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[Automatic evaluation of ERA based on stochastic-ergodic conversion (SEC) (author's transl)].

Averaging of stimulus-locked EEG-samples often leads to unreliable results in patients for which ERA is indispensable for diagnostics, namely in the case of uncooperative children with hearing disorders. SEC converts the EEG into a binary random sequence which after averaging results directly in a probability measure for the response. Clinical experiences with an automatic evaluation procedure based on SEC are reported.

Adult

High volume screening procedures for hypobetalipoproteinemic activity in rats.

We describe high volume screening tests for hypobetalipoproteinemic agents in which compounds are administered orally to cholesterol-cholic acid fed (hypercholesterolemic( or normally fed weanling rats for 4 days. In these tests total serum cholesterol levels and heparin precipitating lipoproteins (HPL) are determined by automated analyses interfaced with a computer which eliminates all manual data reduction and provides necessary reports. The hypercholesterolemic rat test detects compounds which specifically reduce HPL (beta and pre beta lipoproteins) causing a decrease in the HPL: cholesterol ratio. Such activity is called hypobetalipoproteinemia. This activity is exhibited by bicyclo (2.2.2)-octyloxyaniline (U-26328) but not by any of the familiar hypocholesterolemic agents including clofibrats, lifibrats, nicotinic acid, probucol, triparanol, lentysine, D-throxine or the estrogens estrone and diethylstilbestrol.

Analog-Digital Conversion

The resolution of arterial pulses into forward and backward waves as an approach to the determination of the characteristic impedance.

Pressure and flow recordings from a given site in an artery can be used for the resolution of the pulse wave into its forward and backward components if the characteristic impedance (Z) is known. The principle of this method was reported by von Kries in 1892. In the present work, the procedure is first applied to a theoretical, non-uniform tube model. The characteristic impedance of the model are assumed to be real magnitudes. From the results it is seen that the calculated backward wave provides a criterion which indicates whether the true value of Z actually has been used for the resolving procedure. If, as in the case of natural pulses, Z is not known, its value can be obtained by repeatedly performing the resolving procedure using various values of Z, and choosing the value of Z employed to calculate the backward wave which best fits the criterion. The method is demonstrated on pulses of the abdominal aorta and carotid artery of the dog. The results are compared with the average values of the input impedance in the higher frequency range.

Analog-Digital Conversion

Diagnosis and quantification of arrhythmias in ambulatory patients using an improved R-R interval plotting system.

An improved technique for identification, diagnosis and quantification of arrhythmias during rest or ambulatory electrocardiographic recording is described. With simultaneous plotting of the R-R interval and the QRS duration and QRS vector measurement of each beat versus time, all periods of arrhythmias or abnormal complexes can be identified and characterized. Analog electrocardiographic samplings are used to confirm the diagnosis of the arrhythmia and to exclude artifact. The availability of a permanent record for the characterization of each QRS complex enables the physician to check the technician's analysis of the recording and to relate all events to the patient's heart rate and clinical symptoms. This technique also provides data for quantification of ventricular arrhythmias.

Ambulatory Care

Influence of preoperative left ventricular function on results of homograft replacement of the aortic valve for aortic stenosis.

The effect of preoperative left ventricular function on early and late prognosis was assessed in 103 patients with aortic stenosis who underwent left ventricular cineangiography before homograft replacement of the aortic valve. The patients were separated into two groups: Group A (58 patients) with an ejection fraction of 0.46 or more and Group B (45 patients) with an ejection fraction of 0.45 or less. The two groups were compared with respect to clinical and hemodynamic data as well as operative result. There was poor correlation between clinical data and left ventricular function. In Group A there were three early deaths (5.2 percent) and three late deaths (5.2 percent) compared with no early and six late deaths (13.3 percent) in Group B during the follow-up period of 12 to 102 months (mean 43 months). Most patients in Group B showed considerable symptomatic improvement but less than that observed in Group A. Forty-two patients (13 in Group A and 29 in Group B) underwent repeat cardiac catheterization and coronary angiography. Improvement in left ventricular function as assessed by radial analysis of segmental wall motion and ejection fraction was observed in 20 of the 29 patients in Group B. Failure of left ventricular function to improve was associated with additional coronary artery disease in the majority of patients. It is concluded that poor left ventricular function does not increase the risk of aortic valve replacement for aortic stenosis and that improvement in left ventricular function can be expected in the majority of patients.

Adolescent

Sequential frequency analysis: a method to quantify event related EEG changes.

A hybrid method of frequency analysis is described by means of which EEG changes related to stimulus-response tasks have been studied. Frequency analysis was carried out using a bank of 20 analog filters by means of which quantitative spectral data were obtained as a function of time. Storing, averaging and statistical analysis of these time-varying spectral data were performed, using a general purpose computer (PDP 11-20). The method proved to be useful for analysis of the non-stationary properties of EEG changes related to certain behavioural events.

Analog-Digital Conversion

EEG patterns during 'cognitive' tasks. I. Methodology and analysis of complex behaviors.

This paper presents a methodology which uses nonlinear pattern recognition to study the spatial distribution of EEG patterns accompanying higher cortical functions. The multivariate decision rules reveal the essential EEG patterns which differentiate performance of two tasks. Cross-validation classification accuracy measures the generality of the findings. Using this method, EEG patterns were derived from a group of 23 adults during performance of several complex tasks, including Koh's block design, writing sentences, mental paper folding, and reading silently. These patterns discriminate between the tasks, are consistent with, and extend the results of, visual EEG interpretations and univariate analysis of spectral intensities. Since writing sentences could not be distinguished from mere scribbling, it is unclear whether the EEG patterns found to distinguish complex behaviors were related to the cognitive components of tasks, or to sensory-motor and performance-related factors.

Adult

EEG patterns during 'cognitive' tasks. II. Analysis of controlled tasks.

This experiment was designed to distinguish possible EEG correlates of the cognitive components of tasks from EEG patterns associated with stimulus characteristics, limb and eye movements, and performance-related factors such as subjects' ability and effort. Thirty-two right-handed adults each performed 30 trials, lasting 6-15 sec each, of four simplified, controlled tasks: mental rotation of geometric forms, serial addition of a column of signed digits, substitution of letters with subsequent word recognition and visual fixation. The first three tasks could not be differentiated from each other. Each of these tasks could be differentiated from visual fixation by approximately 10% generalized reductions in alpha and beta band intensities, and slight increases in theta band intensities frontally and occipitally. We conclude that the EEG patterns which differentiated the complex tasks described in Part I were due to inter-task differences in stimulus characteristics, efferent activities and/or performance-related factors, rather than to cognitive differences. With these controls, no evidence for lateralization of different types of cognitive activity was found in the EEG.

Adult

Effects of stimulus frequency on the blink reflex during rest and a task.

Blink reflexes were studied in 84 healthy subjects, applying 4 different stimulation frequencies. The experiments were subdivided into 3 periods: rest, binary choice task and final rest period. Independent of the applied stimulation frequency, an increment of R1 during the task was found, and it was concluded that R1 amplitude reflects the state of arousal of the subject. Within each of the 3 periods, R1 amplitudes decreased independently of the applied frequency, while R2 amplitudes decreased dependent on the applied frequency, i.e. at lower frequencies a smaller decrement in time could be observed. It was concluded that R2 habituated at frequencies lower than those so far reported.

Analog-Digital Conversion

Comparison of interwave latencies of brain stem auditory evoked responses in narcoleptics, primary insomniacs and normal controls.

A study of brain stem auditory evoked responses (BAER) was carried out in 10 narcoleptics, 10 primary insomniacs and 10 normal controls to determine if a neurophysiologic abnormality could be detected in these primary sleep disorders. The mean interpeak conduction times of Wave I-III, III-V and Iv were compared between the following groups: normal controls awake and in monitored sleep; narcoleptics awake and in monitored sleep, normal controls awake and narcoleptics awake; normal controls awake and insomniacs awake; narcoleptics awake and insomniacs awake; narcoleptics with cataplexy (n = 6) awake and narcoleptics without cataplexy (n = 4) awake. No significant differences were found which suggests that these sleep disorders represent dysfunctions which do not involve brain stem structures subserving the BAER.

Adult

The measurement of distortion: theoretical considerations.

When very find measurements are recorded for the purpose of establishing distortion values, from the standpoint of accuracy, specific procedures must be developed. In the procedural system defined here, a potential major source of error is indicated and the means of overcoming this error established. From the standpoint of modern electronic technology, the use of an analogue-to-digital interface with a digital computer is considered extremely advantageous and allows the utilization of technical help to carry out the preliminary measurements. Under these circumstances, major error sources, such as reader error and calculation error, are eliminated. Further, multiple readings on each point can be made without significant sacrifice of time. This latter statement can help define the reading accuracy on each point and allows an immediate further set of readings on any point that has a large variation in the initially established set of readings. The applicability of this approach to any system in which an accurate set of readings is required to define distortion or some other parameter is limited only by the imagination of the investigator. Measuring points can be established at any desired location, and the number required is a function of the mathematical analysis being attempted. The use of a digital computer to compute the final values allows an immediate remeasurement of the initial values if necessary, since the computer response time is of the order of seconds for the calculations carried out. This is very important if changes in the experimental setup are likely to occur with time. In general, a computerized scheme such as is proposed here allows the investigator to concentrate on the experiment rather than the calculation of results. Also, the use of technical help to carry out delicate measuring procedures can allow the investigator more time to analyze the final results.

Analog-Digital Conversion

Computer-monitored radionuclide tracking of three-dimensional mandibular movements. Part I: theoretical approach.

A new technique for the three-dimensional recording of a person's mandibular movement is described. A small and harmless radioactive source is fixed on the patient's skin at the point of interest or sealed in a tooth cavity. Using the proper collimation, the motion of the point source is recorded via a gamma camera and minicomputer. Long-term storage on a magnetic device offers playback, slow motion facilities, and data analysis through the use of sophisticated computer languages. Simultaneous recordings using two cameras, or postsynchronization of two different views of an experiment, enable the three-dimensional restitution of mandibular movements. Superimposition of a grid of radioactive spots spaced at measured intervals during the recording permits a straightforward calibration of the patient's motion. Multiple sources in a single experiment may be recorded to describe the displacement of several points of interest. This method, derived from nuclear medicine techniques, offers a powerful tool of general interest for the tracking of dynamic events in many fields of dentistry such as temporomandibular joint dysfunction and prosthetic restorative techniques. Further considerations on our experimental settings and results will be published in part II.

Analog-Digital Conversion

The measurement of distortion: mathematical considerations.

The proposed method for accurately determining the coordinates of given points in a three-dimensional space, along with the mathematical rigid body displacements to move these points into some predefined reference position, builds a complete model of the positional relationships of these points. On this basis additional information can easily be extracted, e.g., the distance between any two given points or the angle in degrees between any two given points or the angle in degrees between any three given points. An important advantage of the procedure is that the normally tedious calculations involved with distortions have been computerized, thus eliminating the tedium of repeated calculations. The possibility of calculation error is also reduced. Perhaps the greatest advantage to the investigator arises from the fact that once the procedural routine has been established and the computer programs written, the entire procedure can be done by technical personnel and does not necessarily require a large time committment from the principal researcher. Also, because of the normally small amount of time needed to read the coordinates and compute the inherent distortions, a set of computed distortions which appear unreasonable may be checked by repeating the entire set of coordinate readings and distortion calculations in a relatively short time.

Analog-Digital Conversion

Pulmonary vascular impedance analysis of adaptation to chronically elevated blood flow in the awake dog.

Pulsatile pulmonary hemodynamics were analyzed in a chronic awake canine high flow model. Standard mean flow and pulsatile flow hemodynamics were measured and alterations in the proximal pulmonary vascular physical properties were quantified by the characteristic impedance (Zo). Pulmonary vascular resistance (PVR), which assesses arteriolar-capillary recruitment of perfusing radius and measures a more distal pulmonary vascular response to changing flows, also was calculated. Twelve control dogs were studied and had mean Qpa (pulmonary blood flow) = 2.02 +/- 0.15 liters/min, Zo = 193 +/- 20 dyne sec cm-5 and PVR = 416 +/- 32 dyne sec cm-5. Ten dogs were studied awake 20 weeks after creation of bilateral arteriovenous fistulae. Five of these shunted dogs, designated group A, developed Qpa = 3-4 liters/min (mean = 3.80 +/- 0.09, P less than 0.001 different from control group); the other five dogs (group B) developed Qpa = 4-8 liters/min (mean = 5.87 +/- 0.16, P less than 0.001). In group A, Zo = 143 +/- 8 (P less than 0.05) and PVR = 249 +/- 6 (P less than 0.10). In group B, Zo = 90 +/- 5 (P less than 0.005) and PVR = 126 +/- 14 (P less than 0.01). The total input power (potential and kinetic) was 125% above the controls for group A (P less than 0.001) and 264% for group B (P less than 0.001), but the mean energy components increased significantly more than did the pulsatile components. These data demonstrate a lower impedance to pulsatile flow during chronically elevated total flow which effects a reduction in both the work load of the right ventricle and the transmission of energy to the precapillary bed. Analysis of the alterations in characteristic impedance suggests a distinct proximal pulmonary vascular mechanism of decreased vessel stiffness (decreased elastic moduli) for adaptation to chronically elevated flow loads which is in addition to the two geometric alterations of proximal arterial dilation and distal vascular channel recruitment.

Analog-Digital Conversion

Low-frequency harmonic acceleration as a test of labyrinthine function: basic methods and illustrative cases.

These preliminary findings reveal that low-frequency harmonic acceleration can be used to detect unilateral peripheral deficits that agree with caloric findings. However, the responses to sinusoidal acceleration are less variable than the caloric responses and allow one to more closely evaluate changes in pathology with time. Therefore, it appears that harmonic acceleration provides additional information that is useful in confirming other test results and that a complete otoneurologic evaluation should include this type of rotational testing.

Adult