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[Visual EEG analysis in controlling intravenous anesthesia using propofol].

Since the discovery of brain waves by Berger, repeated efforts have been made to use the electroencephalogram EEG for monitoring and controlling anesthesia. Owing to its susceptibility to failure and the high expenditure regarding technology and personnel, the technique has not yet been adopted in routine anesthesia, however. In the study now reported an attempt was made to apply the positive experience with the recording and interpretation of EEG in the development of new anesthetic agents in the experimental laboratory, during routine clinical operations. The anesthetic used in the study was Propofol, an induction hypnotic that has only recently been introduced, together with nitrous oxide and repeated doses of fentanyl. Propofol is distinguished by its fast onset of action and short inactivation time; it is therefore suitable for induction and maintenance of anesthesia. The aim of the study was to maintain predetermined stages of sleep during anesthesia with the aid of visual on-line analysis of the EEG and to establish the dose of Propofol required for this purpose. The operations-general and orthopedic surgery-lasted 70-190 min (average duration: 120 min). In accordance with the randomization plan, the maintenance dose of Propofol was controlled in such a way that in ten patients light sleep levels (C0 to D1) and in the other ten deep sleep levels were maintained. The EEG was recorded via five active scalp electrodes (FP2, F4, C4, P4, O2) with reference to a joint electrode (A2). The stages of sleep were classified according to Kugler.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Four-dimensional ultrasonography for dynamic bladder shape visualization and analysis during voiding.

OBJECTIVE: The purpose of this study was to describe initial applications of 4-dimensional ultrasonography (4DUS) for visualizing dynamic change in 3-dimensional (3D) bladder shape as well as for analyzing intravesical volume and diameters during voiding. METHODS: In 15 healthy volunteers and 5 patients with lower urinary tract symptoms, 4DUS images of the bladder during voiding were obtained by transabdominal 4DUS and compared with the outcome of uroflowmetry. Changes of intravesical volume as well as diameters in axial, coronal, and sagittal planes were measured and analyzed in comparison with uroflow data. RESULTS: Dynamic 3D visualization of the bladder shape was feasible in all 20 men. Multiplanar display of 4DUS showed dynamic 3D images of the bladder during voiding to be simultaneously visualized in the axial, coronal, and sagittal planes. The change and decrease rate in intravesical volume calculated by 4DUS data had significant correlation with the average flow rate (P = .02) and the maximum flow rate (P = .04), respectively. Among the 3 diameters, the change of coronal diameter was significantly most correlated with change of the intravesical volume (P < .0001). The change in coronal diameter, which was observed in patients with urinary disturbance, had a significant difference compared with those observed in control subjects (P = .01). CONCLUSIONS: Monitoring of voiding with 4DUS was feasible in healthy men and patients with lower urinary tract symptoms. Four-dimensional ultrasonography has the potential to be a novel noninvasive urodynamic modality to visualize dynamically the lower urinary tract during voiding and to improve pathophysiologic understanding of voiding.

Adult↗

A comparison of the sensitivities of adaptive tracking, eye movement analysis and visual analog lines to the effects of incremental doses of temazepam in healthy volunteers.

The effects of single oral doses of 5, 10, and 20 mg temazepam were evaluated with the adaptive tracking test, analysis of smooth-pursuit and saccadic eye movements, and visual analog lines in a placebo-controlled, double-blind, crossover experiment with 12 healthy volunteers. Pharmacodynamic testing was performed until 10 hours and pharmacokinetics were evaluated until 24 hours. Temazepam, 20 mg, caused effects in all tests, with peak effects occurring at 30 minutes. The 10 mg dose caused effects on saccadic eye movements and subjective scores of alertness, whereas 5 mg temazepam was detected only by analysis of saccadic eye movements. Linear relationships between plasma concentrations and effects were found in nine subjects for saccadic peak velocity and eight subjects for subjective scores of alertness. The results of this study demonstrate manifest differences in the sensitivities of performance tests and stress the importance of validation of methods when effects of drugs on human performance are studied.

Adult↗

Visualization and analysis techniques for three dimensional information acquired by confocal microscopy.

Confocal Scanning Laser Microscopy (CSLM) is particularly well suited for the acquisition of 3-dimensional data of microscopic objects. In the CSLM a specific volume in the object is sampled during the imaging process and the result is stored in a digital computer as a three-dimensional memory array. Optimal use of these data requires both the development of effective visual representations as well as analysis methods. In addition to the well known stereoscopic representation method a number of alternatives for various purposes are presented. When rendering in terms of solid-looking or semitransparent objects is required, an algorithm based on a simulated process of excitation and fluorescence is very suitable. Graphic techniques can be used to examine the 3-dimensional shape of surfaces. For (near-)real time applications a representation method should not require extensive previous data-processing or analysis. From the very extensive field of 3-D image analysis two examples are given.

Cell Nucleus↗

Rhodopsin and visual adaptation: analysis of photoreceptor thresholds in the isolated skate retina.

Photoreceptor thresholds in the isolated retina of the skate, determined by extracellular measurement of the photoreceptor potential during periods of light and dark adaptation, were analyzed in relationship to prevailing states of the visual pigment. The starting assumption of the analysis is that relative levels of three forms of the pigment molecule [native rhodopsin (R), a photoactivated intermediate (R*), and bleached pigment (B)] govern (quasi-) stable levels of threshold measured (a) during exposure of the retina to background light of fixed incident intensity (Ib), and (b) after irradiation that bleaches a defined fraction (B) of the rhodopsin. It is shown that experimental data are described well by the equation It/ It0 = (1 - B)-1 X F X (1 + 0(3)B), where F = [1 + 0(1)Ib(1 - B) + 0(2)B]. In this equation, It/ It0 is the relative threshold for detection of a test flash; (1 - B) approximates the relative efficiency of quantum capture; and 0(1) - 0(3) are constants. For values of 0(1) - 0(3) yielding an optimal fit to experimental data, log (It/ It0 ) approximately log F over a broad range of values of Ib and B. It is further shown that the algebraic form of the term F in the above equation is consistent with the predictions of a (steady-state) model for the role of the pigment molecule in photoreceptor adaptation. The model proposes that R* and B desensitize the photoreceptor by acting (in qualitatively similar fashion) to reduce the availability of E, an intracellular substance whose activation supports generation of the flash response. Results of the analysis are discussed in relation to the Dowling- Rushton equation (Dowling, 1960, 1963; Rushton , 1961), and to the results of more recent studies examining light and dark adaptation.

Adaptation, Ocular↗

Quantitative analysis and effect of attenuation correction on lymph node staging of non-small cell lung cancer on SPECT and CT.

OBJECTIVE: The purpose of our study was to assess quantitative indexes and the effect of attenuation correction on the evaluation of lymph node metastasis in the staging of non-small cell lung cancer (NSCLC) using fused thallium-201 SPECT/CT images. MATERIALS AND METHODS: We evaluated 156 lymph nodes (66 metastatic, 90 nonmetastatic) from 29 patients with NSCLC. Using our combined SPECT/CT system, all patients underwent 201Tl SPECT and CT examinations immediately (early images) and 3 hr after (delayed images) the injection of 201Tl. SPECT images were reconstructed with and without attenuation correction. For the quantitative evaluation of lymph node metastasis, we calculated the early ratio, the delayed ratio, and the washout ratio for SPECT images and the short-axis diameter for CT images. Receiver operating characteristic (ROC) analysis was performed in each index for the differentiation between metastatic and nonmetastatic lymph nodes. Visual analysis was also performed by two experienced radiologists. RESULTS: The area under the ROC curve (A(z)) showed that early ratio and delayed ratio were superior to short-axis diameter for the assessment of lymph node metastasis. In addition, early and delayed ratios on attenuation-corrected images were superior to those ratios on images without attenuation correction. However, the A(z) value for washout ratio was smaller than that for short-axis diameter. Early ratio on attenuation-corrected images was the most useful index (A(z) = 0.94). The sensitivity, specificity, and accuracy for early ratio on attenuation-corrected images were 78.8%, 94.4%, and 87.8% for the diagnosis of lymph node metastasis and 84.6%, 100%, and 93.1% for clinical staging (N0-N1 vs N2-N3), respectively. Fused images showed significantly higher diagnostic accuracy than CT images on visual analysis. CONCLUSION: Quantitative assessment using fused SPECT/CT images is useful for the diagnosis of lymph node metastasis in patients with NSCLC.

Adult↗

[Assessment of myocardial viability by quantitative analysis of stress Tl-SPECT--comparison with FDG-PET].

Stress Tl-201 tomography (SPECT) is widely used for evaluating myocardial viability. To assess its value, redistribution (RD) on SPECT was compared with metabolic imaging using FDG. Thirty patients with coronary artery disease underwent stress-3 hour Tl-201 SPECT and PET using N-13 ammonia and FDG. RD was classified into 4 grading, including complete RD (CR), incomplete RD (IR), persistent defect (PD) and additional minimal RD (MR) defined as no definite RD on visual analysis but faint RD with Bull's eye quantitative analysis (QNT). All but one segment with CR or IR were viable regions (normal or ischemic regions) by PET. Of 74 segments without RD on visual analysis, 31 segments (42%) had RD by QNT (MR). All of them were viable regions by PET. Thus, QNT identified 31 segments (63%) of the metabolically viable segments which the visual Tl-201 analysis did not show RD and classified as myocardial scar. However, even such QNT cannot detect ischemic myocardium in 18 segments (42%) containing metabolic activity on PET. These data indicate that QNT of RD on Tl-201 SPECT is considered as a valuable means for assessing myocardial ischemia.

Aged↗

Automatic detection of interictal spikes using data mining models.

A prospective candidate for epilepsy surgery is studied both the ictal and interictal spikes (IS) to determine the localization of the epileptogenic zone. In this work, data mining (DM) classification techniques were utilized to build an automatic detection model. The selected DM algorithms are: Decision Trees (J 4.8), and Statistical Bayesian Classifier (naïve model). The main objective was the detection of IS, isolating them from the EEG's base activity. On the other hand, DM has an attractive advantage in such applications, in that the recognition of epileptic discharges does not need a clear definition of spike morphology. Furthermore, previously 'unseen' patterns could be recognized by the DM with proper 'training'. The results obtained showed that the efficacy of the selected DM algorithms is comparable to the current visual analysis used by the experts. Moreover, DM is faster than the time required for the visual analysis of the EEG. So this tool can assist the experts by facilitating the analysis of a patient's information, and reducing the time and effort required in the process.

Action Potentials↗

Visual motion analysis for pursuit eye movements in area MT of macaque monkeys.

We asked whether the dynamics of target motion are represented in visual area MT and how information about image velocity and acceleration might be extracted from the population responses in area MT for use in motor control. The time course of MT neuron responses was recorded in anesthetized macaque monkeys during target motions that covered the range of dynamics normally seen during smooth pursuit eye movements. When the target motion provided steps of target speed, MT neurons showed a continuum from purely tonic responses to those with large transient pulses of firing at the onset of motion. Cells with large transient responses for steps of target speed also had larger responses for smooth accelerations than for decelerations through the same range of target speeds. Condition-test experiments with pairs of 64 msec pulses of target speed revealed response attenuation at short interpulse intervals in cells with large transient responses. For sinusoidal modulation of target speed, MT neuron responses were strongly modulated for frequencies up to, but not higher than, 8 Hz. The phase of the responses was consistent with a 90 msec time delay between target velocity and firing rate. We created a model that reproduced the dynamic responses of MT cells using divisive gain control, used the model to visualize the population response in MT to individual stimuli, and devised weighted-averaging computations to reconstruct target speed and acceleration from the population response. Target speed could be reconstructed if each neuron's output was weighted according to its preferred speed. Target acceleration could be reconstructed if each neuron's output was weighted according to the product of preferred speed and a measure of the size of its transient response.

Acceleration↗

Regression analysis of visual field progression in low tension glaucoma.

Eighty four patients (168 eyes) with low tension glaucoma were retrospectively reviewed (mean follow-up was 28 months). The mean age was 66 years, and 69% were females. Regression analysis of their automated Humphrey fields (a mean of eight fields per eye) showed progression in 50% of patients and in 37% of eyes. There was no statistically significant difference between patients with progression and non-progression with respect to age (p less than 0.05) or intraocular pressure (p less than 0.5). Visual field defects were located most frequently in the superior hemifield in both groups of patients. A considerable proportion of patients had advanced field loss at the time of diagnosis.

Adult↗

Motor experience with graspable objects reduces their implicit analysis in visual- and motor-related cortex.

Motor-related regions of parietal and prefrontal cortices have been shown to selectively activate when observers passively view objects that afford manual grasping. Yet, it remains unknown whether these cortical responses depend on prior motor-related experience with the object being observed. To address this question, we asked participants to undergo fMRI scanning while viewing exemplars of two different categories of graspable objects: one associated with extensive motor experience (door knobs) and one associated with no self-reported motor experience (artificial rock climbing holds). Despite participants' lack of experience grasping climbing holds, these objects were found to generate a systematic response in several visuomotor-related regions of cortex-including left PMv and left AIP. Interestingly, however, the response to door knobs did not include activity in any motor-related regions, being limited instead to a comparatively small bilateral area of lateral occipital cortex, relative to the more spatially extensive response in occipital and temporal cortex that was observed for climbing holds. This result suggested that object-specific responses in both visual- and motor-related cortex may in fact negatively correlate with object-specific motor experience. To test this possibility, we repeated the experiment using participants having extensive self-reported experience grasping climbing holds (i.e., veteran indoor rock climbers). Consistent with our hypothesis, both climbing holds and door knobs generated activity limited to lateral occipital cortex. Taken together, these data support the proposal that repeated real-world motor experience with an object category may lead to reduced implicit analysis in both motor- and visual-related regions of cortex.

Adolescent↗

Analysis of visual field progression in glaucoma.

BACKGROUND: Despite the widespread use of computerised perimetry the diagnosis of visual field deterioration in following glaucoma patients over time remains particularly difficult. A new method of analysis using a novel graphical display of longitudinal field data is presented. METHODS: A linear regression model of the luminance sensitivity at each stimulus location against time of follow up transforms the quantitative data from a series of fields into a colour coded form which illustrates the spatial configuration of change to aid the interpretation of field loss. The method of analysis and the developed computer software (PROGRESSOR) is described. Comparison with STATPAC-2 glaucoma change probability analysis is given including levels of agreement between the techniques using series of fields of 10 eyes from patients with normal tension glaucoma. RESULTS: Examples of this new method compare well with STATPAC-2 analysis. The level of agreement between the techniques to separate progressing from stable retinal locations is good (kappa = 0.62; SE = 0.04). CONCLUSIONS: This new technique, which combines the change in perimetric sensitivity over time with colour coding of significant change into one image may provide an efficient method to detect true progression in glaucomatous field loss.

Diagnosis, Computer-Assisted↗

SpectralNET--an application for spectral graph analysis and visualization.

BACKGROUND: Graph theory provides a computational framework for modeling a variety of datasets including those emerging from genomics, proteomics, and chemical genetics. Networks of genes, proteins, small molecules, or other objects of study can be represented as graphs of nodes (vertices) and interactions (edges) that can carry different weights. SpectralNET is a flexible application for analyzing and visualizing these biological and chemical networks. RESULTS: Available both as a standalone .NET executable and as an ASP.NET web application, SpectralNET was designed specifically with the analysis of graph-theoretic metrics in mind, a computational task not easily accessible using currently available applications. Users can choose either to upload a network for analysis using a variety of input formats, or to have SpectralNET generate an idealized random network for comparison to a real-world dataset. Whichever graph-generation method is used, SpectralNET displays detailed information about each connected component of the graph, including graphs of degree distribution, clustering coefficient by degree, and average distance by degree. In addition, extensive information about the selected vertex is shown, including degree, clustering coefficient, various distance metrics, and the corresponding components of the adjacency, Laplacian, and normalized Laplacian eigenvectors. SpectralNET also displays several graph visualizations, including a linear dimensionality reduction for uploaded datasets (Principal Components Analysis) and a non-linear dimensionality reduction that provides an elegant view of global graph structure (Laplacian eigenvectors). CONCLUSION: SpectralNET provides an easily accessible means of analyzing graph-theoretic metrics for data modeling and dimensionality reduction. SpectralNET is publicly available as both a .NET application and an ASP.NET web application from http://chembank.broad.harvard.edu/resources/. Source code is available upon request.

Algorithms↗

Inattention and the perception of visual feature conjunctions.

Visual processing of objects in the absence of focused attention appears to be limited. We varied the degree of attention, or visual processing, that observers paid to objects using an instruction set manipulation. In 2 experiments, subjects performed tasks that required superficial or detailed visual analysis of the objects involved. In subsequent recognition tests, information about conjunctions of shape and internal color/texture pattern was limited when only superficial visual analysis was required to encode the object. This implies that the degree of visual processing, during object encoding affects the likelihood that feature conjunctions are incorporated into the visual representation of these objects.

Adult↗

Can transcutaneous recordings detect gastric electrical abnormalities?

The ability of transcutaneous recordings of gastric electrical activity to detect gastric electrical abnormalities was determined by simultaneous measurements of gastric electrical activity with surgically implanted serosal electrodes and cutaneous electrodes in six patients undergoing abdominal operations. Transient abnormalities in gastric electrical activity were seen in five of the six patients during the postoperative period. Recognition of normal gastric electrical activity by visual analysis was possible 67% of the time and with computer analysis 95% of the time. Ninety four per cent of abnormalities in frequency were detected by visual analysis and 93.7% by computer analysis. Abnormalities involving a loss of coupling, however, were not recognised by transcutaneous recordings. Transcutaneous recordings of gastric electrical activity assessed by computer analysis can usually recognise normal gastric electrical activity and tachygastria. Current techniques, however, are unable to detect abnormalities in electrical coupling.

Diagnosis, Computer-Assisted↗

Correlation functions in the analysis of visual evoked potentials.

Our "vision" laboratory has been working for several years on stimulation methods and data processing. We present here the results of an analysis of correlation functions between VEPs obtained by flashes and patterned stimulations. This study provides additional information about possible interpretations.

Evoked Potentials, Visual↗