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Biomedical subjects

T M Cole

Publications and source records attributed to T M Cole.

At least 19 recordsLinked to original sources
PubMed1999

The relationship in neonates between clinically measured head circumference and brain volume estimated from head CT-scans.

OBJECTIVE: To determine if the frontal-occipital head circumference correlates with brain volume on CT and to investigate correlations between the volumes of different brain subdivisions in live neonates. METHODS: Records were studied from 27 neonates with anatomically normal head CT-scans which were ordered for clinical reasons, and which were performed at Johns Hopkins Hospital. Clinical data were abstracted from medical records. Brain volumes were estimated by digitizing the structures of interest on each slice of head CT-scans. RESULTS: In this sample of 27 infants with a mean birth weight of 3000.4 +/- 668 g, mean head circumference of 33.5 +/- 1.8 cm, and mean gestational age of 37 weeks and 4 days +/- 24 days, the mean of total brain volume was 333.0 +/- 78.3 ml. The correlation between clinically measured head circumference and total brain volume was 0.55 (P < 0.003). Regression of total brain volume on head circumference and its second and third powers accounted for 43% of the variation in total brain volume. Other predictor variables, namely infant race, sex, gestational age, and maternal age, were not significant in this regression once head circumference was included. The slope of the cubic function of head circumference as a predictor of brain volume was greatest below the mean head circumference of 33.5 cm. Brain volume leveled off at head circumferences greater than the mean. CONCLUSION: Head circumference is a powerful predictor of total brain volume in the neonate: below the approximate head-circumference mean of 33.5 cm, smaller head circumference indicates smaller total brain volume.

Birth Weight↗
PubMed1998

Capturing data from three-dimensional surfaces using fuzzy landmarks.

Anatomical landmarks are defined as biologically meaningful loci that can be unambiguously defined and repeatedly located with a high degree of accuracy and precision. The neurocranial surface is characteristically void of such loci. We define a new class of landmarks, termed fuzzy landmarks, that will allow us to represent the form of the neurocranium. A fuzzy landmark represents the position of a biological structure that is precisely delineated, but occupies an area that is larger than a single point in the observer's reference system. In this study, we present a test case in which the cranial bosses are evaluated as fuzzy landmarks. Five fuzzy landmarks (the cranial bosses) and three traditional landmarks were placed repeatedly by a single observer on three-dimensional (3D) computed tomography (CT) surface reconstructions of pediatric dry skulls and skulls of pediatric patients, and directly on four of the same dry skulls using a 3Space digitizer. Thirty landmark digitizing trials from CT scans show an average error of 1.15 mm local to each fuzzy landmark, while the average error for the last ten trials was 0.75 mm, suggesting a learning curve. Data collected with the 3Space digitizer was comparable. Measurement error of fuzzy landmarks is larger than that of traditional landmarks, but is acceptable, especially since fuzzy landmarks allow inclusion of areas that would otherwise go unsampled. The information obtained is valuable in growth studies, clinical evaluation, and volume measurements. Our method of fuzzy landmarking is not limited to cranial bosses, and can be applied to any other anatomical features with fuzzy boundaries.

Child↗
PubMed1998

A simple method for visualization of influential landmarks when using euclidean distance matrix analysis.

Euclidean distance matrix analysis (EDMA) differs from most other morphometric methods for the analysis of landmark coordinate data in that it is coordinate-system invariant. However, strict adherence to coordinate-system invariance (for both biological and statistical reasons) introduces some difficulty in using graphic aids for the analysis and interpretation of EDMA results. We present a simple and effective graphic method to help localize important differences in form, growth, or shape by identifying "influential" landmarks. Examples are presented using simulated data and real data involving both children with craniofacial dysmorphologies and sexual dimorphism in adult Macaca fascicularis.

Acrocephalosyndactylia↗
PubMed1995

Precision, repeatability, and validation of the localization of cranial landmarks using computed tomography scans.

Computed tomography (CT) has brought to the craniofacial surgeon a three-dimensional representation of internal structures. CT scans provide visualization of anatomy for preoperative planning and postoperative evaluation. Beyond visualization, however, a CT scan enables assessment of measurements useful to clinicians and basic scientists. All measurement systems used with CT require the ability to accurately locate regions of interest on the image (i.e., areas, volumes, outlines, curves, surfaces, points). This study evaluates the precision and repeatability of locating anatomic landmarks in three dimensions on CT slice images, and validates these locations using an established measurement system. The average error of landmark position is always less than 0.5 mm and for some landmarks error is negligible. Repeatability studies show that less than 2% of the total variance in our data is due to measurement inaccuracy. Although data collected from CT scans are internally consistent, validation results caution the use of CT data in combination with data collected using calipers or other direct means of measurement.

Adult↗
PubMed1994

Prevention of secondary disabilities after brain injury and spinal cord injury: implications for future research.

Over the past decade there has been increased emphasis upon prevention of disability. Although it is obvious that preventing a disability is the most desirable approach, disabilities will nonetheless occur. When they do, we must treat them and prevent additional disabilities from following the original ones. Indeed, this separation of disabilities has led to a clearer understanding of their prevention, namely primary, secondary, and tertiary prevention.

Brain Injuries↗
PubMed1993

Taxonomic affinity of the early Homo cranium from Swartkrans, South Africa.

A quantitative analysis that employs randomization methods and distance statistics has been undertaken in an attempt to clarify the taxonomic affinities of the partial Homo cranium (SK 847) from Member 1 of the Swartkrans Formation. Although SK 847 has been argued to represent early H. erectus, exact randomization tests reveal that the magnitude of differences between it and two crania that have been attributed to that taxon (KNM-ER 3733 and KNM-WT 15000) is highly unlikely to be encountered in a modern human sample drawn from eastern and southern Africa. Some of the variables that differentiate SK 847 from the two early H. erectus crania (e.g., nasal breadth, frontal breadth, mastoid process size) have been considered to be relevant characters in the definition of that taxon. Just as the significant differences between SK 847 and the two early H. erectus crania make attribution of the Swartkrans specimen to that taxon unlikely, the linkage of SK 847 to KNM-ER 1813, and especially Stw 53, suggests that the Swartkrans cranium may have its closest affinity with H. habilis sensu lato. Differences from KNM-ER 1813, however, hint that the South African fossils may represent a species of early Homo that has not been sampled in the Plio-Pleistocene of eastern Africa. The similarity of SK 847 and Stw 53 may support faunal evidence which suggests that Sterkfontein Member 5 and Swartkrans Member 1 are of similar geochronological age.

Analysis of Variance↗
PubMed1988

Multivariate analysis of relative growth in the limb bones of Arikara Indians.

The description of relative growth in the limb bones of Arikara Indians from a large archeological sample (N = 412 nonadults) is approached by (1) using a multivariate generalization of the bivariate scaling relationship, and (2) extracting the principal components of log shape. The two methods are shown to be complementary, and advantages accrue to both. Although most of the variability among individuals is related primarily to differences in size, significant age-related differences in shape are disclosed by both approaches. Negative forelimb growth allometry contrasts with positive hind limb allometry and results in decreasing intermembral indices with changing size and age. A within-limb, disto-proximal growth gradient is also evident, inasmuch as the proximal element within each limb grows faster than the distal. A functional link to the human specialization for bipedal locomotion and posture is apparent. A comparison between the ontogenetic results of this study and those from an analysis of static adult scaling from the same populations discloses no similarities between the two and suggests that one type of data cannot be substituted for the other.

Adolescent↗
PubMed1988

Patterns of referral to a university hospital consultation service: failure to accurately predict need for physiatric services.

The purpose of this study was to determine the predictive value of screening the narrative sections of the consultation request form to determine the need for physiatric intervention rather than PT intervention alone. We conducted a review of 107 requests for consultation from various acute care services at our hospital. After reviewing the referring physician's narrative summaries, we determined that 36% of 107 patients would require physiatric evaluation, and that the remaining patients could be "passed through" to PT for treatment. After evaluation of the medical records and examination of the patients, 54% of patients required physiatric assessment and only 45% could be "passed through" to PT. The hypothesis that this narrative information would be an adequate predictor of need for physiatric consultation was rejected at the p less than 0.005 level (chi 2 = 18.63; df = 1). In addition, the referring service indicated whether it wished PT or physiatry to evaluate the patient on the consultation form. The hypothesis that screening for the need for physiatric intervention by the indicated preference of the referral was rejected at the p less than 0.0005 level (chi 2 = 20.45; df = 1). We concluded that we could not reliably predict when patients required physiatric or only PT intervention based on the consultation request narrative. Ongoing physiatric involvement on a consultative basis, educational conferences, and other forms of education for house staff and attending physicians may serve to improve understanding of physiatric services and physiatric utilization.

Health Services Needs and Demand↗
PubMed1984

Engineering therapy: an approach to treatment of a patient with severe cognitive and physical handicaps.

"Engineering therapy" may be defined as therapeutic intervention based on technologic aids. The concept is illustrated by the case of a 63-year-old woman who sustained a traumatic brain injury that resulted in severely limited functional capabilities and inability to communicate or interact with her environment in any meaningful way. Although she participated in an intensive rehabilitation program, no significant improvement occurred and she was transferred to a nursing home. Two years postinjury a microcomputer and other technical aids were used to facilitate communication and interaction with her environment. During the course of the engineering therapy, voluntary motor skills and endurance significantly improved and communication skills markedly increased. Many secondary benefits were also noted such as increased participation by the nursing home staff in her therapy. It is concluded that engineering therapy can benefit severely handicapped patients even after many years of disability.

Brain Injuries↗
PubMed1977

The evaluation of sexual health services in a medical setting.

An interdisciplinary Sexual Health Services unit has been established at the University of Minnesota Medical School that offers counseling and treatment programs for a wide variety of sex-related concerns and problems. The programs are based on the principles of responsibility for self, permission to be sexual, the use of reeducation, the facilitation of increased awareness in clients, and structured behavior change. The programs have been evaluated according to client satisfaction with the extent to which they have met pretreatment goals and according to results of pre/posttesting with objective instruments. One year follow-up results from 131 clients and immediate posttreatment results from 411 clients show positive change in a large majority of cases.

Behavior Therapy↗