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PubMed2005

Successful of the B-Lynch compression suture in the management of massive postpartum hemorrhage: case reports and review.

The authors describe three patients who developed massive primary postpartum hemorrhage and review the case reports. In two patients, primary postpartum hemorrhage was due to uterine atony, and in one patient it was due to atony and thrombophilia. In all three patients, excellent effect was achieved with hemorrhage reduction by a compression B-Lynch suture alone, with bimanual compression following medicamentous uterotonic therapy. B-Lynch suture is an efficient, safe, and simple method for the treatment of primary postpartum hemorrhage during cesarean section, which successfully reduces the number of urgent postpartum hysterectomies, also preserving subsequent fertility. In our opinion, the method should be included in the algorithm of primary postpartum hemorrhage management at all obstetric departments.

Adult↗
PubMed2003

Monotony of surprise and large-scale quest for unusual words.

The problem of characterizing and detecting recurrent sequence patterns such as substrings or motifs and related associations or rules is variously pursued in order to compress data, unveil structure, infer succinct descriptions, extract and classify features, etc. In molecular biology, exceptionally frequent or rare words in bio-sequences have been implicated in various facets of biological function and structure. The discovery, particularly on a massive scale, of such patterns poses interesting methodological and algorithmic problems and often exposes scenarios in which tables and synopses grow faster and bigger than the raw sequences they are meant to encapsulate. In previous study, the ability to succinctly compute, store, and display unusual substrings has been linked to a subtle interplay between the combinatorics of the subword of a word and local monotonicities of some scores used to measure the departure from expectation. In this paper, we carry out an extensive analysis of such monotonicities for a broader variety of scores. This supports the construction of data structures and algorithms capable of performing global detection of unusual substrings in time and space linear in the subject sequences, under various probabilistic models.

Algorithms↗
PubMed2006

[Surgical treatment of fracture of the ring of axis - "hangman's fracture"].

PURPOSE OF THE STUDY: To evaluate surgical management of the fracture of the ring of axis (FRA), known as "hangman's fracture", and to discuss adequacy of this treatment. MATERIAL AND METHODS: Between 1994 and 2004, 41 patients with FRA were surgically treated in our hospital. We present a retrospective study of 30 cases treated by anterior cervical fixation and fusion and 11 cases treated by a posterior, CT-guided approach (published recently). Our diagnostic algorithm for evaluation of FRA included plain radiographs for basic diagnosis, detailed CT scan, MRI and finally passive lateral flexion-extension fluoroscopy (performed by physician) to assess stability. We also consider discography in selected cases, allowing further evaluation of discoligamentous injury. Fractures were classified according to Levine. Posterior compressive osteosynthesis according to Judet was performed in 11 patients with Levine type I fractures with fracture fragment distraction > 3 mm. Anterior graft and plate fixation was chosen in 30 patients with type II (25 patients) and type I (5 patients) fractures where C2/3 disc injury was confirmed by MRI or discography. There was no case of facet dislocation in our series (type III). Pain, motion restriction and overall satisfaction with neck status were assessed on a scale 1-5 (1 = best) in patients treated with anterior approach. Self-evaluation questionnaires were administered during follow-up (average, 7.3 years; 24 months to 11 years). RESULTS: Anatomically reduced fracture fusion was achieved in all cases (100%) at one year follow-up. Both autologous tricortical (22) and fibular allografts (8) were used for anterior approach. No perioperative complications occurred and no case was aborted. Average hospital stay in patients with standalone FRA was 6.8 days (3-15). Patients wore Philadelphia collar for 4-6 weeks. One patient died during follow up due to unrelated causes. None of the 29 patients treated with the anterior approach reported severe or very severe pain (grades 4 or 5). The average pain score was 1.28. Three patients with isolated FRAs reported slight subjective restriction of movement (grade 2). The "satisfaction with overall neck status" scale showed an average score of 1.62, never worse than grade 2. DISCUSSION: Despite increasing popularity of anterior surgical approach in the treatment of type II FRA, most authors still recommend conservative treatment. Surgical treatment is consensually recommended in type III fractures only. Type I is treated exclusively conservatively. There is currently no evidence-based data supporting any method of treatment of so called "hangman's fracture". The majority of treating surgeons do not consider the status of the intervertebral disc. Dynamic films, simulating the peak point of injury, are usually not performed. Hence, potentially unstable fractures are overlooked. This also explains the lack of long term follow-up data regarding the radiological status of C2/3 intervertebral disc as well as patients' subjective complaints. CONCLUSIONS: Surgery provides plausible results. Compared to conservative treatment, it can offer significant benefits: 1) immediate, better and stable reposition; 2) high fusion rate; 3) shortening of the treatment period with better quality of life. Contrary to conservative treatment modalities, surgery possesses a potential for further development.

Adolescent↗
PubMed1992

Artificial neural network classification of Drosophila courtship song mutants.

Courtship songs produced by Drosophila males--wild-type, plus the cacophony and dissonance behavioral mutants--were examined with the aid of newly developed strategies for adaptive acoustic analysis and classification. This system used several techniques involving artificial neural networks (a.k.a. parallel distributed processing), including learned vector quantization of signals and non-linear adaption (back-propagation) of data analysis. "Pulse" song from several individual wild-type and mutant males were first vector-quantized according to their frequency spectra. The accumulated quantized data of this kind, for a given song, were then used to "teach" or adapt a multiple-layered feedforward artificial neural network, which classified that song according to its original genotype. Results are presented on the performance of the final adapted system when faced with novel test data and on acoustic features the system decides upon for predicting the song-mutant genotype in question. The potential applications and extensions of this new system are discussed, including how it could be used to screen for courtship mutants, search novel behavior patterns or cause-and-effect relationships associated with reproduction, compress these kinds of data for digital storage, and analyze Drosophila behavior beyond the case of courtship song.

Algorithms↗
PubMed2004

A mixed factors model for dimension reduction and extraction of a group structure in gene expression data.

When we cluster tissue samples on the basis of genes, the number of observations to be grouped is much smaller than the dimension of feature vector. In such a case, the applicability of conventional model-based clustering is limited since the high dimensionality of feature vector leads to overfitting during the density estimation process. To overcome such difficulty, we attempt a methodological extension of the factor analysis. Our approach enables us not only to prevent from the occurrence of overfitting, but also to handle the issues of clustering, data compression and extracting a set of genes to be relevant to explain the group structure. The potential usefulness are demonstrated with the application to the leukemia dataset.

Algorithms↗
PubMed2005

A novel document ranking method using the discrete cosine transform.

We propose a new Spectral text retrieval method using the Discrete Cosine Transform (DCT). By taking advantage of the properties of the DCT and by employing the fast query and compression techniques found in vector space methods (VSM), we show that we can process queries as fast as VSM and achieve a much higher precision.

Algorithms↗
PubMed2005

Wave intensity analysis of left ventricular filling.

Wave intensity analysis (WIA) is a powerful technique to study pressure and flow velocity waves in the time domain in vascular networks. The method is based on the analysis of energy transported by the wave through computation of the wave intensity dI = dPdU, where dP and dU denote pressure and flow velocity changes per time interval, respectively. In this study we propose an analytical modification to the WIA so that it can be used to study waves in conditions of time varying elastic properties, such as the left ventricle (LV) during diastole. The approach is first analytically elaborated for a one-dimensional elastic tube-model of the left ventricle with a time-dependent pressure-area relationship. Data obtained with a validated quasi-three dimensional axi-symmetrical model of the left ventricle are employed to demonstrate this new approach. Along the base-apex axis close to the base wave intensity curves are obtained, both using the standard method and the newly proposed modified method. The main difference between the standard and modified wave intensity pattern occurs immediately after the opening of the mitral valve. Where the standard WIA shows a backward expansion wave, the modified analysis shows a forward compression wave. The proposed modification needs to be taken into account when studying left ventricular relaxation, as it affects the wave type.

Algorithms↗
PubMed2000

[Granule formation mechanisms in fluid-bed melt granulation and their effects on tablet properties].

Melt granulations of lactose and PEG 4000 were made with a fluid-bed granulator and for comparison in a high-speed mixer with scraper. Two different mechanisms of granule formation occurred, coalescence and layering. The agglomeration kinetics of layering was modeled. The granulations were compressed on an instrumented press and examined for uniformity of mass, hardness and disintegration time. Remarkable differences in tablet properties were found between the mechanisms of granule formation.

Algorithms↗
PubMedDate not supplied

Chiropractic management and manipulative therapy for MRI documented cervical disk herniation.

OBJECTIVE: This case study reports on three cases of patients with documented cervical disk herniations, who responded to chiropractic management and manipulative therapy. CLINICAL FEATURES: Three patients complaining of neck pain with radiation of pain and tingling into the upper extremities had positive magnetic resonance imaging scans consistent with cervical disk herniations. They also had positive neurophysiologic testing with positive thermography scans and electrodiagnostic studies. INTERVENTION AND OUTCOME: The patients were prescribed a treatment regimen consisting of chiropractic management including bracing, physiotherapy, cervical manipulative procedures, traction and exercises. The patients responded well to care as evidence by posttreatment MRI, electrodiagnostic studies, clinical exam findings and thermography scan findings. CONCLUSION: Patients with and without nerve root compression secondary to cervical disk herniation can and do respond well to chiropractic care. Chiropractic management of this condition can and should be employed prior to more invasive treatment.

Adult↗
PubMed1995

SD filtering for enhancement of a nuclear medicine image sequence.

This paper explores the use of an image sequence processing algorithm, called the simultaneous diagonalization (SD) filter, which can be effectively applied to long noisy image sequences. This filter was developed to filter a spatially invariant image sequence to form one new image in which a desired feature is enhanced and one or more undesired features (and noise) are suppressed in the filtered image. This filtering technique, applied to a long noisy image sequence, can be used to achieve significant data compression for image storage and provide surprisingly good enhanced image reconstructions. For this investigation, SD filtering is applied to a temporal image sequence, a renogram, with compression of a very noisy 180-image sequence to a 4-image set. The renogram, a nuclear medicine technique, was chosen due to its low signal-to-noise ratio over a long image sequence. Before the application of the SD filter, classical image processing techniques, median and averaging filtering, are used as a preliminary method to reduce the image sequence noise content. Compared to any of the images in the original image sequence, the reconstructed images are remarkably good. The SD filter with prefiltering, thus, can collect information distributed over a 180-image temporal sequence with low signal-to-noise ratio.

Algorithms↗
PubMed2002

Cone-beam volume CT breast imaging: feasibility study.

X-ray projection mammography, using a film/screen combination, or digital techniques, has proven to be the most effective imaging modality currently available for early detection of breast cancer. However, the inherent superimposition of structures makes a small carcinoma (a few millimeters in size) difficult to detect when it is occult or in dense breasts, leading to a high false-positive biopsy rate. Cone-beam x-ray-projection-based volume imaging using flat panel detectors (FPDs) may allow obtaining three-dimensional breast images, resulting in more accurate diagnosis of structures and patterns of lesions while eliminating the hard compression of breasts. This article presents a novel cone-beam volume computed tomographic breast imaging (CBVCTBI) technique based on the above techniques. Through a variety of computer simulations, the key issues of the system and imaging techniques were addressed, including the x-ray imaging geometry and corresponding reconstruction algorithms, x-ray characteristics of breast tissue and lesions, x-ray setting techniques, the absorbed dose estimation, and the quantitative effect of x-ray scattering on image quality. The preliminary simulation results support the proposed CVBCTBI modality for breast imaging in respect to its feasibility and practicability. The absorbed dose level is comparable to that of current mammography and will not be a prominent problem for this imaging technique. Compared to conventional mammography, the proposed imaging technique with isotropic spatial resolution will potentially provide significantly better low-contrast detectability of breast tumors and more accurate location of breast lesions.

Algorithms↗
PubMed2004

Computed tomography sound velocity reconstruction using incomplete data.

An approach based on limited-angle transmission tomography for reconstruction of the sound velocity distribution in the breast is proposed. The imaging setup is similar to that of x-ray mammography. With this setup, the time-of-flight data are acquired by a linear array positioned at the top of the compressed breast that both transmits and receives, and a metal plate is placed at the bottom as a reflector. The setup allows acoustic data acquisition for simultaneous B-mode image formation and the tomographic sound velocity reconstruction. In order to improve the sound velocity estimation accuracy, a new reconstruction algorithm based on a convex programming formulation has been developed. Extensive simulations for both imaging and time-of-flight data based on a 5-MHz linear array were performed on tissues with different geometries and acoustic parameters. Results show that the sound velocity error was generally 1-3 m/s, with a maximum of 5.8 m/s. The radii of the objects under investigation varied from 2 to 6 mm, and all of them were detected successfully. Thus, the proposed approach has been shown to be both feasible and accurate. The approach can be used to complement conventional B-mode imaging to further enhance the detection of breast cancer.

Algorithms↗
PubMed2000

American College of Cardiology/European Society of Cardiology International Study of Angiographic Data Compression Phase I: The effect of lossy data compression on recognition of diagnostic features in digital coronary angiography.

OBJECTIVES: This study intended to determine the effect of varying degrees of lossy Joint Photographic Experts Group (JPEG) compression on detection of coronary angiographic features. BACKGROUND: Compression of digital coronary angiograms facilitates playback of images and decreases cost. There are little data on the effect of compression on the accuracy of coronary angiography. METHODS: At six centers, 71 angiographers each reviewed a set of 100 angiographic sequences. The 100 sequences were divided into four, 25-sequence subsets. Each subset of 25 was displayed either as original images or at one of three compression ratios (CRs) (6:1, 10:1 or 16:1). The effect of lossy compression on the sensitivity and specificity for detection of diagnostic features was determined. The effect of compression on subjective measures of image quality graded by the angiographers was also examined. RESULTS: Lossy compression at a ratio of 16:1 decreased the sensitivity for the detection of diagnostic features (76% vs. 80% p = 0.004). The largest effect was in the detection of calcification (52% vs. 63% at 16:1 compression vs. original images, p < 0.001). Subjective indicators of image quality indicated a reduction in confidence in interpretation at CRs of 10:1 and 16:1. CONCLUSIONS: With increased ratios of lossy compression, a degradation of digital coronary angiograms occurs that results in decreased diagnostic accuracy. The sensitivity for detection of common diagnostic features was decreased, and subjective assessment of image quality was impaired. Caution is warranted in the interpretation of coronary angiograms that have been subjected to lossy JPEG compression beyond a ratio of 6:1.

Adult↗
PubMed1998

[Window width as a dosage-relevant factor in high-contrast structures in CT].

PURPOSE: To establish the relationship between window width and dose to be applied in low-dose high-resolution (HR) computed tomography (CT). MATERIAL AND METHODS: Low-dose HR CT-scans of the petrous bone displayed with different window values were analyzed for identification of osseous details. For two homogeneous phantoms, standard deviation of CT-numbers were measured in order to calculate the fraction of pixels not displayed within the correct grey level. RESULTS: The broadest window used (4000 HU) allowed the best distinction of osseous structures. Standard deviation of CT-numbers in the phantoms varied between 28.5 and 43.2 (mean = 33.6) HU. Thus, only 26.6% of all pixels are displayed in the correct grey level for a 1000 HU-window, but 82.3% for a 4000 HU-window. CONCLUSION: When using low doses and HR-reconstruction algorithms, large window widths allow for an optimal assessment of high-contrast structures. Under these conditions, even high standard deviations of the CT-numbers will not compromise image evaluation. Due to the restricted number of grey-levels that can be distinguished by the human eye, image noise is compressed into a smaller number of discernable grey-levels. Because of the inverse square root function between dose to be applied and window width used (derived in the article), an even minor enlargement of window permits considerable reductions of patient exposure while the discernable image noise remains constant.

Artifacts↗
PubMed1990

Quadtree-based data compression of abdominal CT images.

An ROC study was performed to evaluate the effect of quadtree-based data compression on the diagnostic yield of CT images. Seventy images were selected from a series of consecutive abdominal/pelvic CT scans. Following the application of quadtree-based compression, all images were reviewed independently by three radiologists. The images were analyzed at six decreasing irreversible compression ratios (30.6:1 to 7.4:1), as well as after reversible compression (2.9:1). ROC curves reveal a gradual decrease in clinical accuracy with increasing compression ratios. At a compression ratio of 7.4:1, sensitivity for all major abnormalities was 99% with a specificity of 93%. As the compression ratio was increased to 30.6:1, sensitivity and specificity dropped to 75% and 83% respectively. Execution times for compression and decompression of the CT images with a PC-AT based digital radiography system varied from 24.7 to 18.5 seconds and from 16.2 to 5.1 seconds respectively, decreasing with higher levels of compression. We conclude that quadtree-based compression of abdominal CT images may have practical applications for a PC based digital radiography system.

Algorithms↗
PubMed1988

Implications of protein folding. Additivity schemes for volumes and compressibilities.

Partial specific volume and compressibility properties of the extended state of proteins are estimated from additivity schemes using revised amino acid and peptide data. These calculated properties are compared with the experimental data of the native state in order to assess the contribution from folding. Results of this treatment show that, in the case of partial specific volumes, there is close agreement between the two data sets for a number of proteins. The implication is that subtle compensatory contributions in volume occur during the folding process. In the case of compressibilities, however, a substantial difference is observed which is believed to arise because of the hydrophobic interior created in the native protein as a result of the folding process. Using suitable measures of protein hydrophobicities and estimates of the fraction of buried apolar residues, a "micellar model of protein compressibility" is proposed and tested for several proteins. Results obtained from this model show good agreement with the experimental data for the native state of a number of proteins.

Algorithms↗
PubMed1988

Clinical usefulness of an algorithm for the early diagnosis of spinal metastatic disease.

We have previously reported an algorithm that invokes several imaging modalities in the early detection of metastatic and benign disease of the spine in patients with cancer (J Clin Oncol 4:576, 1986). The development of new lesions (shown by Tc99m bone scans) in cancer patients with normal neurological examinations is further evaluated with plain radiographs, spinal computed tomography (CT), and CT myelography (CT-M). Of 60 patients in the original study, 28% were diagnosed as having only benign disease and the remainder had spinal metastases. Thecal sac impingement was seen in 47% of patients with metastatic disease and disruption of the posterior vertebral cortex was noted in all patients with epidural compression. We now report the 2-year follow-up of 55 of these patients. Without treatment, the 17 patients diagnosed with benign disease have shown no evidence of local failure in the spine and median survival is greater than 27 months. Thirty-eight patients diagnosed with spinal metastases had a median survival time of 16.9 months. Radiation therapy directed by CT-M findings provided pain relief in 78% of patients with back pain and metastatic disease. No patient, including 19 with thecal sac impingement, developed clinical myelopathy. These results demonstrate the usefulness of an imaging algorithm for the early identification and distinction of spinal metastatic disease and benign disease in patients with cancer.

Algorithms↗
PubMed2005

Pregnancy-related vertebral hemangioma. Case report, review of the literature, and management algorithm.

Pregnancy is a recognized risk factor for quiescent vertebral hemangiomas becoming symptomatic; this usually occurs during the 3rd month of gestation. The natural history of these lesions is poorly understood, and treatment practices must consider the overall safety of the mother and fetus. The authors report a case of cervical vertebral hemangioma presenting during the 24th week of pregnancy and review the current literature. A 26-year-old woman in her 24th week of pregnancy presented with upper-back pain and progressive spastic paresis in the legs. Neuroimaging studies revealed a diffuse C-7 vertebral body lesion with extradural extension and compression of the spinal cord consistent with a vertebral hemangioma. Successful decompression was accomplished, and the fetus experienced no adverse effects from the surgery. In a review of the literature, 23 cases of pregnancy-related vertebral hemangioma dating back to 1927 were identified. Prepartum surgical decompression was performed in eight patients, postpartum surgery was performed in 12, and surgery was not performed in four. Overall, patients experienced excellent neurological recovery, regardless of the severity and duration of spastic paresis. Observation should be considered for symptomatic patients at greater than 32 weeks gestation. Surgery should be considered for patients with severe neurological deficits at less than 32 weeks of gestation.

Adult↗