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At least 775 records · Page 43Linked to original sources
PubMed1996

Effects of valve substitute on changes in left ventricular function and hypertrophy after aortic valve replacement.

BACKGROUND: Residual left ventricular hypertrophy adversely affects long-term outcome after aortic valve replacement. A stentless biological valve in the aortic position has been shown to offer a better hemodynamic profile than a stented one. However, it remains to be defined whether this difference is translated into inter-mediate-term effects on left ventricular structure and function. METHODS: One hundred thirty-seven patients receiving single aortic valve replacement (52 with concomitant coronary artery bypass graft) were enrolled in this study. Ninety-eight were men, and the mean age was 68 years (range, 55 to 90 years). Of the 137 patients, 39 had an aortic homograft, 72 a Toronto stentless porcine valve, and 26 had a stented porcine or bileaflet mechanical valve, with mean valve size of 25 +/- 2.5 mm (mean +/- standard deviation). Left ventricular muscle mass and function were assessed by M-mode echocardiography performed before and 0.5, 6, 12, 24, and 36 months after operation, and recorded on paper for off-line digitizing. Peak valve prosthesis pressure gradients were quantified by continuous wave Doppler. RESULTS: A total of 330 echocardiograms obtained during this study were adequate for computer digitizing. Clinical data, preoperative left ventricular function, and hypertrophy were similar between the three groups. Significant improvement in left ventricular function and major regression of left ventricular hypertrophy had occurred in the entire population by 6 months after operation. Multivariate analysis of variance showed that patients with previous aortic regurgitation had a larger left ventricular cavity size (p < 0.001) and greater mass index (p = 0.001) postoperatively than those with previous aortic stenosis. In addition, peak valvular gradient was lower (p < 0.001), mass index less (p < 0.001), and left ventricular function more normal both systolic, by a greater peak velocity of dimension shortening (p = 0.05) and wall thickening (p = 0.002), and diastolic, by a greater peak velocity of dimension lengthening (p = 0.046), with an aortic homograft or stentless porcine valve compared with a mechanical or stented biological valve. There was no significant difference in peak valve gradient, left ventricular mass index, or function between the aortic homograft and the stentless porcine valve. Age, sex, and concomitant coronary artery bypass graft, as well as aortic cross-clamp time, cardioplegia method, and valve size all proved to be insignificant determinants of postoperative left ventricular hypertrophy or function. CONCLUSIONS: In the first 2 years after implantation, the superior hemodynamic performance of aortic homograft and stentless porcine valve appears to result in more extensive regression of ventricular hypertrophy and greater improvement of left ventricular function than occurs with a mechanical or stented biological valve. These findings encourage the use of a stentless biological valve in older patients requiring aortic valve replacement, and a larger scale long-term randomized study of stentless versus stented biological valve or mechanical valve seems warranted.

Aged↗
PubMed1990

Experience with the Athena semi-automated karyotyping system.

The traditional analysis and assembly of metaphase chromosomes into a karyogram is a slow and tedious process requiring intermediate photographic steps and manual manipulation of the chromosome images. Much of this task is highly repetitive and readily lends itself to partial automation. Semi-automated karyotyping systems now are being used increasingly in both clinical and research cytogenetic laboratories. Digital image processing techniques are used to capture, manipulate, and make an initial classification of chromosome images. The Athena system uses commercially available components based on a Macintosh II personal computer. Digital image processing procedures automatically isolate chromosome images from the metaphase and arrange them into a karyogram, using information about relative chromosome length, centromeric index, and banding pattern. The operator uses the intuitive graphics interface of the Macintosh computer to monitor each phase of the analysis, to resolve any problems in isolating chromosome images, and to rearrange the individual chromosome images while assembling the final karyogram. Athena is designed as a semi-automated karyotyping system that is easy to learn and has sufficient power and versatility for routine use in the analysis of human metaphase chromosomes.

Humans↗
PubMed1991

One-dimensional computer analysis of oscillatory flow in rigid tubes.

The dynamic characteristics of catheter-transducer systems using rigid tubes with compliance lumped in the transducer and oscillatory flow of fluid in rigid tubes were analyzed. A digital computer model based on one dimensional laminar oscillatory flow was developed and verified by exact solution of the Navier-Stokes Equation. Experimental results indicated that the damping ratio and resistance is much higher at higher frequencies of oscillation than predicted by the one dimensional model. An empirical correction factor was developed and incorporated into the computer model to correct the model to the experimental data. Amplitude of oscillation was found to have no effect on damping ratio so it was concluded that the increased damping ratio and resistance at higher frequencies was not due to turbulence but to two dimensional flow effects. Graphs and equations were developed to calculate damping ratio and undamped natural frequency of a catheter-transducer system from system parameters. Graphs and equations were also developed to calculate resistance and inertance for oscillatory flow in rigid tubes from system parameters and frequency of oscillation.

Blood Flow Velocity↗
PubMed1994

Factors determining the diagnostic accuracy of digitized conventional intraoral radiographs.

A number of factors may determine the diagnostic accuracy of digitized intraoral radiographs. Conventional film radiographs were digitized with three different digitizers, a laser-scanner, a drum-scanner and a TV camera. Digital images, varying in pixel size, grey level and image processing, were displayed on three different video-monitors and assessed by 10 dentists. The detectability of incipient proximal surface caries was used as an index of the diagnostic accuracy and the effect of the different factors compared by means of receiver operating characteristic (ROC) analysis. Images digitized by the drum-scanner were found to have the best diagnostic accuracy. Sufficient diagnostic accuracy could be attained on the low-cost video monitor of a personal computer. Digital images with a pixel size of 100 microns and 32 grey levels were found to be acceptable for intraoral radiographs for diagnostic purposes. These results provide a practical guide for establishing a digital image acquiring system for any intraoral radiographs, reducing demands on data storage to a minimum.

Analysis of Variance↗
PubMed1983

Conceptual issues in computer-aided diagnosis and the hierarchical nature of medical knowledge.

Attempts to formalize the diagnostic process are by no means a recent undertaking; what is new is the availability of an engine to process these formalizations. The digital computer has therefore been increasingly turned to in the expectation of developing systems which will assist or replace the physician in diagnosis. Such efforts involve a number of assumptions regarding the nature of the diagnostic process: e.g. where it begins, and where it ends. 'Diagnosis' appears to include a number of quite different cognitive processes, some of which seem more subject to formalization than others. Underlying the difficulties inherent in these efforts at formalization, is the hierarchical structure of medical knowledge including that of diseases. (By 'hierarchical structure', I mean no more than that our descriptions of clinical objects necessarily refer to different levels of organization; atomic, molecular, cellular, physiological system, entire patient). Since diagnosis is in part a form of classification, measures of similarity between the clinical findings of a particular patient and a potential disease, are needed. This is complicated by the fact that some diseases are described using the vocabularies of physics and chemistry, others with the vocabulary of psychology, and most, with terms taken from a number of different hierarchical levels. The differences between the descriptions made using these vocabularies will be seen to exert systematic (if not uniform) influences upon the diagnostic process.

Diagnosis, Computer-Assisted↗
PubMed1998

Quantitative cardiac SPECT in three dimensions: validation by experimental phantom studies.

A mathematical framework for quantitative SPECT (single photon emission computed tomography) reconstruction of the heart is presented. An efficient simultaneous compensation approach to the reconstruction task is described. The implementation of the approach on a digital computer is delineated. The approach was validated by experimental data acquired from chest phantoms. The phantoms consisted of a cylindrical elliptical tank of Plexiglass, a cardiac insert made of Plexiglass, a spine insert of packed bone meal and lung inserts made of styrofoam beads alone. Water bags were added to simulate different body characteristics. Comparison between the quantitative reconstruction and the conventional FBP (filtered backprojection) method was performed. The FBP reconstruction had a poor quantitative accuracy and varied for different body configurations. Significant improvement in reconstruction accuracy by the quantitative approach was demonstrated with a moderate computing time on a currently available desktop computer. Furthermore, the quantitative reconstruction was robust for different body characteristics. Therefore, the quantitative approach has the potential for clinical use.

Body Composition↗
PubMed1981

Digital image processing of two dimensional echocardiograms: identification of the endocardium.

Digital computer image-processing techniques were applied to two dimensional echocardiograms to improve the accuracy of cardiac spatial measurements by enhancing endocardial recognition. Images were photographed from the two dimensional echocardiographic monitor and digitized using an optical densitometer. Image-processing algorithms were applied to the digitized images as follows: (1) Multiple images were averaged; (2) a gray level threshold was chosen to separate the image into tissue and cavity regions on the basis of amplitude (brightness) of the returning echoes; (3) endocardium was traced between the regions; (4) endocardial position was confirmed by matching this boundary with a contrast edge map of the original images; and (5) the endocardial boundaries were tested by comparison with simultaneous M mode echocardiograms. A linear correlation was found between M mode and computer-processed two dimensional echocardiographic measurements of ventricular septal thickness (r = 0.88); this was superior to the correlation between M mode and unprocessed two dimensional echocardiographic septal measurements (r = 0.55). The correlations between M mode and processed or unprocessed two dimensional echocardiographic measurements of left ventricular internal dimension were similar (r = 0.89 and 0.85, respectively), but the slope of the regression line for the processed data more closely approximated the line of identity (p less than 0.05). It is concluded that endocardial outlines derived with use of digital image-processing techniques lead to left ventricular measurements that correlate more closely with M mode measurements than do dimensions derived from unprocessed two dimensional echocardiography.

Computers↗
PubMed1982

Individual sarcomere length determination from isolated cardiac cells using high-resolution optical microscopy and digital image processing.

Discrete sarcomere lengths have been determined from dynamically contracting isolated cardiac cells with a high-speed, high-resolution direct optical imaging system. Calcium-tolerant cardiac cells from the rat are isolated by perfusion with collagenase and hyaluronidase. Individual sarcomere lengths can be determined by directly imaging the cell's striation pattern onto a solid-state charge-coupled device (CCD) detector interfaced with a digital computer. The precision of detection in a real light microscopic optical system is discussed in relation to the type of image detector, optical contract enhancement techniques, and digital image processing. The optical performance of the direct striation pattern image apparatus has been determined empirically with test grids under standard bright-field and Nomarski-differential interference contrast (DIC) conditions for application to real muscle imaging. Discrete striation positions of isolated cells have been detected and followed with high precision during phasic contraction-relaxation cycles down to average sarcomere lengths as short as 1.43 +/- 0.053 microns. The maximum rates of contraction and relaxation are rapid and synchronous in time course along the length of the cell. These results indicate that direct optical imaging can provide an accurate means to monitor discrete striations and sarcomere lengths along the length of Ca2+-tolerant heart cells.

Animals↗
PubMed2002

Electronic patient records for dental school clinics: more than paperless systems.

The Electronic Patient Record (EPR) or "computer-based medical record" is defined by the Patient Record Institute as "a repository for patient information with one health-care enterprise that is supported by digital computer input and integrated with other information sources." The information technology revolution coupled with everyday use of computers in clinical dentistry has created new demand for electronic patient records. Ultimately, the EPR should improve health care quality. The major short-term disadvantage is cost, including software, equipment, training, and personnel time involved in the associated business process re-engineering. An internal review committee with expertise in information technology and/or database management evaluated commercially available software in light of the unique needs of academic dental facilities. This paper discusses their deficiencies and suggests areas for improvement. The dental profession should develop a more common record with standard diagnostic codes and clinical outcome measures to make the EPR more useful for clinical research and improve the quality of care.

Computer Communication Networks↗
PubMed1997

Radiology's Achilles' heel: error and variation in the interpretation of the Röntgen image.

The performance of the human eye and brain has failed to keep pace with the enormous technical progress in the first full century of radiology. Errors and variations in interpretation now represent the weakest aspect of clinical imaging. Those interpretations which differ from the consensus view of a panel of "experts" may be regarded as errors; where experts fail to achieve consensus, differing reports are regarded as "observer variation". Errors arise from poor technique, failures of perception, lack of knowledge and misjudgments. Observer variation is substantial and should be taken into account when different diagnostic methods are compared; in many cases the difference between observers outweighs the difference between techniques. Strategies for reducing error include attention to viewing conditions, training of the observers, availability of previous films and relevant clinical data, dual or multiple reporting, standardization of terminology and report format, and assistance from computers. Digital acquisition and display will probably not affect observer variation but the performance of radiologists, as measured by receiver operating characteristic (ROC) analysis, may be improved by computer-directed search for specific image features. Other current developments show that where image features can be comprehensively described, computer analysis can replace the perception function of the observer, whilst the function of interpretation can in some cases be performed better by artificial neural networks. However, computer-assisted diagnosis is still in its infancy and complete replacement of the human observer is as yet a remote possibility.

Diagnostic Errors↗
PubMed1979

Conceptual and methodological considerations towards the development of computer-controlled research on the electro-physiology of sleep.

A critical discussion of the visual scoring approach to the measurement of sleep electrophysiology details some theoretical shortcomings of that procedural model. An alternative approach employing high-speed, general purpose digital computers is then presented. It is argued that the measurement potential of computers is barely tapped by using computers to score sleep stages and the advantages of collecting data which are suitable for parametric and multivariate statistical analysis are described. Researchers are urged to include detailed reports on their procedural choices along with a discussion of the methodological implications of these procedures. Examples of computer collected data are presented along with a description of some simple data reduction strategies.

Computers↗
PubMed1985

Rat medulla oblongata. IV. Topographical distribution of catecholaminergic neurons with quantitative three-dimensional computer reconstruction.

We examined serial 40 micron vibratome, immunoperoxidase-stained sections of the medulla with tyrosine hydroxylase (TH), dopamine-beta-hydroxylase (DBH), and phenylethanolamine N-methyltransferase (PNMT) antisera followed by Nissl staining to locate catecholaminergic neurons in cytoarchitectonic regions followed by a three-dimensional (3D) computer reconstruction of these cell groups to determine their spatial organization. Overlay drawings of low and high power photomicrographs showing cell bodies and nuclear boundaries were entered into a digital computer storage system. Every section in the series was plotted to yield an accurate representation of regional densities of cells and location of nuclei, as revealed by two-dimensional plots of individual sections as well as three-dimensional plots of groups of sections. Data files were scanned in a number of ways to obtain total cell counts of TH-, DBH-, and PNMT-immunoreactive cells within a designated area or cell counts of only one type of immunoreactive cell. This combination of data manipulation produced the following results: (1) A1 group is a homogeneous population of noradrenergic neurons at levels caudal to the obex, and at the obex it is mixed with adrenergic cells. The dimensions of the A1 cell group are 1.3 X 2.7 mm, extending from -2.5 to +0.2. Part of this cell group lies in the lateral reticular nucleus. (2) A2 group is not purely noradrenergic as previously suspected. It is a very mixed cell group containing mainly dopaminergic neurons in the area postrema (periventricular region) and the dorsal motor nucleus of the vagus, mainly noradrenergic neurons in the medial subnucleus of the nucleus of the tractus solitarius (nTS), mainly adrenergic neurons in the dorsal strip and dorsal subnucleus of the nucleus of the tractus solitarius, and a mixture of all three catecholaminergic neurons in the other subnuclei of the nTS. The dimensions of this group are 0.4 X 3 mm extending from -2.7 to +0.3. (3) C1 group is a homogeneous population of adrenaline cells extending from +1 to +2.5 with dimensions of 1.5 X 1.5 mm and consisting of scattered neurons some of which occupy the gigantocellular reticular nucleus. (4) C2 group is a homogeneous population of adrenaline neurons extending from +1 to +3 with dimensions of 2.5 X 3 mm. Accurate visual imaging and quantitation of the spatial organization of medullary catecholaminergic neurons within the classical anatomical framework of cytoarchitecture provides an enhanced comprehension of the organization of this region of the central nervous system.

Animals↗
PubMed1992

Digiplot: a PC programme for drawing tumour volumes for radiation therapy treatment planning using computed tomography images.

Computed tomography (CT) provides explicit information for tumour localisation. However, CT data are displayed in the transverse plane, whereas on the Radiotherapy Simulation films, radiation portals are commonly directed into anteroposterior and lateral planes. Using present day radiotherapy planning computers, it is possible to read in the CT data to determine the tumour volume in anterior/posterior and lateral directions and to perform dosimetry calculations. In cases where the digital computer data cannot be used directly by the radiotherapy planning computer, (for example, owing to compatibility problems) the radiation oncologist must transfer information about tumour location from the CT hard copy images to the longitudinal planes of the simulation film by hand. This manual data transfer can now also be performed using the new personal computer programme, Digiplot, which we have developed and is described below. The application of Digiplot to the head and neck area has shown that it complies with the accuracy requirements laid down by the radiation oncologist. The clinical impact of Digiplot was tested on ten patients with a brain tumour. In two cases, Digiplot detected errors which had not been observed using the conservative (manual) method.

Humans↗
PubMed1980

The normal condition of the fetal electrocardiogram during labour.

A real-time computer system was employed to monitor continuously the fetal electrocardiogram (ECG) during labour. Signals from a scalp electrode were amplified, filtered and passed through an interface system to a digital computer. From 110 patients studied, 37 were selected by rigid criteria which fulfilled a strict definition of normal fetal condition in labour and delivery. The mean values and the range of the various parameters of the fetal ECG complex were defined. As a large amount of data was generated by the system, a method was developed to display the short and long-term dynamic behaviour of the fetal ECG during labour in the form of labour profiles. By further averaging of these labour profiles, the pattern of normal behaviour was established. Certain changes in the fetal ECG, previously thought to be characteristic of fetal distress, occurred in normal patients. The P-R interval was up to 10 per cent shorter during contractions towards the end of labour and there was a long-term trend towards the end of labour for the P-R interval to fall by 7 per cent. The P wave amplitude fell by 30 per cent over the last hour. These trends were statistically significant. The QRS complex was found to lengthen slightly towards the end of labour, but the R-T interval and ST segment displacement displayed no significant changes.

Computers↗
PubMedDate not supplied

Application of discrete computer modeling to the dynamics of cell populations.

Computer simulation of the dynamics of cell populations is discussed in the paper. Fundamental features of CELLSIM simulation language are described. Acute leukemia cell population model was implemented on a digital computer using CELLSIM. Some of the computer outputs are shown. The results obtained so far are interesting and promissing for further research.

Acute Disease↗
PubMed1999

Optical processing architecture and its potential application for digital and analog radiography.

In this report we introduce the fundamental architectures and the potential applications of optical processing techniques in medical imaging. Three basic optical processing architectures were investigated for digital and analog radiography. The processors consist of a module that converts either the analog or the digital radiograph into a coherent light distribution; a coherent optical processing architecture that performs various mathematical operations; a programmable digital-optical interface and other accessories. Optical frequency filters were implemented for mammographic and other clinical feature enhancement. In medical image processing, digital computers offer the advantages of programmability and flexibility. In contrast, optical processors perform parallel image processing with high speed. Optical processors also offer analog nature, compact size, and cost effectiveness. With technical advances of digital-optical interface devices, the medical image processor, in the foreseeable future, may be a hybrid device, namely, a programmable optical architecture.

Equipment Design↗
PubMed1983

Effect of doublet impulse sequences in the crayfish claw opener muscles and the computer-simulated neuromuscular synapse.

The effects of doublet impulse sequences of the excitatory motor axon on the movement of the claw opener muscles in the crayfish were examined. The excitatory motor axon was stimulated electrically with various patterns of doublet impulse sequences generated by a digital computer. Doublet impulse sequences of stimulation produced a larger sustained movement than an uniform impulse sequences at the same mean rate of stimulation. The movement was largest when the interval between the impulses of a doublet was about 5 ms. This interval generated a movement amplitude 25% greater than that for the uniform impulse sequence. A simple model was formulated to stimulate the neuromuscular synapse of the claw opener muscle. The relationship between stimulation sequences with alternating long and short intervals and responses (firing probabilities) of the neuromuscular synapse at the same mean rate was investigated. The responses was classified into two typical types which are noneffective Type I and effective Type II to the absolute refractory period (ARP). The characteristics which are larger responses with short intervals in Type I and reduction of responses in the ARP region of Type II formed a plateau peak of the experimental results. By incorporating the reduction of end-plate potential (EPP) as a property of nonlinear rule for temporal summation into the model, it was shown that Type I response is maximal with a plateau peak at short interval, agreeing well with the experimental results from the claw opener muscles.

Animals↗
PubMed1977

Aspects of on-line digital integration of pulmonary gas transfer.

Digital computers are often used in work physiology to find pulmonary gas transfer on a breath-by-breath basis. A measurement procedure was simulated to determine the effects of sample rate, signal noise levels, and numerical filters on the digital calculations. The results indicated that a trapezoidal rule integration at a sample rate of 30 Hz with no numerical filter can provide satisfactory data. The flow rate and concentration signals should not be out of phase by more than 25 ms. The simple computational procedures give accurate results while minimizing the memory requirements and computation time.

Computers↗