Biomedical subjects
Publications and source records attributed to M Gorek.
This article addresses smooth muscle physiology, electromechanical and pharmacomechanical coupling, computed-based interpretations, and the role of electromyography in the diagnosis of erectile dysfunction.
An electromyogram of the corpora cavernosa (CC-EMG) imparts information on the autonomic cavernous innervation and/or the cavernous smooth muscles. The CC-EMG is interpreted mainly by evaluation of signal patterns of higher activity. The time required for interpretation is reduced by the implementation of a computer-assisted diagnosis program with a Microsoft Windows user interface. The program offers four levels of diagnosis: on the first level, recordings can be edited; on the second and third levels, signal patterns can be searched or evaluated; and on the last level the final diagnosis is provided. The computer-assisted interpretation is based on digital measurement data. These data have been obtained through a 170.6-Hz sampling frequency and a quantization of 10 V/12 Bit of the amplified signal. The first task of this diagnosis program is to discover and extract signal patterns of higher activity from data stored on the hard disk of a personal computer (PC). For a mathematic description of these patterns the following features were defined: relative time position, relative reproducibility, part of normal phases, and part of whip phases. Syntactic pattern recognition was introduced to identify the characteristic signal forms. An evaluation of the patterns could be derived from these features using fuzzy logic. For a summary of the evaluated patterns the variable global normality was established. The global normality forms an important evaluation basis along with the global synchronism, which represents an investigator's first impression of a recording. The final diagnosis is completed using fuzzy logic. The program was tested by comparison of expert and computer diagnoses. A total of 30 records were independently evaluated by an expert team and the computer program. With reference to the four classified levels of diagnosis a correspondence of 70% could be found. Furthermore, the rate in each of the classified levels was higher than 50%. The discrimination between normal and abnormal evaluation was 80% for clinical routine. Our results show that a computer-assisted interpretation of the CC-EMG can be achieved using mathematically based software. Within the last 7 months this computer-assisted CC-EMG program proved to be of great help in routine diagnosis. Furthermore, it demonstrated results comparable with a blinded-expert interpretation. This approach should bring about dramatic improvements in the diagnosis of erectile dysfunction.
The electromyogram of the corpora cavernosa (CC-EMG) provides information on the autonomic innervation and/or smooth musculature. The interpretation of the CC-EMG, usually by evaluating signal patterns of higher activity, is time-consuming. To improve this situation, a computer-aided diagnosis employing a Microsoft Windows user interface was developed. The computer-aided interpretation is based on digital measurement data obtained using a 170.6 Hz sampling frequency and quantization of 10 V/12 bits of the signal. The first task of the program is to extract signal patterns of higher activity from stored data. To describe these patterns in mathematical terms, the features "relative time position", "relative reproducibility", "portion of normal phases", and "portion of whip phases" are calculated. Characteristic signal forms (normal and whip phases) are identified by means of syntactic pattern recognition. Using fuzzy logic, the features are used to effect pattern evaluation. To summarize the evaluated patterns, the variable "global normality" has been established, and linked to the "global synchronicity" at a second fuzzy logic level, to produce the final diagnosis. Finally, 30 records were evaluated independently by a team of experts and by the computer program. In relation to four established diagnostic classes, a correspondence of 70% was found. Furthermore, the accuracy achieved in each of the individual classes was better than 50%. Discrimination between normal and abnormal evaluation, which is of particular interest, reached 80%.
Recently, corpus cavernosum EMG (CC-EMG) has been introduced into the diagnostic evaluation of erectile dysfunction. It has been demonstrated that CC-EMG may be a valuable tool in the evaluation of the integrity of the autonomic innervation of the corpus cavernosum. The interpretation and comparison of the recorded data still remains problematic due to a lack of standardization of recording procedures, technical equipment and of data analysis software. The assessment of recorded data was originally performed visually and nonquantitatively, however, more recently, computer-aided analysis of digitized measurements has proved to be more objective, less time-consuming and more reliable. Future efforts should be aimed at creating larger databases and differentiating between the various sources of lesions within the autonomic neural network of the corpus cavernosum.