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Computerized EEG pattern classification by adaptive segmentation and probability density function classification. Clinical evaluation.

A series of 63 clinical EEGs showing a variety of normal and abnormal patterns was analysed by computer with particular reference to the different types of pattern within the same EEG. Boundaries between different patterns were established by means of adaptive segmentation, so that the duration of the resulting segments was determined by the particular EEG itself (thus the term 'adaptive'). Four channels from each EEG were analysed, paired (left and right) channels were simultaneously segmented and analysed interactively. Similar segments were then clustered without supervision by estimating a probability density function in a 2-dimensional 'feature space' having dimensions of mean frequency and mean power. Individual clusters emerged as well-defined peaks of the surface, individual segments or small groups of duration insufficient to constitute a separate cluster, being identified as 'singular events' (e.g., rare sharp waves, artifacts). The autocorrelation function was used to characterize the EEG both for the segmentation and for the subsequent clustering of the resulting segments. In confirmation of our previous work, adaptive segmentation based on the autocorrelation function of the EEG was found to be quite satisfactory. Unsupervised clustering by estimation of the probability density function in feature space was found to give the correct number of clusters (usually less than 5) in a majority of the records (65%), but in the remaining minority of cases (35%), either overclustering or underclustering occurred. Further, the 'singular events' were occasionally partly included in a formal cluster. Comparison of these results of EEG clustering by unsupervised probability density function estimation with earlier results obtained by supervised hierarchical clustering suggests that there may be subtle cues used by the electroencephalographer in the classification of EEG patterns which have not been adequately approximated by the computer algorithms thus far used in this work. Hence at least some minimal degree of supervision in the clustering process may be necessary, at least for the present. On the other hand, the method recommends itself for the representation of illustrative EEG summaries which, in conjunction with a short written report, would provide the clinical neurologist with a sufficient picture of the real EEG without, in most cases, the need to inspect the original record.

Action Potentials

[Histological classification of malignant non-Hodgkin's lymphomas and patient survival: the Kiel classification versus the working formulation].

In 163 out of 251 histologically classified malignant Non-Hodgkin's lymphomas, a comparison was made of the patient survival with respect to both histological type and malignant grade according to the Kiel Classification (KC) and the three prognostic groups of the Working Formulation (WF). As expected, the survival rate of 94 low-grade malignant lymphoma cases (KC) was significantly better than that of 69 high-grade cases (p < 0.0001). Similar results were found both for 46 low grade cases (WF) in comparison to 50 high grade cases (p < 0.001) and for 67 intermediate grade cases (WF) compared with the 50 high grade cases (p < 0.05). The survival rates of low and intermediate grade cases (WF), however, showed no statistically significant difference. The low- and high-grade malignant lymphoma entities of KC, which together constitute the intermediate grade of WF, differed significantly with respect to patient survival (p < 0.05). Therefore, it appears that an intermediate grade is not essential in the KC.

Humans

Hyperlipidemia, dyslipoproteinemia and apolipoproteinopathia--classification and risk of atheroslcerosis. Part I: Principles of classification and methods of dyslipoproteinemia determination.

This paper sums up new findings in the field of pathogenetic relations between lipid and lipoprotein metabolical disorders on the one hand and the risk of early forms of atherosclerosis on the other hand. Detail classification of disorders proceeds from precise clinical and biochemical criteria, genetic considerations and therapeutical aspects. It provides definitions of hyperlipidemia, hyperlipoproteinemia, normolipidemic (latent) dyslipoproteinemia, secondary hyperlipidemia, apolipoproteinopathia and relatively harmless (benign) hyperlipidemia. The paper provides detail tables and systematic graphs.

Adult

Classification and prognostic evaluation in multiple myeloma. A retrospective study of relationship of survivals and responses to chemotherapy to immunological types, 20 single prognostic factors, 15 clinical staging systems, and 6 morphological classifications.

In a group of 136 completely followed up patients with multiple myeloma, the prognostic significance of the immunological myeloma types, of 20 different single prognostic factors, of 15 clinical staging systems, and of 6 morphological classifications was retrospectively investigated by means of the calculation of mean survivals, survival curves, and responses to chemotherapy. A univariate analysis was employed in order to correlate each prognostic parameter at presentation with the survival in the whole group; a multivariate analysis according to the Cox's hazards regression model was used in order to select the most powerful prognostic variables. The patients were grouped according to the myeloma immunological types, to the mean value of each single prognostic factor, and to each stage of the clinical and morphological systems. Causes of death were also related to immunological multiple myeloma types. All single variables, except age and serum calcium, presented a significant relationship with the survival, even if at different significance levels. Cox's regression model selected among them, serum levels of beta 2-microglobulin, percentage of bone marrow plasma cells, hemoglobinemia, lytic bone lesions, and Bence-Jones proteinuria as the most significant factors related to survival. Each clinical and morphological staging system divided groups of patients with significant differences in mean survivals, or in survival curves, or in response to therapy. Multiple myeloma type IgA and micromolecular, with Bence-Jones proteinuria, and type lambda were associated with a poor prognosis, with low therapeutical response, and with the development of fatal renal failure. All these parameters, together with new prognostic factors, are useful in the prognostic evaluation, and, when applied in different steps of the diagnosis and the therapy, allow of studying the clinical course of multiple myeloma under different perspectives, in order to have a more complete picture of the disease and of the single patient.

Adult

The classification of anxiety disorders in current and future classifications.

Comments are made on the main categories by which specific states of morbid anxiety are classified in the ICD-9, ICD-10, DSM-III and DSM-III-R. The latest classifications, ICD-10 and DSM-III-R, contain many more such categories than ICD-9, and although they differ in the priority given to panic versus agoraphobia, the content is very largely similar. ICD-10 contains several categories of special interest to mental health workers in developing countries and primary health care.

Anxiety Disorders

An International Classification of Retinopathy of Prematurity: development of the classification of the late stages of retinopathy of prematurity.

In another publication [6], an agenda for ROP was outlined for the future. High on that list was the completion of the task of classifying ROP. This has been accomplished, but it is obvious that no classification is any better than the use to which it is put. This is the case with this work. Its implementation in a prospective, controlled trial of surgical therapy of end-stage ROP will more than justify the labors of all who participated in its development.

Anterior Eye Segment

Classification of animal lymphomas: the implications of applying Rappaport's classification for human lymphomas to experimental tumors.

One hundred and seventy animal lymphomas (species ranging from molluses to monkeys) were reclassified histologically according to the modified Rappaport classification for human lymphomas. The results were correlated with the etiology of the lymphomas, their clinical course, and in selected cases with their immunological type. The study stresses the value of such a procedure for comparative reasons, allowing a more adequate selection of animal models for human lymphomas.

Animals

Illustrated histopathologic classification criteria for selected vasculitis syndromes. American College of Rheumatology Subcommittee on Classification of Vasculitis.

We describe the histopathologic criteria for the diagnosis of 7 selected vasculitis syndromes: polyarteritis nodosa, Churg-Strauss syndrome, Wegener's granulomatosis, hypersensitivity vasculitis, Henoch-Schönlein purpura, giant cell (temporal) arteritis, and Takayasu arteritis. The criteria apply to the stereotypical cases in each category; they were formulated after a review of submitted biopsy material from 278 of the 1,000 patients entered into the American College of Rheumatology Vasculitis Study Registry, and from prior experience with the pathologic diagnosis of vasculitis in 1,079 nonregistry patients.

Churg-Strauss Syndrome

Comparison of the ICD-10-classification with the ICD-9- and the DSM-III-classification of mental disorders.

The diagnostic concepts in ICD-10 show better congruence with those in DSM-III than with those in ICD-9. The diagnostic definitions used by ICD-10 and DSM-III for the majority of diagnoses turn out to be similar; the definitions of anxiety disorders and schizoaffective disorders are, however, still at variance. Consequently, the empirical results from the WHO field trial in German-speaking countries reveal a high degree of overlap between the two systems; the degree of overlap between ICD-9 and ICD-10 was lower, but still surprisingly high overall. These empirical results support the validity of ICD-10.

Humans