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PubMed1986

Spinal computed tomography and computed tomographic metrizamide myelography in the early diagnosis of metastatic disease.

New lesions were shown by Tc99m bone scans to have developed in sixty patients with known metastatic cancer or high-risk primary cancer and normal neurologic examinations; they were further evaluated with plain radiographs, spinal computed tomography (CT), and CT myelography (CT-M) according to an algorithm. Three groups were identified based on plain radiographs: group 1 (normal radiograph), group 2 (compression fracture as indicated by radiograph), group 3 (evidence of metastasis as indicated by radiograph). In group 1 (n = 18), spinal CT revealed that 33% of the patients had benign disease and 67%, metastases; epidural compression was seen in 25% of the patients with metastasis as indicated by CT-M. In group 2 (n = 26), CT-M disclosed that 38% had a benign compression fracture and 62% had metastases and that 63% of the patients with metastases had an epidural compression. In group 3 (n = 16), spinal CT revealed that 15 patients had metastases (one patient had benign disease). Epidural cord compression was seen in 47% of the patients with metastatic disease. In all groups, the presence of cortical bone discontinuity around the neural canal (seen in 31 patients) was highly associated with epidural compression (seen in 20 patients). Our approach allowed the early and accurate diagnosis of spinal metastasis and epidural tumor as well as the diagnosis of benign disease and was useful in planning optimal local therapy.

Bone and Bones↗
PubMed1984

Computed tomography plane of the target approach in computed tomographic stereotaxis.

A computed tomographic (CT) stereotactic system that uses the principle of bringing the reference markers and the probe holder into the CT plane of the target is described. This eliminates the need for obtaining the Z coordinate and enables one to measure directly the X and Y coordinates. The use of an arc and of a rotary arc carrier permits one to approach the target from any point on the skull. Off-axial reconstruction permits visualization of the trajectory in both the coronal and the sagittal planes.

Brain Diseases↗
PubMed1986

Is computed tomographic scanning necessary in patients with tentorial herniation? Results of immediate surgical exploration without computed tomography in 100 patients.

Computed tomographic (CT) scans are performed on virtually all patients with severe head injury at the time of admission. Because of the time involved in obtaining these studies, the evacuation of significant intracranial mass lesions is delayed. To avoid such delays, the authors performed burr-hole exploration for the diagnosis of intracranial hematomas before CT scans were obtained in 100 consecutive head-injured patients with clinical signs of tentorial herniation or upper brain stem dysfunction upon admission to the emergency room. Patients in whom a hematoma was discovered had a craniotomy for evacuation of the clot; those in whom the exploration was negative had a CT brain scan immediately after operation. Burr-hole exploration revealed extracerebral mass lesions in 56 patients. In 38 patients, the exploration was negative, and postoperative CT scanning showed no significant hematoma. Of 6 patients in whom the CT scan demonstrated extraaxial hematomas requiring surgical evacuation, 4 had subdural hematomas that were missed because the exploration was incomplete; 1 patient had an epidural hematoma and 1 had a subdural hematoma contralateral to a craniotomy on the side of a positive initial burr-hole exploration. Our results indicate that the relatively small subgroup of head-injured patients with early tentorial herniation or upper brain stem compression have a high incidence of immediate extraaxial hematomas and a low incidence of intracerebral hematomas. This is particularly true of patients over 30 years of age and those who suffer low speed trauma, such as falls and vehicle-pedestrian accidents.

Adult↗
PubMed2000

Clinical usefulness of computed tomography arteriography and computed tomography during arterial portography for the diagnosis of early and early advanced hepatocellular carcinoma.

OBJECTIVE: We examined the clinical usefulness of two techniques of Angio Computed tomography (CT), namely, CT arteriography (CTA) and CT during arterial portography (CTAP), for the diagnosis of early hepatocellular carcinoma (HCC) and early advanced HCC. MATERIALS AND METHODS: The subjects were six patients with a total of seven lesions: three had one early HCC lesion each, and three had four early advanced HCC lesions between them. There were five men and one woman, aged 61 approximately 73 years (mean: 65 years). A catheter was inserted into each inguinal artery according to Seldinger's method, and the results of CTA and CTAP were compared with those of conventional CT. RESULTS: Visualization of tumor borders, arterial blood feeding areas, and portal blood flow areas gave results equal to or better than those of conventional CT. CONCLUSIONS: A combination of CTA and CTAP is useful for the diagnosis of early HCC and early advanced HCC.

Aged↗
PubMed1982

Computed tomography in the diagnosis of fatty liver: total lipid content and computed tomography number.

Fifty-three histologically proved cases of various diffuse liver disease were studied for their computed tomography numbers (CTN). The machine used was Ohio Nuclear's Delta Scanner 50FS type and CTN was expressed by the Hounsfield unit (H). Mean CTN in each group was as follows: 66.6 +/- 2.6 H in normal control (N), 63.3 +/- 6.0 H in chronic hepatitis (CH). 61.8 +/- 7.0 H in liver cirrhosis (LC), and 44.4 +/- 10.6 H in fatty infiltration (FI). There were no significant differences among them except FI group. As N group were all above 60 H and CH and LC groups were all above 50 H, CTN below 60 H suggests chronic liver disease or fatty infiltration and CTN below 50 H strongly suggests fatty infiltration. In eleven cases where total lipid content of the liver could be be biochemically determined by the sulfo-phospho-vanillin reagent, a relation of total lipid content to CTN was studied. As a result, a significant correlation existed between them (r = -0.89; p less than 0.001). If the diagnostic criterion of fatty liver was set at total lipid content above 100 mg/g wet liver, CT criterion was estimated at CTN below 48 H from the regression formula.

Chronic Disease↗
PubMed2000

Subepicranial varix mimicking sinus pericranii: usefulness of three-dimensional computed tomography angiography and bone window computed tomography--case report.

A 16-year-old female presented with a rare case of subepicranial varix in the left temporal area manifesting as a soft mass in the left temporal area when she laid down in the left lateral position. Bulging of the mass was observed when intracranial venous pressure was raised by the Valsalva maneuver, the left lateral position, or the prone position. Bone window computed tomography (CT) revealed a tiny hole, 1 mm in diameter, in the outer bone table. Three-dimensional CT (3D-CT) angiography clearly visualized a mass with a diameter of approximately 10 mm connected to the diploic vein. The mass was totally resected by operation. Venous bleeding was observed from the tiny hole. Histological examination revealed a venous lesion mimicking sinus pericranii and containing endothelial cells. No communication with the intracranial venous sinuses was identified, so the diagnosis was subepicranial varix. Radiological examination by direct injection of contrast medium is usually performed to identify subepicranial varix, but 3D-CT angiography is a non-invasive preoperative examination that can visualize this small venous lesion. Adjustment of the CT acquisition conditions may allow 3D-CT angiography to identify sinus pericranii in the future.

Adolescent↗
PubMed1981

Computer assisted diagnosis and computer consultation in neurology: preliminary testing of diagnostic accuracy for the neurologist system.

The Neurologist system is a computer program for consultation in clinical neurology which employs human-like reasoning in diagnosis, covers a broad diagnostic domain, has the capacity to explain strategies and conclusions and is readily expandable. Neurologist employs the strategy of first localizing a neurologic disease, then uses these data as well as mode of disease onset, rapidly to focus on a limited number of diagnostic possibilities which are then sequentially investigated. This paper presents the results of the preliminary assessment of Neurologist's diagnostic accuracy. For a set of 30 test cases, the system's leading diagnosis was correct in 77%, and separation of correct and incorrect diagnostic hypotheses was excellent. Further evaluations of the system are in progress.

Brain Diseases↗
PubMed1997

Computer programs and clinical contexts: two computer based exercises for cognitive rehabilitation.

Two examples taken from computer programs for cognitive rehabilitation of patients with schizophrenia show how different groups of clinicians attribute different meanings to the same exercise. This illustrates that the meaning of an artifact or a technology is socially constructed and thereby intimately bound to the context of use. This perspective has implications on issues such as the design process, the assessment of technology and the issue of standardization.

Cognition Disorders↗
PubMed1999

Can computer autoacquisition of medical information meet the needs of the future? A feasibility study in direct computation of the fine grained electronic medical record.

The project describes feasibility testing of a two-year clinical deployment of an electronic record keeping system for primary care medicine that allowed financial medical management and clinical disease study without the encumbrance of human encoding. The software used an expert system for acquisition of historical information and automatic database encoding of each independent fact. The historical acquisition system was combined with a screen-based physician data entry system to create a fine-grained medical record. Fine-grained data allowed direct computer processing to mimic the ends that presently require human encoding--gatekeeping, disease characterization and remote disease surveillance. The project demonstrated the possibility of real time gatekeeping through direct analysis of data. Detection and characterization of disease states using statistical methods within the database was possible, however, limited in this study because of the large numbers of patient interviews required. The possibilities for remote disease monitoring and clinical studies are also discussed.

Chi-Square Distribution↗
PubMedDate not supplied

[Computer modeling of mechanisms of the information processing in the olfactory bulb. II. Mechanisms of identification and short-term storage in the olfactory bulb: results of the computer experimentation].

The results of experimentation with the computer model of the olfactory bulb are presented. The architecture and scenario of the work of the model were described previously. The dynamic character of the identification process and the mechanism of memorizing short-term of smell stimuli are described. During the identification, a self-adjustment of the olfactory bulb to incoming signals occurs. The self-modification of mitral and tufted cell synapses enhances responses of the cells; upon subsequent presentation of the stimulus, the olfactory bulb responds with a higher activity. The modeling confirmed the validity of the assumption that the functions of mitral and tufted cells are to identify the components of a complex smell and the image of the smell as the whole.

Animals↗
PubMed1992

[Computer simulation of blood level profiles. Drug liberation from two sustained-release preparations and computer simulation of single- and multiple-dose pharmacokinetics].

A series of computer programs (BASIC) is introduced for the evaluation of in vitro dissolution data as well as for the calculation of pharmacokinetic parameters and for blood level curve fitting to the respective in vitro data. Furthermore, programs are offered for the simulation of blood level profiles under variable conditions. In order to demonstrate the practical use of these programs, the expected blood level profiles following the administration of two commercial sustained-release dosage forms containing the drug pentoxifylline have been compared.

Computer Simulation↗
PubMed1990

[Contribution of x-ray computed tomography and MRI to the surgical diagnosis of bronchial cancers. Comparative evaluation of x-ray computed tomography, MRI and thoracotomy in 111 cases].

Computed tomography and magnetic resonance imaging have respectively decreased the incidence of exploratory thoracotomy by 11.6% to 5.7% then 5.3% after their successive inclusion in the assessment of the operability of lung cancers. Based on a systematic comparison of CT and MRI with exploratory thoracotomy in 111 patients, the yield, sensitivity and positive predictive value of these examinations was assessed in relation to tumour extension to various sites: to the chest wall, for which the sensitivity was poor (38% for CT, 54% for MRI) with a moderate predictive value (71% for CT, 77% for MRI); to the mediastinum with improved sensitivity (69% and 72%) but an uncertain predictive value (61% and 72%). The sensitivity and predictive value were then measured for lymph node involvement: N1: moderate sensitivity (69% and 76%) but a good predictive value (95% and 92%); N2 and N3: good sensitivity (79% and 93%) but a poor predictive value (70% and 66%). Apart from a few particular indications specific to MRI, especially in the apex, left hilum and in contact with the atrium, the efficacy of these two investigations is very similar. However, their lack of specificity means that certain exploratory thoracotomies are still justified in order to assess the operability of the tumour. A surgical or mediastinoscopic anatomical assessment is still necessary for a good classification of lymph node extension of lung tumours.

Carcinoma, Bronchogenic↗
PubMed1986

An analysis of computed tomographic brain scans. A computer-based study.

A microcomputer was used to analyse prospectively 1,000 sequential computed tomographic (CT) brain scans to assess whether the scanner was being used in a cost-effective and efficient manner. Of the patients scanned 58% had cerebral lesions. All the usual indications for CT examination were shown to be worth while, the exception being psychiatric cases.

Adolescent↗
PubMed1983

Computer assisted patient evaluation (CAPE): a multi-purpose computer system for an anesthesia service.

We have designed and built a database management system, the computer assisted patient evaluation (CAPE) system, for use in patient management, research, and administration in our anesthesia practice. An important part of the system is the use of specially designed forms on which anesthesiologists record patient histories and management information during the course of patient care. The forms provide means for convenient and complete record keeping, as well as for direct computerization. We demonstrate the flexibility and utility of the CAPE system by presenting a series of examples of its use. These include development and implementation of a preoperative screening program to identify patients at high risk of postoperative respiratory complications; a study of anesthesia technique and outcome; auditing for quality of care; and utilization review of respiratory therapy.

Anesthesia Department, Hospital↗
PubMed1980

[Findings of computed tomography in multiple sclerosis-correlation of clinical findings with computed tomography in clinically definite 14 patients of multiple sclerosis (author's transl)].

Recent introduction of Computed Tomography (CT) in clinical neurology made it possible to visualize the brain lesion without any invasive procedures. In multiple sclerosis (MS), the demyelinating foci were reported to be observed as low density areas on CT, but occasionally contrast enhanced high density areas were reported also. So far as we know, only a few reports which analysed interrelationship between clinical signs and CT findings were published. In this report we tried to examine the correlation of clinical findings with CT in MS. All scans were performed using an EMI head scanner (EMI 1000) with a 160 X 160 matrix. Contrast material was administered as an intravenous bolus of 60% meglumine iothalamate. In clinically definite 14 MS patients, CT showed localized, circumscribed low density areas in 4 patients, periventricular low density in 1 patient, widening of cortical sulci with ventricular dilatation in 11 patients and no abnormalities in 3 patients. The widening of cortical sulci with ventricular dilatation were noted to be particularly common findings. The periventricular low density was not so frequently seen as we expected. Localized, circumscribed low density areas on CT were well correlated with the neurological findings in 2 patients. In these cases the abnormalities on CT persisted in spite of neurological improvement. As a conclusion, we think CT might be useful as a diagnostic evaluation of MS.

Adolescent↗
PubMed1980

Computer-assisted interpretation of electro- and vectorcardiograms. Chapter IV. Achievements in the field of computer-assisted interpretation of electrocardiograms.

The most important advantage of computer-assisted ECG/VCG interpretation in our center is the enhancement of the diagnostic accuracy of ECG interpretation, as compared to that reported in the literature for the visual analysis of ECGs and VCGs. Favourable side effects are also obtained from the optimization of various functions involved n ECG data processing, like data handling, editing, reporting, storage and retrieval. Improvement of the arrhythmia program and creation of a new pediatric VCG program are currently in progress in our laboratory. Computerized electrocardiography has made us aware of the limitations of conventional, visual reading of electrocardiograms. Thanks to the current efforts towards standardization of the quantitative analysis of ECGs and VCGs and towards optimization of diagnostic criteria, computerized electrocardiography will undoubtedly lead to a generalized improved accuracy of ECG interpretation.

Belgium↗