assay coefficients of variation were 2.99% and 5.23% respectively, and the average recovery was 102.2%. The total assay time for the serum sample was within 30 min. We found a good correlation compared with HPLC ultraviolet detection. CONCLUSION: This method is simple, rapid, accurate in measuring phenylalanine and tyrosine in serum quantitatively.

Adolescent↗
PubMed2004

[Determination of 4-nonylphenol and bisphenol A in rat serum by high performance liquid chromatography with fluorescence detection].

OBJECTIVE: This study was directed to the development of a simple and highly sensitive method for determination of 4-nonylphenol (4-NP) and bisphenol A (BPA) in rat serum using HPLC with fluorescence detector. METHODS: 4-NP and BPA in serum samples were extracted by a mixed solvent of n-hexane and diethyl ether (70:30), the organic layer was dried with nitrogen flow and dissolved with mobile phase. The operating conditions such as C18 column (250 mm x 4.6 mm, 5 microns), acetonitrile-ammonium acetate buffer (pH 4.5) as mobile phase at a flow rate of 1 ml/min and fluorescence detector with the excitation and emission wavelength at 227 nm and 313 nm respectively were used for the determination. RESULTS: There was good linear relationship between the concentrations of the analytes in rat serum and their peak areas in the ranges of 0.013-5.0 micrograms/ml for 4-NP and 0.004-3.0 micrograms/ml for BPA. The detection limit of the method was 13 ng/ml for 4-NP and 4 ng/ml for BPA. Recoveries of rat serum samples were 83.8%-100.0% for 4-NP and 83.3%-100.0% for BPA. The intra-day precision was 1.70%-2.70%, the inter-day precision was 2.06%-9.78%. CONCLUSION: The results showed that the method is suitable for the determination of BPA and 4-NP in serum.

Animals↗
PubMed2006

Speckle correlation method used to detect an object's surface slope.

We present a technique employing a speckle pattern correlation method for detection of the slope of an object's surface. Controlled translation of an object under investigation and numerical correlation of speckle patterns recorded during its motion give information used to evaluate the tilt of the object. The proposed optical setup uses a symmetrical arrangement of detection planes in the image field and enables one to detect the tilt of an object's surface within the interval (10 degrees-30 degrees). Simulation analysis shows how to control the measuring range. The presented theory, simulation analysis, and setup are verified through an experiment by measurement of the slope of a surface of a cube made out of steel.

Journal Article↗
PubMed2004

Differences in thyroid-infiltrating B lymphocytes in patients with Graves' disease: relationship to autoantibody detection.

OBJECTIVE: Thyroid-infiltrating B (Thyr-B) lymphocytes are thought to play an important role in the pathogenic mechanisms underlying Graves' disease. DESIGN AND METHODS: In this study, a broad phenotypic analysis of these cells has been performed in 15 consecutive patients who underwent thyroidectomy. RESULTS: Data reveal the occurrence of two distinct types of Thyr-B cell infiltrates. Type 1 was present in most of the cases (10/15) and consisted of a combination of IgM+ IgD(low to-) B lymphocytes showing features of marginal zone B cells, and IgG+ classic memory B cells. In contrast, in 5 of the 15 cases, a second type of Thyr-B cell infiltrate occurred, exhibiting the profile IgM- IgD- CD44(low to-) CD38++ CD71+ CD95+. This phenotype is highly suggestive of germinal center (GC) B cells, a finding not always anticipated from routine histologic examination. The presence of these ectopic GC was closely associated with the elevated serum level of anti-thyroid peroxidase (TPO), but not with anti-thyrotropin receptor (TSHR), autoantibodies. Moreover, local active anti-thyroglobulin (Tg) antibody secretion was only detected in cultures of type 2 Thyr-B cells. CONCLUSION: These findings indicate that high titers of anti-TPO, but not anti-TSHR antibody, might be associated with intrathyroidal GC development.

Adolescent↗
PubMed2005

Comparison of ninhydrin method of detecting amine compounds with other methods of halitosis detection.

OBJECTIVES: Halitosis is a result of overactivity of Gram-negative bacteria for which protein amino acids are the major source of energy. Therefore, statistical correlation between concentrations of volatile sulphur compounds (VSCs) and low-molecular-weight amines should be expected. MATERIALS AND METHODS: Eighty-four patients suffering from halitosis and 40 healthy volunteers aged 20-62 years (average 39.7) participated in the study. In all subjects low-molecular-weight amines were evaluated by the ninhydrin method. Patients with halitosis were randomized into treatment groups. Zinc tablets, tablets and mouthwash containing chlorhexidine or lyophilized lactic acid-forming bacteria were used. RESULTS: Analysis showed that the level of amines was highest in subjects with halitosis (0.39, s.d. +/- 0.06, P < 0.001) and correlated significantly with results of VSC measurement and organoleptic scores (P < 0.001). Reduction of amine levels after treatment was statistically significant (P < 0.001). Three months following treatment the amine levels began to increase (0.37, s.d. +/- 0.05). The amine levels in healthy controls were lower (0.29, s.d. +/- 0.07) and remained at a stable level. CONCLUSION: The salivary amine levels significantly correlated with VSC levels and organoleptic scores. Therefore, the ninhydrin method of detecting salivary amines may be an alternative or additional method of diagnosing halitosis. This method may also be used to evaluate treatment efficacy.

Adolescent↗
PubMed1996

Use of morning report to enhance adverse event detection.

OBJECTIVE: To determine whether or not prompting of medical residents at morning report enhances reporting of adverse events in hospitalized patients. DESIGN: Prospective trial comparing 3-month blocks of intensive prompting, modest prompting, and no prompting on adverse event reporting by housestaff at morning report. SETTING: Inpatient internal medicine service at a university-affiliated, Veterans Affairs Medical Center teaching hospital. INTERVENTIONS: Intensive prompting (daily), modest prompting (once or twice weekly), and no prompting of medical residents to report hospital-associated adverse events. MEASUREMENTS AND MAIN RESULTS: The number, type, and severity of hospital-acquired adverse events occurring on an internal medicine service were determined during the various periods of intervention on a per houseofficer basis. Residents were reminded to record events once or twice weekly, daily, or not at all. These data were compared with those identified by usual hospital surveillance. The addition of housestaff reporting to usual hospital surveillance increased the numbers of adverse events reported. There was little overlap in episodes reported by the two strategies. Increasing the level of prompting increased the number of reports per houseofficer. Housestaff prompting increased reporting at all levels of adverse event severity from mild to serious and detected a wide variety of types of adverse events, especially adverse drug reactions and procedure complications. CONCLUSIONS: Our study demonstrates that physician self-reporting of adverse events adds to the usual hospital surveillance adverse event reporting, and finds that such reporting can be easily accomplished within the context of a daily teaching activity. The information provided about adverse events by housestaff at morning report is additive to that obtained by usual surveillance methods. The use of such a strategy provides information in a timely fashion.

Analysis of Variance↗
PubMed2003

[Determination of salbutamol in human plasma by column-switching HPLC with UV detection].

OBJECTIVE: To make better the RP-HPLC method with column-switching technique for the determination of salbutamol in human plasma. METHODS: A high-pressure flow channel selection valve and Kromasil C18 pretreatment column (20 x 4 mm, 5 microns), Ultrasphere Cyano analysis column (250 mm x 4.6 mm, 5 um, Beckman) were used. To the plasma sample 1.0 ml, 0.5 ml phosphate buffer (2.0 mol/L, pH 9.0) containing 0.4% diphenylboric acid 2-aminoethyl ester was added, then extraction was performed with the use of 4.0 ml chloroform containing 1% tetraoctylammonium bromide. The organic layer was removed and extracted again with 300 microliters (0.08 mol/L) acetic acid. 100 microliters of the acid layer was injected onto the column. The mobile phase of pH 2.8, 0.025 mol/L phosphate buffer-acetonitrile-methanol (95:4:1) was pumped at the rate of 0.9 and 1.0 ml.min-1 through the pretreatment and analysis column, respectively. The column-switching time was from 0.7 min to 1.5 min. The detector at 0.002 aufs was set at 224 nm. RESULTS: The retention time for salbutamol was 6.7 min and that for internal standard (morphine) 7.6 min. The standard curve was linear over the concentration range from 0.5 to 32 micrograms/L. The lowest concentration of detection in plasma was 0.5 microgram/L. The method recovery was 96%-107%; the intra-day RSD less than 5%; the inter-day RSD less than 8%. CONCLUSION: This method was found to be simple, rapid, sensitive and accurate for determination of salbutamol in human plasma.

Adrenergic beta-Agonists↗
PubMed2003

Implications of SARS: medical geography and surveillance in disease detection.

OBJECTIVE: To expose pharmacy educators and practitioners to concepts of medical geography and medical surveillance. Severe acute respiratory syndrome (SARS) is used as a case example because it is an emerging infection and a prime example of the type of disease that pharmacists may encounter in daily practice (e.g., easily transmitted, resembles the common cold). DATA SOURCES: We retrieved data from publications related to medical geography, medical surveillance, and SARS. Data on current SARS cases in Hong Kong were obtained from the Hong Kong Department of Health Web site. STUDY SELECTION AND DATA EXTRACTION: Variables regarding new cases and deaths due to SARS were evaluated. DATA SYNTHESIS: Background information on medical geography and medical surveillance was reviewed. Descriptive statistics were calculated for incidence, prevalence, and the number of deaths due to SARS in Hong Kong from March 14 to May 31, 2003. CONCLUSIONS: Emerging infections are a serious concern for both the public and healthcare practitioners. The recent global diffusion of SARS highlights the ease in which diseases can diffuse from place to place. Understanding concepts related to medical geography and medical surveillance can help pharmacists be better prepared to anticipate disease diffusion and to evaluate signs of emerging infections. In turn, this can help pharmacists be better prepared to provide information and care to their patients. The long-term benefit of understanding how diseases spread and the specific activities related to disease detection is an opportunity for expanding the scope of pharmacy practice.

Canada↗
PubMed2002

Glucose monitoring at the arm: risky delays of hypoglycemia and hyperglycemia detection.

OBJECTIVE: We have examined whether rapid changes in blood glucose (BG) result in clinically relevant differences between capillary BG values measured at the forearm and the fingertip and whether local rubbing of the skin before blood sampling can diminish such differences. RESEARCH DESIGN AND METHODS: Capillary BG samples were collected every 15 min for 3-5 h from the fingertip and the forearm of 17 insulin-treated diabetic patients and analyzed with different glucose monitors (FreeStyle, One Touch Ultra, and Soft-Sense). In a subgroup of patients (n = 8), local rubbing of the forearm skin was performed before blood sampling. A rapid increase in BG was induced by oral administration of glucose, and subsequently, a rapid decrease in glucose was induced by intravenous administration of insulin. RESULTS: In the fasting state, the BG values at the fingertip and at the forearm were similar (7.8 +/- 2.4 vs. 7.2 +/- 2.3 mmol/l, P = 0.06). However, during rapid increase in glucose, BG values at the fingertip were consistently higher than at the forearm (maximal difference 4.6 +/- 1.2 mmol/l, P < 0.001). During rapid decrease in glucose, lower BG values were recorded at the fingertip (maximal difference to forearm 5.0 +/- 1.0 mmol/l, P < 0.001). At the forearm, BG was delayed by a median of 35 min (P < 0.01) in relation to the fingertip. Rubbing of forearm skin decreased the observed differences but with a large intraindividual and interindividual variability. There were no obvious device-specific differences. CONCLUSIONS: To avoid risky delays of hyperglycemia and hypoglycemia detection, BG monitoring at the arm should be limited to situations in which ongoing rapid changes in BG can be excluded.

Awareness↗
PubMed2005

Evaluation of arteriovenous malformations (AVMs) with transcranial color-coded duplex sonography: does the location of an AVM influence its sonographic detection?

OBJECTIVE: The clinical value of transcranial color-coded duplex sonography (TCCS) in the evaluation of arteriovenous malformations (AVMs) has not yet been fully investigated. In this study, 54 intracranial AVMs confirmed by angiography were prospectively examined over 6 years. The purpose of the study was to describe their typical sonographic features and to define sensitivity for diagnosis with regard to the location of an AVM. METHODS: Transcranial color-coded duplex sonographic findings for 54 patients with intracranial AVMs are presented. The vessels of the circle of Willis were identified by location, course, and direction of flow on color flow images. RESULTS: In accordance with digital subtraction angiography, the intracranial AVMs could be visualized in 42 cases (sensitivity, 77.8%). The pathologic vessels were coded in different shades of blue and red, corresponding to varying blood flow directions in the AVM. The major feeding vessels could be easily identified. Hemodynamic parameters showing increased systolic and diastolic flow velocities and a decreased pulsatility index were better attainable with TCCS than with conventional transcranial Doppler sonography. Arteriovenus malformations located near the cortex, that is, in the parietal, frontal, occipital, and cerebellar regions of the brain, could not be visualized. In contrast, AVMs located in the basal regions were very easy to image (sensitivity, 88.9%). Additionally, TCCS proved useful for follow-up examinations postoperatively or after embolization. CONCLUSIONS: Transcranial color-coded duplex sonography is a valuable noninvasive method for the diagnosis and long-term follow-up of intracranial AVMs. Arteriovenous malformations located in the axial imaging plane can be more easily detected. Nevertheless, TCCS should not be used as a screening method.

Adult↗
PubMed2005

Does the incidence and outcome of brain metastases in locally advanced non-small cell lung cancer justify prophylactic cranial irradiation or early detection?

OBJECTIVE: The radical treatment of locally advanced non-small cell lung cancer (LA-NSCLC) currently involves combined modality therapy (CMT) with the use of chemotherapy in addition to radiation therapy and/or surgery. Chemotherapy has been shown to improve survival, but does not alter brain relapse. We reviewed the outcomes of Stage IIIA and IIIB LA-NSCLC patients treated with CMT at our institution. We assessed the incidence of brain metastases and the management and outcome of these patients. METHODS: Using our radiation-planning database (RSTS), we identified 230 consecutive patients from the years 1999 and 2000 who received radical radiation therapy to the lung. Extracting data from the chart, we identified 83 patients who were treated radically with chemotherapy, radiation and possibly surgery. These patients form the basis of this study. RESULTS: At 2 years, the actuarial rates for any brain failure, first failure in the brain and sole failure in the brain were 34.2%, 24.6% and 11.0%, respectively. Age was the only factor among sex, histology, stage, weight loss and the timing of chemotherapy and radiation that predicted for an increased risk of first failure in the brain. Patients less than age 60 had a risk of 25.6% versus 11.4% for those greater than 60 (p = 0.022). Among the patients who failed first in the brain, those who had aggressive management of their brain metastases with surgical resection in addition to whole brain radiotherapy had a median survival of 26.3 months compared with 3.3 months for those treated with palliative whole brain radiotherapy alone. CONCLUSION: Brain metastases are common in patients with LA-NSCLC treated with CMT. These patients may benefit from either prophylactic cranial irradiation or early detection and aggressive treatment of brain metastases.

Aged↗
PubMed2005

Clinical utility of human glandular kallikrein 2 within a neural network for prostate cancer detection.

OBJECTIVE: To assess, using artificial neural networks (ANNs), human glandular kallikrein 2 (hK2), prostate-specific antigen (PSA), and percentage free/total PSA (f/tPSA), for discriminating between prostate cancer and benign prostatic hyperplasia (BPH). MATERIAL AND METHODS: Serum samples from 475 patients with prostate cancer (n = 347) or BPH (n = 128) within the PSA range of 1-20 ng/mL were analysed for tPSA, fPSA and hK2 (research assay, Toronto, Canada). Data were analysed in the ranges of 1-4, 2-4, 4-10, and 2-20 ng/mL tPSA. Back-propagation ANN models with the variables PSA, f/tPSA, and hK2, hK2/fPSA and hK2/(f/tPSA) were constructed. The diagnostic validity was evaluated by receiver-operating characteristic (ROC) curve analysis. RESULTS: Whereas the median concentration of hK2 was not significantly different between patients with BPH or prostate cancer in any of the tPSA ranges, the f/tPSA, hK2/fPSA and hK2/(f/tPSA), and the hK2-based ANN outputs were always significantly different between patients with prostate cancer or BPH. Using ROC curve comparison, all variables were significantly better than hK2 in all ranges. The hK2-based ANN performed better than f/tPSA except in the 4-10 ng/mL tPSA range. At 90% and 95% sensitivity, the hK2-based ANN was also significantly better than f/tPSA in the 1-4 ng/mL tPSA range. hK2/(f/tPSA) achieved equal results to the hK2-based ANN except in the range 2-20 ng/mL tPSA. CONCLUSIONS: The hK2-based ANN improves the outcome of f/tPSA but not hK2/(f/tPSA) in almost all analysed subgroups. When comparing the results at 90% and 95% sensitivity the hK2-based ANN only performed significantly better than f/tPSA in the lowest tPSA range. Only in lower tPSA ranges do hK2-based ANNs show an advantage for further improving prostate cancer detection.

Adult↗
PubMed1996

Blunt thoracic aortic trauma. A cost-utility approach for injury detection.

OBJECTIVE: To evaluate the influences of patient preference and treatment costs on the diagnostic approach to blunt aortic trauma. METHODS: Decision and cost-utility analysis. DATA SOURCES: A MEDLINE search of all literature dealing with the diagnosis and management of blunt aortic injury was used to establish assumptions and assign baseline probability estimates. Utility assignments were made from published data and our own assignments. We obtained institution-specific cost data. STUDY SELECTION: Only randomized, prospective trials that used aortography as the gold standard test were used to assign baseline accuracy of transesophageal echocardiography and dynamic chest computed tomography. Other baseline estimates were taken from class II and class III published data. DATA SYNTHESIS: A decision tree compared 4 diagnostic approaches for blunt chest trauma after an initial normal chest radiograph: observation with follow-up chest radiography, aortography, transesophageal echocardiography, and dynamic chest computed tomography. Utility (a quality-of-life measure) was assigned to ultimate health states to incorporate patient preference. Chest radiography and aortography had similar utility. Aortography gained 1 quality-adjusted life year for minimal cost. Transesophageal echocardiography and dynamic chest computed tomography lose quality-adjusted life-years at increased cost. No variable changed the relative cost-utility of the screening methods in 2-way sensitivity analyses. CONCLUSIONS: Aortography gains additional quality life at minimal cost when used as a screening method for all patients with blunt chest trauma regardless of the results of the initial chest radiograph. With a normal initial chest radiograph, transesophageal echocardiography and dynamic chest computed tomography are associated with increased cost and loss of quality-adjusted life.

Aorta, Thoracic↗
PubMed2004

Prenatal diagnosis of autosomal dominant hereditary spastic paraplegia (SPG4) using direct mutation detection.

OBJECTIVE: To present a report on prenatal diagnosis using direct SPG4 gene analysis in a family with autosomal dominant hereditary spastic paraplegia (AD-HSP). METHODS: Genetic linkage and haplotype analysis were previously carried out with chromosome 2p markers. DNA was obtained from affected individuals, the affected father, the mother, and fetal DNA from an ongoing pregnancy by chorionic villus sampling (CVS) in the first trimester. The spastin gene (SPG4) was completely sequenced. RESULTS: A novel 832insGdelAA frameshift mutation, predicted to cause loss of functional protein, was identified in the affected father and in the fetal DNA. CONCLUSIONS: This is the first report on direct prenatal diagnosis of chromosome 2p-linked AD-HSP (SPG4). In addition, we report a novel SPG4-combined small insertion/deletion mutation in exon 5, which may be the first SPG4 mutational hot spot.

Adult↗
PubMed2006

Algorithm architectures for patient dependent seizure detection.

OBJECTIVE: The goal of this work is to determine whether improved performance (compared to patient independent algorithms) can be achieved by an algorithm, developed on the fly, that requires no user input beyond the identification of the first one or two seizures in the record. METHODS: The previously developed AutoLearn algorithm, which employs the probabilistic neural network (PNN), is tested on 209 seizures obtained from the epilepsy monitoring unit (EMU) or ambulatory recordings. A construction algorithm is used to compare a variety of algorithm architectures and factors. The Taguchi design of experiments (DoE) method is employed find the significant factors without resorting to a full factorial design. RESULTS: Architectures that train a single PNN per channel and use segmentation to identify ranges of similar activity are preferred. The two best architectures are insensitive to the levels of any of the other factors tested. The training time for the algorithm is less than 1s, and approximately 2 min are required to find the seizures in an 8 h record. CONCLUSIONS: The final algorithm, which requires no input from the user other than the marking of the first seizure in a record, performs as well or better than the 3 seizure detectors on EMU and ambulatory records. The algorithm performs nearly as well as human experts on the EMU records. SIGNIFICANCE: The described method can be used to identify unusual seizures (or other patterns) that will be missed by the current generation of seizure detectors. We expect that the methods developed here will also aid the development of patient independent seizure detectors that can improve their performance over time by incorporating new examples.

Algorithms↗