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At least 37 records · Page 2Linked to original sources
PubMed2002

Curve prevalence of a new classification of operative adolescent idiopathic scoliosis: does classification correlate with treatment?

STUDY DESIGN: A retrospective multicenter consecutive case review of operative adolescent idiopathic scoliosis. OBJECTIVES: To define the curve prevalence of a large consecutive series of cases with operative adolescent idiopathic scoliosis as classified by a new system and to test the ability of this new classification system to correlate with regions of the scoliotic spine to be instrumented/fused. SUMMARY OF BACKGROUND DATA: A new comprehensive, two-dimensional classification system, intended to be treatment based, has been developed. However, it has not been tested whether all presenting operative cases of adolescent idiopathic scoliosis are classifiable in a large consecutive series, nor has the prevalence of specific curve types been determined. In addition, it is unknown whether this classification is truly treatment based, as to whether it can correlate with regions of the spine to be instrumented/fused. METHODS: A multicenter retrospective review of 606 consecutive operative cases of adolescent idiopathic scoliosis was performed. All cases were classified by a new triad classification system, which included the following: a curve type (1-6), a lumbar spine modifier (A, B, C), and a sagittal thoracic modifier (-, N, +). Prevalence of the individual three components of the system and the classification grouping of all three components together were performed. In addition, the authors assessed whether this system could correlate with regions of the spine that should be included in the instrumentation and fusion, based on exactly which regions were fused during the operative procedure. RESULTS: All 606 cases were classifiable by this system. Prevalence of the six curve types noted was as follows: Type 1, main thoracic (n = 305, 51%); Type 2, double thoracic (n = 118, 20%); Type 3, double major (n = 69, 11%); Type 4, triple major (n = 19, 3%); Type 5, thoracolumbar/lumbar (n = 74, 12%); and Type 6, thoracolumbar/lumbar-main thoracic (n = 17, 3%). The five most common curve classifications noted were as follows: 1AN, 1BN, 2AN, 5CN, and 1CN, which accounted for 58% of all curve classifications noted. An average of 90% of the operative cases had surgically structural regions of the spine included in the instrumentation and fusion as predicted by the curve type. CONCLUSIONS: A new comprehensive classification system for operative adolescent idiopathic scoliosis found all 606 consecutive cases of adolescent idiopathic scoliosis classifiable, with the Type 1, main thoracic curve pattern, the most common curve type found (51%). This new classification system appears to correlate with treatment of surgically structural regions of the spine fused in 90% of cases by the objective radiographic criteria used.

Adolescent↗
PubMed2003

New glaucoma classification method based on standard Heidelberg Retina Tomograph parameters by bagging classification trees.

PURPOSE: In this article we propose and evaluate nonparametric tree classifiers that can handle non-normal data and a large number of possible predictors using the full set of standard Heidelberg Retina Tomograph measurements for classifying glaucoma. METHODS: The classifiers were trained and tested using standard Heidelberg Retina Tomograph parameters from examinations of 98 subjects with glaucoma and 98 normal subjects of the Erlangen Glaucoma Registry. All patients and control subjects were evaluated by 15 degrees -optic disc stereographs, Heidelberg Retina Tomograph measurements, standard computerized white-in-white perimetry, and 24-hour-intraocular pressure profiles. The subjects were matched by age and sex. Standard classification trees as well as bagged classification trees were used. The classification outcome of the trees was compared with the classification by two published linear discriminant functions based on Heidelberg Retina Tomograph variables with respect to their cross-validated misclassification error. RESULTS: The bagged classification tree had the lowest misclassification error estimate of 14.8% with a sensitivity of 81.6% at a specificity of 88.8%. The cross-validated error rates of the two linear discriminant function procedures were 20.4% (sensitivity 82.6%, specificity 76.7%) and 20.6% (sensitivity 81.4%, specificity 77.3%) for our set of observations. Bagged classification trees were able to reduce the misclassification error of glaucoma classification. CONCLUSIONS: Bagged classification trees promise to be a new and efficient approach for glaucoma classification using morphometric 2- and 3-dimensional data derived from the Heidelberg Retina Tomograph, taking into account all given variables.

Case-Control Studies↗
PubMed1997

The Revised European-American Classification of Lymphoid Neoplasms (REAL): a new perspective for the classification of cutaneous lymphomas.

Differing classification schemes for malignant lymphomas have been used in Europe and the United States. Attempts to translate between the principle classifications have been unsuccessful and historically it has been difficult to arrive at an unified approach. In addition, many new lymphoma entities have been recognized in recent years that are not delineated in any of the existing classification schemes. To provide a unified international basis for clinical and investigative work in this field, in 1994 the International Lymphoma Study Group (ILSG) proposed a new classification termed Revised European-American Classification of Lymphoid Neoplasms (REAL). This review discusses the REAL classification, especially as it pertains to cutaneous lymphomas, and provides insight into the clinicopathologic features of lymphoproliferative disease involving the skin. The premise of the REAL classification is that a classification scheme should be based on the delineation of disease entities, utilizing pathologic, immunophenotypic, genetic, and clinical features. Therefore, if cutaneous involvement is an integral aspect of any lymphoma subtype, this clinical information is included in the definition of that neoplasm. We conclude that the principles of the REAL classification are applicable to cutaneous lymphomas, as well as lymphomas involving other anatomic sites.

Humans↗
PubMed2002

The reliability of the pre-operative classification of open tibial fractures in children a proposal for a new classification.

The purpose of this observational study was to evaluate the accuracy of Gustilo's classification of open tibial fractures in children. Pre- and post-debridement (using the parameters of Gustilo's classification) wound gradings in 27 children with a mean age of 10 years (3 to 15 years) who had sustained an open tibial fracture were compared. Pre-operative Polaroid photographs of the wound were taken of all these patients in the accident and emergency department. In every case, the fracture was treated with prophylactic intravenous antibiotic administration, wound debridement and lavage. Following wound exploration in the operating theater, the wound was classified using Gustilo's parameters again; this was different from the initial grading. We compared post-debridement classification according to Gustilo to the new classification which we propose. The latter classification is a peroperative assessment of the extent of soft tissue damage and it addresses bone stability. According to this classification, the majority of open tibial fractures were stable, requiring no skin graft or flap and had a good outcome. Only five patients were treated by initial external fixation of the tibia; the remainder were treated by cast immobilization. Wounds were treated as appropriate. The clinical outcome study included the assessment of wound and fracture healing and the incidence of complications. The mean period for follow-up was 8 months (6 to 24 months). There were no cases of nonunion or deep wound infection and the wounds healed in all these patients. We conclude that Gustilo's classification is not specific and does not reflect the extent of soft tissue and skeletal damage. Factors such as the degree of soft tissue damage and periosteal stripping that are noticed following wound debridement and velocity of injury are far more important than the wound size. Our proposed peroperative classification covers the extent of soft tissue injury and skeletal stability, thus predicting the outcome more than the Gustilo classification.

Adolescent↗
PubMed1996

[The pT-classification of primary vocal cord carcinomas and its significance for T-classification].

Since the pretherapeutic T and pT classification of vocal cord cancer according to the UICC has often been found to fail in a high percentage of cases, frequently resulting in an insufficient separation of the different T categories, the pT classification proposed by Glanz was applied in order to obtain a more exact and better reproducible pretreatment system. In a histopathological investigation of 223 previously untreated carcinomas of the vocal cord dating from 1978 to 1988, specimens from total and partial laryngectomies were examined by subserial sectionings. The extension of each lesion was ascertained by measuring tumor in three dimensions per millimeter and determining affected histopathological structures. Neck lymph nodes were also examined for metastases. The different tumor stages were then evaluated with the UICC T/pT classification of Glanz's pT classification. The survival rates and recurrence-free rates of both classification systems were compared. Our evaluation showed that 24% of all the vocal cord cancers studied had to be classified to a higher tumor stage. The pT classification developed by Glanz was better able to separate the different tumor categories than the UICC T/pT classification. Glanz's pT classification system, staging a glottic cancer according to its exact size and laryngeal structures involved, is a significant improvement on the UICC T and pT classification used to date.

Adult↗
PubMed1997

[Prognostic value of histologic classifications of advanced stomach cancer: comparative study of Lauren's and Goseki's classifications].

Controversy exists about the prognostic value of the histological classifications of gastric cancer commonly used. Recently Goseki proposed a new classifying system based on intracellular mucus production and the degree of tubular differentiation. The aim of this study was to compare Lauren and Goseki classifications with particular emphasis on their prognostic significance. Eighty-nine patients, who underwent potentially curative resections (RO) and radical lymphadenectomy for advanced gastric cancer from September 1988 to April 1996 were analysed. Cox regression model was used to evaluate the prognostic significance of Goseki classification, Lauren classification, age, sex, type of lymphadenectomy, depth of tumour invasion (T), node metastases (N) and number of metastatic nodes. A statistically significant correlation between the different Goseki grades and histology according to Lauren was found (p < 0.001). By multivariate analysis the only parameters predictive of long term outcome were depth of tumour invasion, nodal status and histology according to the Lauren classification. Also after excluding the Lauren classification from the analysis, the Goseki histological grading system did not affect survival independently. This study on advanced gastric cancer patients identified depth of invasion, lymph node metastases and Lauren classification as significant independent pathological variables influencing survival. The classification proposed by Goseki did not add anything further to the prognostic informations provided by TNM staging and Lauren classification.

Adenocarcinoma↗
PubMedDate not supplied

Classification of 1H MR spectra of human brain neoplasms: the influence of preprocessing and computerized consensus diagnosis on classification accuracy.

We study how classification accuracy can be improved when both different data preprocessing methods and computerized consensus diagnosis (CCD) are applied to 1H magnetic resonance (MR) spectra of astrocytomas, meningiomas, and epileptic brain tissue. The MR spectra (360 MHz, 37 degrees C) of tissue specimens (biopsies) from subjects with meningiomas (95; 26 cases), astrocytomas (74; 26 cases), and epilepsy (37; 8 cases) were preprocessed by several methods. Each data set was partitioned into training and validation sets. Robust classification was carried out via linear discriminant analysis (LDA), artificial neural nets (NN), and CCD, and the results were compared with histopathological diagnosis of the MR specimens. Normalization of the relevant spectral regions affects classification accuracy significantly. The spectra-based average three-class classification accuracies of LDA and NN increased from 81.7% (unnormalized data sets) to 89.9% (normalized). CCD increased the classification accuracy of the normalized sets to an average of 91.8%. CCD invariably decreases the fraction of unclassifiable spectra. The same trends prevail, with improved results, for case-based classification. Preprocessing the 1H MR spectra is essential for accurate and reliable classification of astrocytomas, meningiomas, and nontumorous epileptic brain tissue. CCD improves classification accuracy, with an attendant decrease in the fraction of unclassifiable spectra or cases.

Astrocytoma↗
PubMed2002

The Quebec classification and a new Swedish classification for whiplash-associated disorders in relation to life satisfaction in patients at high risk of chronic functional impairment and disability.

Unlike the Quebec classification system, which is based primarily on pathoanatomy, a new Swedish classification system is based on the site of functional impairment and disability. A prospective study was performed on 85 patients with whiplash-associated disorders grade II according to the Quebec classification. The patients were examined 3-36 months following trauma. A team of professionals with different training performed the diagnostic procedure. An independent assessor classified these patients according to a Swedish classification system. All patients answered questionnaire regarding life satisfaction. Logistic regression demonstrated significant differences in 6 of 10 specific dimensions of life satisfaction between the classification categories C and D (presence of arm symptoms) in a Swedish classification. Patients with whiplash-associated disorders grade II and neuropsychological symptoms seem to have a worse prognosis for spontaneous recovery than those without. A new Swedish classification system seems to be an important complement to the Quebec classification.

Absenteeism↗
PubMed2000

[Evaluation of classification of pancreatic cancer by the Japan Pancreas Society and Union Internationale Contre le Cancer and proposal for a new international classification].

Different classification systems of pancreatic cancer by the Japan Pancreas Society (JPS, 1996) and Union Internationale Contre le Cancer (UICC) (1997), both of which are based on the TNM system, have been hampering the exchange of data between Japan and Western countries. In the present study, both classifications were assessed using data from 67 patients with invasive ductal carcinoma of the pancreatic head who underwent resection at our clinic. We also propose a new TNM classification and stage grouping system that draws on the merits of both. The results showed that UICC stage grouping did not reflect outcome well, while the JPS system predicted outcome much better. The prognostic value of tha T category is sufficiently reliable in both classifications, but the major drawback of the JPS system is its complex structure and difficult handling. To meet the ideal standard for an international classification system, we propose a new classification: the T category is a minor modification of that of the UICC, and the N category is a modification of that of the JPS for much simpler grouping. Based on the data from our 67 resected patients cases, our new staging system reflects the outcome in the four stages well. Our new classification system may improve the staging classification and lead to the establishment of a more practical and universal staging system for ductal carcinoma of the pancreas.

Humans↗
PubMed2000

[Malignant lymphoma: REAL classification to new WHO classification].

The Revised European-American Classification of Lymphoid Neoplasms(REAL) proposed in 1994 represented a new paradigm for the classification of lymphomas. This classification emphasized that each disease was a distinct entity, defined by a constellation of clinical and laboratory features, i.e., morphology and genetic features, immunophenotype, clinical presentation, and course. And it also noted that the site(s) of presentation were a signpost for important underlying biologic distinctions. A new WHO classification is planed to be proposed, re-categorizing entities of the REAL classification. Now, WHO members planed to publish the new classification as the bluebook of WHO at first in 1998 and now in 2000. This paper reports mainly different points in the new WHO classification of malignant lymphoma from the REAL classification.

B-Lymphocytes↗
PubMedDate not supplied

The Lukes-Collins and Kiel classifications for non-Hodgkin lymphomas. A retrospective study considering both classifications and their relationships to stage, sex, age, and survival.

359 patients with non-Hodgkin lymphomas referred to Oulu University Hospital between 1964 to 1981, inclusive, were reclassified histologically according to the criteria of Lukes-Collins as well as Lennert's histological classifications. The requirements to enter this study were fulfilled only in 280 cases. After the evaluation of the results certain observations emerged. Firstly, within the Lukes-Collins classification: Nodularity was predominantly related to the SC and LC types. Nodularity is indicative of better survival. The Lukes-Collins classification correlates well with clinical stage as well as with age. The Burkitt and convoluted types were found to be predominantly related to childhood or to younger patients and the non-Burkitt type most frequently to the older groups. The Lukes-Collins classification separates well two clear prognostic groups, the favourable group (LC, SC, PC, and SL types), with an overall median survival of 44 months, and the unfavourable group (LNC, IS, convoluted, undefined, and SNC types), with an overall median survival of 11 months. No differences in survival were observed between the LNC, LC, and IS diffuse types. Stage, general symptoms and laboratory findings were also evaluated. Secondly, within the Kiel classification: Nodularity has been found mainly in the CB-CC type, but also in 27% of the CC cases. The relationship of the subtypes according to the Kiel classification and age resembles the same relation found with the Lukes-Collins classification. According to the Kiel classification, the Burkitt, convoluted, and lymphoblastic types were related to children and young adults. A proportion of the LB type occurs also in older groups. Three prognostic groups were identified, the favourable (CB-CC foll. and PC types), with an overall median survival in excess of 80 months, an intermediate group (CB-CC foll. - diff., CC, and CLL), with an overall median survival of 38 months, and an unfavourable group (Conv, CB, CB-CC diff., UC, IB, and Burkitt types), with a median survival of 11 months. The CC type in this study was controversial in its morphological acceptability.

Adolescent↗
PubMed1999

An imaging-based classification for the cervical nodes designed as an adjunct to recent clinically based nodal classifications.

Over the past 18 years, numerous classifications have been proposed to distinguish among the diverse nodal levels. Some classifications have used surgical landmarks, others physical assessment criteria. These classifications do not agree precisely and exhibit sufficient variation that competent physicians could arrive at slightly different staging of the patient's nodal disease. In the past 2 decades, computed tomography and magnetic resonance imaging have offered progressively more refined anatomical precision, reproducibility, and visualization of deep, clinically inaccessible structures. Because the majority of patients with head and neck malignancies presently undergo sectional imaging prior to treatment planning, we felt a need to integrate anatomical imaging criteria with the 2 most commonly used nodal classifications: those of the American Joint Committee on Cancer and those of the American Academy of Otolaryngology-Head and Neck Surgery. The imaging-based nodal classification proposed herein has been developed in consultation with surgeons interested in such classifications in the hope that the resultant classification would find ready acceptance by both clinicians and imagers. It is our desire that the best attributes of imaging, combined with those of the physical assessment, can result in a better and more consistently reproducible nodal staging than is possible by either

Head and Neck Neoplasms↗
PubMed1982

National Cancer Institute sponsored study of classifications of non-Hodgkin's lymphomas: summary and description of a working formulation for clinical usage. The Non-Hodgkin's Lymphoma Pathologic Classification Project.

An international multi-institutional clinicopathologic study of 1175 cases of non-Hodgkin's lymphoma sponsored by the National Institute has been completed. Histologic slides and clinical records were examined from previously untreated patients seen during the period between July 1971 and December 1975 at four institutions, three in the United States and one in Italy. The reproducibility and clinical relevance of the six major classifications of the non-Hodgkin's lymphomas was tested by six "expert" pathologists, each a proponent of a major classification, and six very experienced pathologists not identified with one of the major classifications. Immunologic methods were not employed in the study design. A summary of the methods employed and the conclusions of the study is described. The major conclusion was that all six classifications were valuable and comparable in reproducibility and clinical correlations. The clinical significance of a follicular architecture, independent of cell type was confirmed. A working formulation of non-Hodgkin's lymphomas is described which separates the disease into ten major types utilizing morphologic criteria only. Subtypes are also described which allow translation of all of the major classifications into comparable groups. Histologic criteria are presented for each major type and equivalent terms are given for each type in the six major classifications. The formulation is not proposed as a new classification but a means of translation among the various systems and to facilitate clinical comparisons of case reports and therapeutic trials. The report contains commentaries by five of the "expert" pathologists on the value and conclusions of this unique study.

Actuarial Analysis↗
PubMed2002

The National Vegetation Classification Standard applied to the remote sensing classification of two semiarid environments.

The National Vegetation Classification Standard (NVCS) was implemented at two US National Park Service (NPS) sites in Texas, the Padre Island National Seashore (PINS) and the Lake Meredith National Recreation Area (LMNRA), to provide information for NPS oil and gas management plans. Because NVCS landcover classifications did not exist for these two areas prior to this study, we created landcover classes, through intensive ground and aerial reconnaissance, that characterized the general landscape features and at the same time complied with NVCS guidelines. The created landcover classes were useful for the resource management and were conducive to classification with optical remote sensing systems, such as the Landsat Thematic Mapper (TM). In the LMNRA, topographic elevation data were added to the TM data to reduce confusion between cliff, high plains, and forest classes. Classification accuracies (kappa statistics) of 89.9% (0.89) and 88.2% (0.87) in PINS and LMNRA, respectively, verified that the two NPS landholdings were adequately mapped with TM data. Improved sensor systems with higher spectral and spatial resolutions will ultimately refine the broad classes defined in this classification; however, the landcover classifications created in this study have already provided valuable information for the management of both NPS lands. Habitat information provided by the classifications has aided in the placement of inventory and monitoring plots, has assisted oil and gas operators by providing information on sensitive habitats, and has allowed park managers to better use resources when fighting wildland fires and in protecting visitors and the infrastructure of NPS lands.

Conservation of Natural Resources↗
PubMed2003

Lack of agreement in classification of the severity of acute asthma between emergency physician assessment and classification using the National Asthma Council Australia guidelines (1998).

AIMS: To determine the level of agreement in classification of the severity of acute asthma at presentation to the emergency department, between emergency physician global assessment and severity classification according to the National Asthma Council Guidelines, Australia 1998 (NACG). METHODS: Prospective observational study in emergency departments throughout Australia, participating in the Asthma Snapshot 2000 project. Patients between the ages of one and 60 years presenting to participating emergency departments with acute asthma between 21 August and 3 September 2000 were included. Data collected were emergency physician global assessment of asthma severity and severity classification according to the National Asthma Council Guidelines and disposition. RESULTS: Five hundred and five subjects had completed data for emergency physician assessment of severity and for calculation of severity classification according to the National Asthma Council Guidelines. Weighted kappa for agreement in classification was 0.48 (95% confidence interval: 0.40, 0.56). Emergency physicians assess asthma as less severe compared to the National Asthma Council Guidelines assessment. CONCLUSIONS: Agreement between physician assessment of severity of acute asthma and severity classification according to National Asthma Council Guidelines is only moderate. This may have implications in treatment and disposition. This also suggests that emergency physicians may be using other methods to classify acute asthma than the National Asthma Council Guidelines classification.

Asthma↗
PubMed1977

Visual classification of banded human chromosomes ii. classification and karyotyping of integrated density profiles.

Visual classification and karyotyping of 897 integrated density profiles generated from straight and non-overlapping chromosomes from 22 trypsin-banded metaphases of average quality was carried out and evaluated. The results were compared with visual classification of photographic prints of the same 897 chromosomes. The experiments were carried out by one observer. About 5% errors were made in classification of isolated profiles; 0-5% errors were made in karyotyping profiles and about 3% errors were made in classification of isolated chromosome prints. The reason for the small error rate obtained by karyotyping profiles as compared to the error rate when classifying isolated profiles was assumed to be the use of a priori knowledge of the composition of (normal) metaphases and the possibility of making appropriate comparisons between the individual profiles within the metaphase. Comparison between classification of isolated prints and of profiles showed different error patterns on the basis of which it was assumed that prints constitute a better basis for visual classification than profiles. The results seemed to indicate two ways of improving computer classification of banded chromosomes: (1) information of value in the chromosomes (band pattern, shape etc.) should be extracted from the digitized chromosome image in a manner superior to the simple integration by which profiles are produced; (2) computer karyotyping should simulate the human method, thus taking advantage of a priori knowledge of the composition of the metaphases and being able to make appropriate comparisons between individual chromosomes.

Chromosomes↗
PubMed1976

[A proposal of a T.N.M. type of classification of the ear. O.P.A.C. classification of chronic surgical otitis].

With the advent of modern otology, cophosurgeons anxious to compare their results soon became aware of the need for a "T.N.M" type of classification for the ear. The classification described here by the authors is, in principle, a classification of the "T.N.M" type: that is, a purely descriptive classification without prognostic, pathogenetic or therapeutic pretensions. This "O.P.A.C." classification is based on a description of 4 main characteristics: 1) the existence and characteristics of potential otorrhoea, described under the letter C; 2) the characteristics of potential perforation of the tympanum, described under the letter P; 3) the appearance of the middle ear, excluding the ossicular chain, described under the letter A; 4) the condition of the ossicular chain when the surgeon has completed his exploration of the lesions, described under the letter C. Two years experience seems to have proved the convenience and usefulness of this purely clinical classification, providing otologists with a common language. While they are aware of the objections and criticisms to which it may give rise, the authors hope, on time, to improve in this classification.

Cerebrospinal Fluid Otorrhea↗
PubMed2003

Relative frequency of the different types of cutaneous T cell and natural killer cell lymphomas in Korea based on the proposed WHO classification and the EORTC classification.

The R.E.A.L. classification was largely adopted recently by the proposed WHO classification. The usefulness of this classification in cutaneous T cell and natural killer (NK) cell lymphomas in Korea was evaluated compared to that of the European Organization for Research and Treatment of Cancer (EORTC) classification. Overall, 78 patients with cutaneous T cell and NK cell lymphomas were diagnosed in Asan Medical Center in the 1990's. The clinical records, slides of H&E and immunohistochemical stainings were reviewed. By the proposed WHO classification, mycosis fungoides (20 cases), lymphomatoid papulosis (13 cases), nasal type NK/T-cell lymphoma (10 cases), CD30+ anaplastic large cell lymphoma (8 cases), subcutaneous panniculitis-like T-cell lymphoma (6 cases), peripheral T-cell lymphoma, unspecified (3 cases), Sézary syndrome (1 case) and blastic NK cell lymphoma (1 case) comprised the primary cases. Secondary or undetermined cases included peripheral T-cell lymphoma, unspecified (10 cases), nasal type NK/T-cell lymphoma (5 cases), and angioimmunoblastic T-cell lymphoma (1 case). EORTC classification for cutaneous T cell and NK cell lymphomas did not include nasal and nasal type NK/T-cell lymphomas, unspecified non-pleomorphic T-cell lymphoma, undetermined cases among primary or secondary ones and some rare types of skin lymphomas which can be classified by WHO. The WHO classification is more useful for skin lymphomas in Korea since it encompassed all the various types of skin T cell and NK cell lymphomas in Korea.

Adolescent↗