PubMed HealthSearch

SEARCH · PubMed Health

Results for “Surgery, Computer-Assisted”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources

The Use of Computer Tomography in Ophthalmology.

Fifty-three orbital lesions of various types were studied by computer tomography to assess the capabilities and limitations of this technique. Although CT scanning in ophthalmology is in its infancy, results showed that it is useful in the investigation of a number of pathological conditions, including congenital anomalies, arteriovenous malformations, bone lesions, trauma, inflammation, granulomas, pseudotumors, epidermoid cysts, and tumors arising in or near the optic nerve, behind the optic bulb, or in the lacrimal region, as well as changes following eye surgery.

Adolescent

A study of transsexuals seeking gender reassignment.

The authors report the results. of a computerized psychodiagnostic assessment of 19 males and 1 female seeking sex-reassignment surgery. The most pervasive finding was hysterical personality trend (13 of 20 cases). Twelve patients exhibited psychotic trends: 6 showed psychotic thinking on test scores, and 6 received computer-preferred diagnoses of paranoid or schizoid personality. However, most of these 12 patients were not considered psychotic on interview, and those who had sex-reassignment surgery had good results

Antisocial Personality Disorder

[Use of mathematical analysis of the cardiac rhythm in evaluation of the functional state of a patient in surgical interventions].

In 112 patients mathematical analysis of the cardiac rhythm indices and a biochemical investigation were effected during operative interventions with diverse types of endotracheal anesthesia. The correlation analysis of the cardiac rhythm parameters showed that at the most traumatic moment of the operation the synchronization of the functional links aimed at maintaining homeostasis was going up. Pharmacological block of adrenergic receptors results in weakening correlational interlinks. By analyzing the degree of synchronization marking functional links of the cardiac rhythm parameters that characterize the vegetative homeostasis it becomes possible to obtain information as to the level of the level of the adaptive-regulatory mechanisms tension and the correspondence of the depth of anesthesia to the seriousness of the operation trauma at different stages of surgery.

Acid-Base Equilibrium

[Prognostication of the outcome of surgical treatment of hemorrhagic strokes using a computer].

A new mathematical method is suggested for making the prognosis of the results of surgery for haemorrhagic strokes due to essential hypertension and atherosclerosis. Twenty-two signs characterizing the patient's state are fed into the computer trained on the basis of 124 case reports of patients, both surviving and dying after surgery. The computer operating in accordance with the "Kopa-3" programme works out a vital prognosis for both the medicamental and surgical treatment. The prognosis proved correct in 90% of the cases. The described method permits an objective determination of the indications for surgery in hemorrhagic stroke.

Cerebral Hemorrhage

Electronic stethoscope for detection of cerebral aneurysm, vasospasm and arterial disease.

A specially designed acoustic stethoscope electronic-computer-analysis system has repeatedly detected and identified angiographically demonstrated anteriorly located intracranial aneurysms by their characteristic signals. The system has detected and measured clinically significant disease in the carotid siphon and bifurcation, even in cases with normal angiograms, and has recorded the onset and disappearance of cerebral vasospasm. Our data suggests that an aneurysm may act as a flexible Helmholtz resonator, possibly being driven by vortex shed or turbulence. Our goal is the development of a safe, non-invasive method by which the physician could investigate warning symptoms of aneurysms, cerebral vasospasm, and arterial disease in order to recommend preventive surgery or medical treatment early before the patient's condition might deteriorate. Individual cases, falsely positive and negative results are discussed.

Adult

Carotid endarterectomy: an analysis of 234 operative cases.

This paper offers a computer-assisted analysis of the author's experience with 234 carotid endarterectomy procedures in 188 patients. The patients' ages, sex, smoking habits, symptoms, carotid bruits, arteriographic findings and associated diseases are summarized. There were 28 operations in asymptomatic patients, 170 operations in patients with transient ischemic attacks (TIA), 35-operations in patients with a completed stroke and one operation in a patient with a stroke in evolution. After surgery, transient neurologic deficits were noted in both the asymptomatic group (two instances) and the group with TIA (5 instances); permanent neurologic deficits followed 4 operations in the TIA group (2.4% incidence). Two operative deaths occurred in the TIA group (1.2% mortality), and 10 deaths occured after operation for a completed stroke (28.6% mortality). Nine of the deaths in the completed stroke group followed operations performed less than 2 weeks after a stroke. A 100% followup was obtained, and the average period of followup was 48 months. Of the patients surviving operation, all in the asymptomatic group were judged functionally normal, 94% of the TIA group were either functionally normal or improved, 76% with a completed stroke were improved, and the patient with a stroke in evolution was unchanged. There were 69 late deaths with heart disease accounting for 58% of the deaths and stroke another 17%.

Adult

Radionuclide diagnosis of bleeding Meckel's diverticulum in children.

The preoperative diagnosis of rectal bleeding due to Meckel's diverticulum in children has major difficulties when only standard clinical and radiographic technics are utilized. During the past three years we have done 70 studies with Tc99m pertechnetate for this suspected diagnosis using scintillation camera imaging and computer analysis. Five positive cases were identified and all verified at surgery. No false positives were noted. We believe this to be a safe and available procedure that should be considered a primary diagnostic modality in the investigation of young children with suspected bleeding Meckel's diverticulum.

Child

Monitoring of cerebral perfusion during anesthesia by time-compressed Fourier analysis of the electroencephalogram.

Time-compressed Fourier analysis of the electroencephalogram has proven to be a useful analytical procedure during anesthesia and surgery which simplifies data interpretation by presenting the EEG in a time-compressed frequency domain rather than the conventional time domain. This method of data analysis graphically accentuates the electroencephalographic correlates of ischemia-induced cerebral dysfunction and other cerebral oxygen consumption abnormalities. The ability to accentuate trends in frequency and power is derived from sequential plotting of spectra to produce a graph with three dimensional axes of frequency, time, and power. In carotid endarterectomies the system has proven more useful than the conventional EEG in assessing the need for a vascular shunt to maintain internal carotid flow during endarterectomy. In open-heart surgery time-compressed EEG spectral analysis has allowed early recognition of cerebral ischemia resulting from arterial hypotension and venous hypertension. Five cases are presented which demonstrate the ability of our system to reflect developing cerebral ischemia.

Aged

Evaluation of automated multiphasic health testing in the survey of the north-west region of Melbourne.

The results of automated multiphasic health testing (AMHT) in a randomly selected population of 664 subjects are reported. AMHT revealed a number of conditions that had not been diagnosed previously. A total of 535 newly diagnosed conditions in 301 patients could be attributed to the survey. The yield of new diagnoses by AMHT was not affected by previous surgery attendance or by attendance intervals. Follow-up over one year revealed that treatment was recommended for 342 of the 535 newly diagnosed conditions and that the response was satisfactory in 189 (55%), but the "uncertain" response of 124 (36%) should be investigated by more thorough follow-up in future projects. It is concluded that AMHT is beneficial because of the amount of information that is revealed, because of the financial value and because of the benefit to patients.

Adult

[The SITAR Project. A new approach to diagnosis and surgical indication in arteriopathic patients].

The extreme variations with which atherosclerotic disease presents as regards progression index, arterial bed localization frequency, malignity and invasiveness in different ages and often as regards different anatomopathological aspects characterizing the formation and course of the primary lesion, mean that there are still many unknowns in the aetiopathogenesis, diagnosis and operative indications for this disease. Such problems are more and more important to the vascular surgeon who, with the development of atherosclerotic disease, sees the long-term results of his arterial reconstructive surgery compromised. The vascular surgeon is therefore directly involved with his colleagues in the internal medicine and pharmacological departments in problems connected with the pathogenesis of arteriosclerosis, and indeed he contributes to setting new constraints on the choice of prosthetic materials, for use in cases of bridge-work, and in the creation of new surfaces by means of thrombendarteriectomy. On the basis of such considerations, the IInd Surgical Clinic of Milan University began, in 1975, a study whose end purpose was the drafting of a clinical card designed for data computerization. Compiled by the surgeon, it is intended essentially for vascular surgeons. However, as it is personally considered that by the very nature of the disease, the atherosclerosis approach must be interdisciplinary, it also concerns physicians in the internal medicine, pharmacological and dietological departments.

Arterial Occlusive Diseases

Atrial electrogram monitoring in a cardiac care unit.

Routine monitoring of a bipolar atrial electrogram (AEG) simultaneously with the electrocardiogram is a useful and safe clinical technique for the diagnosis of complex cardiac dysrhythmias. The large-amplitude A waves of the AEG can be more reliably identified than the corresponding low-amplitude p waves of the electrocardiogram. Epicardial wires placed during cardiac surgery, catheter-mounted endocardial electrodes, and esophageal electrodes can all be used for routine AEG monitoring. A multipurpose pulmonary arterial catheter with a pair of electrodes, and esophageal electrodes can all be used for routine AEG monitoring. A multipurpose pulmonary arterial catheter with a pair of electrodes mounted on the proximal shaft can be used for combined AEG and hemodynamic monitoring. The equipment needed for AEG monitoring and recording consists of an additional bedside amplifier with 12- to 100-Hz band-pass filter, a dual-channel display scope, and a dual-channel strip chart recorder. Care must be used to keep the atrial electrodes electrically isolated for patient safety. In addition to enhancing the diagnosis and management of dysrhythmias, recording an AEG provides a signal that is suitable for automatic processing.

Arrhythmias, Cardiac

Observations on the epicardial activation of the normal human heart.

Serial hand mapping techniques in man have identified 3 to 5 sites of epicardial breaktrough (EBT). However, transmural epicardial excitation from the widely distributed His/Purkinje system suggests a more complicated pattern may exist. Multielectrode arrays used with large mapping systems during surgery often present complicated and sometimes inconsistent activation patterns. The purpose of this work is to reconcile epicardial activation in the normal human heart with anatomical and endocardial/intramural physiological recordings using multichannel computer mapping requiring only a single beat, and rigorously defined and applied activation time detection algorithms. Eighteen subjects undergoing surgery for Wolff-Parkinson-White syndrome were recorded with a 119 site sock array during nonpreexcited sinus rhythm. None had evidence of coronary artery disease and all exhibited a normal 12-lead ECG except during periods of preexcitation or tachycardia. Each was recorded bipolarly and four also were recorded monopolarly. Recordings revealed 8.0 +/- 1.6 EBTs (range 5 to 12). Closely spaced, multiple EBTs often were observed and usually confirmed using different activation time detection algorithms. The earliest EBT always occurred over the anterior right ventricle at 14.3 +/- 6.5 msec (range -1 to 29 msec) after QRS onset. Subsequent EBTs could occur at any ventricular site with variable latencies. In contrast to previous reports describing epicardial spread of activation from a few foci, a mosaic of epicardial activation emerges. These data are consistent with endocardially initiated transmural activation of the epicardium suggested by the anatomy of the His/Purkinje system and intramural recordings.

Algorithms

Computer-aided diagnosis of "dyspepsia".

Experience with computer-aided diagnosis of "dyspepsia" in a consecutive prospective series of 212 patients coming to surgery is described. Analysis is concentrated upon 122 patients who presented to an outpatient clinic de novo for diagnosis. During their first (outpatient) hospital contact, a firm diagnosis was made in just over half of these patients (though where made, it was usually correct). After full investigation, the diagnostic accuracy (prior to operation) was 92.6%. Using data elicited solely from the house surgeon's interview at the time of admission, the computer's overall diagnostic accuracy was 87.7%. The cost of each new computer diagnosis was around 25 new pence ($0.60). and the time taken was about 5 minutes. In a further small series designed to discriminate between organic and functional dyspepsia, the computer correctly assigned all but 1 of 23 patients with organic disease to the correct disease category. However, almost half of 33 patients with x-ray negative dyspepsia were predicted by the computer to have organic lesions. Time alone will tell whether the computer is a better early predictor of eventual organic disease than currently available radiologic methods.

Bayes Theorem

[Visualized three-dimensional reconstruction and image analysis in orthopedics and trauma surgery].

Computer tomography is a commonly used technique for detecting pathological alterations in soft tissue and the skeleton. The remote access to image informations as well as the allocation of display and processing tools via networks enables improved diagnostic and therapeutic practice in orthopaedic and traumatologic surgery. The realization of a user friendly image analysis system displays and processes the acquired images in a modality oriented manner. Our method is based on a unique file format and specific evaluation procedures to produce the input data for three-dimensional display and algorithms for the individual design of implants. Our image analysis system can process the data of conventional computer tomographies with three or more mm distance. In contrast to the available systems there is a low significance of radiation effects.

Computer Graphics

Long term follow-up of EEG changes following therapeutic surgery in epilepsy.

Four cases, given in some detail, illustrate the effort to compare scalp EEGs taken before surgery for intractable seizures with those recorded some years postoperatively, and to relate these, together with the computer analyses of seizure activity recorded in depth, with the pathology found in the removed tissue and, importantly, with the postoperative clinical state of the patient. These four cases illustrate the following results: (1) Confirmation by histology and ultrastructure studies of abnormal neuronal tissue at the site pinpointed by computer analysis of EEGs as the driving focus for the electrical seizure discharge. (2) Correlation of clinical and behavioral improvement with normalization of the EEG, objectively quantified by computer analysis. Examples are given of excellent recovery (3 cases) and one of, at present, partial recovery.

Adolescent

A symptomatic discriminant to identify recurrent ulcer in patients with dysperpsia after gastric surgery.

A questionnaire has been completed by 99 patients referred for investigation of symptoms after gastric operations. The replies were analysed in an attempt to distinguish patients with a recurrent peptic ulcer from those with no recurrent ulcer. All cases were investigated by barium meal, endoscopy, and oral cholecystography. All recurrent ulcers were confirmed by reoperation and patients with gastric carcinoma, gallstones, or symptomatic hiatus hernia were excluded. The study was retrospective in 40 patients in whom the diagnosis was already confirmed when the questionnaire was analysed and prospective in 59 in whom the diagnosis was originally unknown. The replies were analysed with (a) a small computer using Bayes' theorem, (b) weighted tables, and (c) a discriminant analysis. The computer prediction of the prospective data was 85% accurate. The results of simpler methods were almost as good as the computer prediction, and questions related only to the severity of pain and vomiting accurately distinguished recurrent ulcer from other causes of dyspepsia in 81% of patients.

Diagnosis, Computer-Assisted

Atraumatic evaluation of myocardial revascularization procedures with 43K1.

Least-squares regression analysis was computerized to provide functional color images of myocardial perfusion patterns. In 8 of the 9 patients studied, changes in pattern indicated that the revascularization procedure speeded the appearance time and/or net rate of 43K uptake. The functional images correlated well with coronary arteriograms made before and after surgery. This noninvasive isotope technique may prove to be clinically useful in (a) evaluating coronary artery disease, (b) defining the remaining viable myocardium when an aneurysm is present, and (c) determining the effectiveness of the revascularization procedure.

Adult

Enlarged acid-base and blood gas calculations by electronical data computing in the blood gas laboratory.

A rapid anaysis of parameters of the acid-base equilibrium and blood gases during open heart surgery and emergency therapy is absolutely necessary. Computing of the several parameters of the acid-base status by slide rules or nomograms is time consuming and can be shortened by computer applications. The central blood gas laboratory consists of a blood gas analyzer for PO2, PCO2 and pH, an electronic desktop calculator, a four color X-Y-plotter and two data lines to the cardiac surgery unit and to the intensive care unit. The time needed for computing and feedback of the parameters could be decreased to one quarter. In addition to numerical data printout, a graphical representation of the several parameters is possible on a X-Y-plotter and includes the Rahn-Fenn-O2-CO2-Diagram with venous admixture, ventilation perfusion ratio, alveolar dead space ventilation and the standard and actual oxygen dissociation curve as well as the pH/HCO3- Acid-Base nomogram. Furthermore, a computer diagnosis of the actual disturbances can be plotted.

Acid-Base Equilibrium