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At least 73 records · Page 4Linked to original sources

Variability of repeated coronary artery calcium measurements by 16-MDCT with retrospective reconstruction.

OBJECTIVE: High reproducibility on coronary calcium scoring is an important factor in monitoring the progression of coronary atherosclerosis. The purposes of this study were, using a 16-MDCT scanner with retrospective reconstruction, to compare the effects of thin-slice images and overlapping image reconstruction on the reproducibility of coronary calcium scoring and to compare 16-MDCT with electron beam CT (EBCT). MATERIALS AND METHODS: Fifty patients underwent two sequential examinations using both EBCT and MDCT. For MDCT, images were reconstructed from the same raw data using the following thicknesses and increments (thickness/increment): 1.25 mm/1.25 mm, 2.5 mm/2.5 mm, and 2.5 mm/1.25 mm. The Agatston, volume, and mass scores were calculated on four pairs of image sets. Statistical analysis was performed to determine significant differences in interscan variability among image acquisition protocols and among measurement algorithms. RESULTS: Overlapping reconstructed images (thickness/increment, 2.5 mm/1.25 mm) obtained on a 16-MDCT scanner showed the lowest variability (mean, 13%; median, 10%) when compared with the Agatston score. CONCLUSION: The use of 16-MDCT with overlapping reconstruction by retrospective reconstruction, yielding low variability of coronary artery calcium measurement on two sequential scans, has an advantage over EBCT in monitoring the progression of atherosclerosis.

Aged↗

MR-based brain and cerebrospinal fluid measurement after traumatic brain injury: correlation with neuropsychological outcome.

PURPOSE: To determine the magnitude and time course of changes in the volume of brain and intracranial cerebrospinal fluid (CSF) spaces in patients who have sustained traumatic brain injury and to assess the relationship between these findings and long-term cognitive traumatic outcome. METHODS: Axial intermediate and T2-weighted MR images of 123 patients with traumatic brain injury were quantified using a multispectral segmentation algorithm. Measurements were corrected for differences in age, sex, and head size using a previously reported normative database. Brain morphology was compared across groups formed on the basis of chronicity of injury. Cognitive functioning and severity of injury were statistically correlated with brain measurements. RESULTS: Time-dependent expansion of CSF spaces and decreases in brain volume were observed. Increases in ventricular CSF volume, particularly in the temporal horns and third ventricle, preceded subsequent changes in total brain and subarachnoid CSF. High and moderate correlation was observed between volume measures and cognitive outcome and injury severity. Particularly strong was the relation between the volume of the left temporal horn and verbal IQ scores. CONCLUSION: Predictable time-dependent atrophic changes occurring after traumatic brain injury can be quantified using MR volumetric studies. Our results suggest significant contributions by both diffuse and focal mechanisms of injury. In the postacute period (more than 70 days after injury), MR volumetric studies may be predictive of eventual cognitive outcome.

Adolescent↗

Minimally invasive estimation of systemic vascular parameters.

A cardiovascular parameter estimator to identify the systemic vascular parameters was developed using an extended Kalman filter (EKF) algorithm. Measurements from a ventricular assist device (VAD) and arterial pressure were used in the estimator. The systemic vascular parameters are important indices of heart condition. However, obtaining these parameters usually requires invasive measurements, which are difficult to obtain under most clinical environments. Including a VAD model into the estimator and using the signals from a VAD to identify the cardiovascular parameters for VAD patients would minimize the need for indwelling sensors. This paper illustrates the use of a Novacor left ventricular assist system (LVAS) model with a cardiovascular model in the estimator to identify the systemic vascular parameters: characteristic resistance, blood inertance at the aorta, systemic compliance, and systemic resistance. Performance of the estimator was evaluated using data from a computer simulation and from a mock circulatory system experiment. Robustness of the estimator to the available measurements was also described. The estimation results showed that the estimates converged with reasonable accuracy in a limited time when the LVAS pump volume and arterial pressure were used as measurements. These parameter estimates can provide additional diagnostic information for patient and device monitoring and can be used for future VAD control development.

Algorithms↗

Measurement accuracy: a comparison of two intra-oral digital radiographic systems, RadioVisiography-S and FlashDent, with analog film.

OBJECTIVES: To compare the accuracy of measurement algorithms incorporated into the software provided with two CCD-based digital radiographic systems and compare assessments using intra-oral film. METHODS: A test object with three radiopaque reference points was imaged using Ektaspeed intra-oral film, both with and without an overlaid 1 mm reference grid, the RVG-S, the measurement software of which overlays a 2 mm grid, and the FlashDent, which uses a mouse-driven cursor to estimate distances. Geometric factors, including source-to-object and receptor-to-object distances, vertical and horizontal cone angulation, and vertical angulation of receptor, were successively altered. Six viewers estimated vertical, horizontal and diagonal distances for each image. RESULTS: Increased source-to-object distance resulted in a 5-10% reduction in image dimensions, whereas increased receptor-to-object distance produced a magnification of 15-20% with all techniques. Increased vertical and horizontal cone angulation resulted in slight increases in magnification (0-5%) whereas greater receptor angulation resulted in noticeable magnification under all test conditions (10-15%). Estimated values for vertical, horizontal and diagonal measurements were approximately 5-10% higher than the actual dimensions, irrespective of the technique used. The FlashDent mouse-driven cursor system and direct measurement of distances from conventional film were more accurate in horizontal and diagonal dimension estimates than using an overlaid grid. Intra-observer and inter-observer differences were found for specific situations. CONCLUSION: The mouse-driven computerized measurement cursor and intra-oral film assessment using a ruler provided the most accurate, reliable and consistent dimensional measurements.

Analysis of Variance↗

Topographic assessment of irregular astigmatism after photorefractive keratectomy.

OBJECTIVE: To correlate new quantitative topographic indexes of corneal irregular astigmatism to best spectacle-corrected visual acuity (BSCVA) following excimer laser photorefractive keratectomy (PRK). SETTING: Department of Ophthalmology, LSU Eye Center, and Refractive Surgery Center of the South, Ear, Nose & Throat Hospital, New Orleans, Louisiana; Manhattan Eye, Ear and Throat Hospital, New York, New York, USA. METHODS: Videokeratography data (TMS-1) were obtained preoperatively and 1, 3, 6, 12, 18, and 24 months postoperatively from 100 eyes having PRK for low to mild myopia. Algorithms measured fine local irregularity with the surface regularity index (SRIp), varifocality with the coefficient of variation of corneal power (CVPp), and central islands with the elevation/depression magnitude (EDM). RESULTS: The SRIp and CVPp increased after surgery and remained significantly higher than the preoperative levels throughout the 24 month follow-up (P < .05). The increase in EDM was significant from 1 to 6 months (P < .05) but not thereafter. Multiple regression analysis revealed that variables having a statistically significant relationship with postoperative BSCVA were CVPp and EDM at 1 month, CVPp at 3 months, and CVPp, haze, and age at 6 months. No statistically significant correlation between any measures of irregular astigmatism and BSCVA was found after 1 year of follow-up. CONCLUSION: The quantitative measures used in this study are sensitive methods by which irregular astigmatism after keratorefractive procedures can be classified, evaluated, and compared.

Algorithms↗

Single-beat analysis of ventricular late potentials in the surface electrocardiogram using the spectrotemporal pattern recognition algorithm in patients with coronary artery disease.

AIMS: Post-infarction risk stratification can be ascertained from beat-to-beat variations in ventricular late potentials. However, gaining such information by conventional late potential analysis using signal averaging is still not possible. METHODS: We therefore developed the spectrotemporal pattern recognition algorithm in order to detect beat-to-beat variations in late potentials. Based on the spectrotemporal pattern recognition algorithm two-dimensional correlation function, the typical spectral pattern of late potentials can be identified in spectrotemporal maps of single beats, even in the presence of noise. RESULTS: Surface electrocardiograms of 385 patients after myocardial infarction (85 with documented sustained ventricular tachycardia (group 1), 100 with fast, polymorphic ventricular tachycardia (> 270 cycles.min-1) or primary ventricular fibrillation (group 2), 200 without ventricular arrhythmias (group 3) and 45 healthy volunteers (group 4), were analysed. The spectrotemporal pattern recognition algorithm detected late potentials in single beats in 89% of group 1 patients, in 79% of group 2, in 22% of group 3 and in 4% of normals. The spectrotemporal pattern recognition algorithm measured late potential frequency and extension of late potentials into the ST segment, which was significantly different between groups 1 and 2. Beat-to-beat variations in late potentials, with respect to frequency and extension into the ST segment, were markedly higher in patients with a history of primary ventricular fibrillation. CONCLUSION: Single-beat analysis using the spectrotemporal pattern recognition algorithm may improve risk stratification of patients after myocardial infarction, and provides information on patients prone to ventricular fibrillation.

Action Potentials↗

An algorithm for selection of instrumentation levels in scoliosis.

Appropriate levels for instrumentation and fusion in scoliosis have been a matter of debate among surgeons since the introduction of operative management of this deformity. We set out to examine the hypothesis that the amount of correction achieved in all planes during surgical instrumentation of a curve should be less than, or comparable to, the degree of correction attainable at any non-instrumented adjacent curve. An algorithm was designed to facilitate preoperative planning and intraoperative performance of spinal fusion procedures in the management of scoliosis. To test the validity of the hypothesis and the proposed algorithm, measurements were taken from the preoperative radiographs of 200 patients. The dimensions of the curves were obtained from an initial set of four X-ray films: (1) standing anteroposterior film of the whole spine, (2) standing lateral film of the whole spine, (3) two properly performed side-bending films including each curve of the spine. With this data, a plan was designed using the algorithm. The results of this plan were compared with the actual results of the surgery, which were revealed only at this stage. All patients in whom actual instrumentation levels fell within those predicted by the proposed algorithm had no imbalance at follow-up. All patients whose actual instrumentation levels were short of those recommended by the algorithm showed obvious imbalance on final postoperative standing radiograph.

Adolescent↗

Algorithmic complexity of growth hormone release in humans.

Most hormones are secreted in an pulsatile rather than in a constant manner. This temporal pattern of pulsatile hormone release plays an important role in the regulation of cellular function and structure. In healthy humans growth hormone (GH) secretion is characterized by distinct pulses whereas patients bearing a GH producing tumor accompanied with excessive secretion (acromegaly) exhibit a highly irregular pattern of GH release. It has been hypothesized that this highly disorderly pattern of GH release in acromegaly arises from random events in the GH-producing tumor under decreased normal control of GH secretion. Using a context-free grammar complexity measure (algorithmic complexity) in conjunction with random surrogate data sets we demonstrate that the temporal pattern of GH release in acromegaly is not significantly different from a variety of stochastic processes. In contrast, normal subjects clearly exhibit deterministic structure in their temporal patterns of GH secretion. Our results support the hypothesis that GH release in acromegaly is due to random events in the GH-producing tumorous cells which might become independent from hypothalamic regulation.

Acromegaly↗

In vivo comparison of Visualix-2 and Ektaspeed Plus in the assessment of periradicular lesion dimensions.

UNLABELLED: Accurate assessment of intraosseous lesion dimensions is useful in determining strategies for treatment of periradicular pathoses of dental causation. OBJECTIVES: To compare the efficacy of digital versus analog imaging for the measurement of mesiodistal and vertical dimensions of periapical lesions in patients that require apical surgery. METHODS: Fourteen examiners assessed the dimensions of 28 lesions with a millimeter ruler and Ektaspeed Plus radiographs (Eastman Kodak, Rochester, N.Y.), and with the Visualix-2 (Gendex/Dentsply, Milan, Italy) in unenhanced, contrast-stretched and equalized modes with proprietary software mouse-driven measurement algorithm. Impregum F (Premier Dental Products) impressions at surgery were used as the "gold standard." Ten randomly chosen images were reread 2 weeks later to assess intra-operator reliability. As the Mauchly sphericity test was significant for all tests, a multivariate analysis of variance was used to assess accuracy. To explain the exact difference between means, the Bonferroni test was applied. Intra-observer reliability was assessed with Friedman's two-way analysis of variance; inter-observer effects were determined with Cronbach's alpha. RESULTS: For accuracy in measurement, the closest to the "gold standard" were achieved with the Visualix-2 with image equalization. The contrast-stretched Visualix-2 and unenhanced Visualix-2 measurements were less accurate; conventional film was consistently the least accurate (p < 0.002). On the other hand, subjective preference placed film radiographs above the unenhanced Visualix-2 images; contrast-stretched Visualix-2 images were preferred over all other modalities. CONCLUSIONS: Charge-coupled device-based images with the Visualix-2 are preferable to film-based radiographs for measuring periapical lesion dimensions.

Alveolar Bone Loss↗

Ranking documents with a thesaurus.

This article reports on exploratory experiments in evaluating and improving a thesaurus through studying its effect on retrieval. A formula called DISTANCE was developed to measure the conceptual distance between queries and documents encoded as sets of thesaurus terms. DISTANCE references MeSH (Medical Subject Headings) and assesses the degree of match between a MeSH-encoded query and document. The performance of DISTANCE on MeSH is compared to the performance of people in the assessment of conceptual distance between queries and documents, and is found to simulate with surprising accuracy the human performance. The power of the computer simulation stems both from the tendency of people to rely heavily on broader-than (BT) relations in making decisions about conceptual distance and from the thousands of accurate BT relations in MeSH. One source for discrepancy between the algorithms' measurement of closeness between query and document and people's measurement of closeness between query and document is occasional inconsistency in the BT relations. Our experiments with adding non-BT relations to MeSH showed how these non-BT non-BT relations to MeSH showed how these non-BT relations could improve document ranking, if DISTANCE were also appropriately revised to treat these relations differently from BT relations.

Abstracting and Indexing↗

Optimizing the use of antithrombotic therapy for atrial fibrillation in older people: a pharmacist-led multidisciplinary intervention.

OBJECTIVES: To develop, implement, and evaluate a pharmacist-led multidisciplinary intervention in a hospital setting that would optimize antithrombotic use in elderly atrial fibrillation patients. The hypothesis that there would be an increase in the proportion of patients receiving antithrombotic therapy at discharge was tested. DESIGN: Evidence-based algorithms were developed to define the criteria (stroke risk vs contraindications) by which an elderly patient's requirement for antithrombotic therapy was assessed. SETTING: A major Sydney teaching hospital. PARTICIPANTS: Two hundred eighteen consecutively admitted elderly patients (mean age 85.2) were recruited over a 6-month period. INTERVENTION: A pharmacist-coordinated multidisciplinary review process was implemented to coordinate risk assessments and subsequently recommend appropriate antithrombotic therapy, as per the algorithms. MEASUREMENTS: The proportion of patients receiving antithrombotic therapy was assessed on admission (preintervention), at discharge (postintervention), and postdischarge (follow-up at 3 and 6 months). RESULTS: As a result of the intervention, 78 patients (35.8%) required changes to their existing antithrombotic therapy. Of these changes, 60 (76.9%) were "upgrades" to more-effective treatment options (e.g., from no therapy to any agent or from aspirin to warfarin). The remaining 18 (23.1%) changes were "downgrades" to less-effective, albeit safer, options. Despite a significant increase in anti thrombotic use overall (59.6% vs 81.2%, P<.001), fewer patients received warfarin postintervention, after having been assessed as inappropriate candidates (20.7% vs 17.4%, P=.39). CONCLUSION: A pharmacist-led multidisciplinary process was successfully developed and implemented within the hospital setting to increase overall antithrombotic use. Having addressed some of the known barriers and limitations to warfarin use, these algorithms may allow allied health workers, patients, and clinicians to work collaboratively to achieve optimal and, importantly, appropriate (i.e., safe and effective) antithrombotic use in at-risk elderly patients.

Aged↗

A new technique to determine the correlation between the QT interval and heart-rate for control and SIDS babies.

The ability of the autonomic nervous system to alter the QT interval in response to heart rate changes is essential to cardiovascular control. An accurate way to determine the relation between QT intervals and their corresponding RR intervals is described. A computer algorithm measures the RR intervals using digital filtering and cross-correlating the QRS sections of consecutive waveforms. The QT intervals is calculated by choosing a section of, the ECG that includes the T wave and cross-correlating it with all the consecutive T waves. At least 4000 pairs of QT-RR intervals are computed for each subject and a best fit correlation function determines the relations between the QT and RR intervals. This technique enables to establish a precise correlation between RR and QT in order to distinguish between control and SIDS babies.

Algorithms↗

Lipid-lowering efficacy, safety, and costs of a large-scale therapeutic statin formulary conversion program.

STUDY OBJECTIVE: To assess the lipid-lowering efficacy, safety, and costs of a large-scale statin formulary conversion program. DESIGN: Prospective, observational study. SETTING: Tertiary academic medical center. PATIENTS: A total of 980 patients consented to participate; 942 patients completed the study. INTERVENTION: Patients were converted from their current statin therapy to either cerivastatin 0.4 or 0.8 mg/day, or simvastatin 80 mg/day, using a conversion algorithm. MEASUREMENTS AND MAIN RESULTS: Efficacy and safety were evaluated at baseline and after 6 weeks of therapy; costs were also measured. Overall attainment of the National Cholesterol Education Program (NCEP) goal for low-density lipoprotein cholesterol (LDL) increased from 64.8% to 74.5% of patients (p<0.001); mean LDL decreased from 115+/-30 mg/dl to 106+/-25 mg/dl (p<0.001). Adverse events occurred in 3% of patients, and included myositis (0.6%) and increased hepatic transaminases (0.1%). Overall costs were reduced by $115/patient treatment-year. CONCLUSION: Statin therapeutic interchange can improve lipid control at reduced costs. The possibility of uncommon but potentially serious adverse effects suggests that these programs require appropriate monitoring.

Aged↗

Interactive computer-aided assignment of multiple probes to cytogenetic bands by simultaneous dual color fluorescence in situ hybridization and DAPI banding.

A macro function was developed to run in conjunction with the popular image analysis package NIH Image, to allow simultaneous determination of mapping positions of one or two separate probes with respect to cytogenetic bands by dual color fluorescence in situ hybridization (FISH) and DAPI banding, and by determination of their fractional distance from pter (FLpter). In order to allow maximal flexibility, a user-defined line along the chromosome is used for measurements. Algorithms were developed to detect the ends of the chromosome and the cytogenetic bands. Results of the analysis are presented in graphical form, comprising a display of the DAPI intensity along the chromosome, the positions of the probe(s), the locations of bands as determined by analysis of the second derivative of the DAPI intensity profile, and a standard ideogram of the chromosome for comparison. The approach was validated and compared to visual assignment of probes to DAPI bands using the cosmid clone PYGM, which has been previously mapped to chromosome 11q13, and has been used as a landmark for mapping for other probes.

Cells, Cultured↗

Computer rejection of EEG artifact. II. Contamination by drowsiness.

As part of an effort to automatically measure a background EEG baseline against which changes due to therapy or experimental manipulations may be measured, algorithms to detect EEG patterns associated with drowsiness have been developed and objectively evaluated. The decision of drowsiness is tentatively based upon changes in simple signal features, including increased ratios of both delta-band to alpha-band and theta-band to alpha-band spectral intensity as compared to thresholds automatically determined from a waking calibration period. Several heuristic criteria are then required to reach a final decision. Thirty-one normal and abnormal, 3-minute, 8-channel clinical EEG recordings containing drowsiness were scored by 5 expert scorers. Out of a total of 106 events labeled drowsy by at least one judge, 85 were found by a consensus of 3 or more of the 5 experts. On the 20 recordings not used for training the decision thresholds (testing data set), the system found 84% for the 85 episodes found by the consensus, and 89% of the 62 episodes found by all 5 scorers. Only one event was found by the system which was not found by any scorer, or which did not border on a consensus-defined episode of drowsiness. This performance is adequate to justify inclusion of these algorithms into a previously described real time EEG analysis system, ADI-EEG, allowing integration of the decisions of the separate subsystems for detection of artifact, sharp transients and drowsiness.

Computers↗

Karhunen-Loève transform as a tool to analyze the ST-segment. Comparison with QT interval.

The spatial and temporal courses of ventricular repolarization are quite sensitive to the biochemical and biophysiologic environment of the myocardial cells, and are therefore often an early marker of heart disease, particularly of ischemia. The detailed morphology of the surface electrocardiogram contains considerable information about the repolarization process. The ST-segment changes with ischemia, injury, and drugs. The QT interval is affected by drugs, heart rate, and autonomic tone, and in some situations may identify individuals at high risk for arrhythmias and sudden death. Variability in the shape, including duration, of the ST-T waves reflects autonomic nervous system activity and may identify high-risk patients. Automated methods for quantitatively characterizing ST-T complexes are important in studying long-term electrocardiographic records. Two computer-based measurement procedures for characterizing the repolarization period were comparatively analyzed: Karhunen-Loève (KL) transform representation of the ST-T shape and measurement of beat-to beat durations of repolarization (QT intervals). The results of KL transform representation and time-domain QT measurement algorithms for studying the repolarization period of the electrocardiogram on the European ST-T database are presented. It was found that about 20% of the records present a quasiperiodic KL pattern of ischemic ST-T activity and another 20% exhibit repetitive but not clearly periodic patterns of ischemic ST-T changes. From these ischemic records, 50% showed QT variations in at least one lead associated with the ischemic episodes.

Algorithms↗

A high-resolution phantom for MRI.

Assessment of spatial resolution is an important step to test the performance of new sequence techniques-especially ultrafast techniques with dedicated k-space trajectories or interpolation algorithms. Measurement of the modulation transfer function (MTF) is a rather difficult procedure, but using suitable resolution phantoms allows a simple visual evaluation of spatial resolution. In contrast to commonly used test objects with a very restricted number of resolution patterns we developed a phantom containing resolution patterns from 0.1 to 1.5 mm in steps of 0.1 mm. One resolution pattern consists of five parallel Plexiglas strips with the distance of the strips being equal to their thickness. Together with a Plexiglas cuboid the resolution patterns are mounted on a Plexiglas plate on the bottom of the cylindrical phantom. An aqueous solution of manganese chloride is used to fill the phantom. High resolution cross sections (pixel size: 50 microm) through the resolution patterns were measured to confirm the correct dimensions of the phantom. To verify the appropriateness of the 0.1 and 0.2 mm stacks micro-CT images with a pixel size of 25 microm were acquired additionally for both patterns. Besides visual inspection evaluation of the profile function of signal intensity across the stacks demonstrates that the resolution patterns are sufficiently correct. T(1)-weighted SE sequences with slightly different pixel sizes as well as T(1)- and T(2*)- weighted gradient echo sequences were applied to demonstrate some possible applications of this phantom. In conclusion, the proposed phantom is well suited to assess the spatial resolution qualitatively (i.e., visually) and quantitatively over a wide range in steps of 0.1 mm.

Humans↗

In vivo accuracy and reliability of color-coded image enhancements for the assessment of periradicular lesion dimensions.

OBJECTIVE: The purpose of this study was to compare dimensions on charge-coupled device-acquired images under various enhancements with dimensions on film radiographs and in vivo dimensions with respect to the linear measurement of periradicular radiolucent lesions. STUDY DESIGN: The dimensions of 25 lesions imaged by means of a charge-coupled device-based digital receptor and Ektaspeed Plus radiographic film were measured and compared with dimensions as actually measured on impressions of the lesions taken during surgery. Digital images were displayed in unenhanced, equalized, and equalized/color-coded modes. The color-coding protocol was repeated to determine the method error, and each image treatment was also remeasured to determine intrarater reliability. Differences were compared through use of a Friedman 2-way analysis of variance with a follow-up Wilcoxon signed rank test (alpha = 0.01). RESULTS: Actual lesion dimensions were larger than dimension estimates obtained with digital images (range, 23% to 35%) and film radiographs (range, 29% to 43%). Color-coded images were significantly less accurate than equalized images and unenhanced images. Images equalized through use of the measurement algorithm of the resident software provided estimates that were more accurate than estimates made with film radiographs and a standard millimeter rule. Intrarater variability was low. The application of color coding was found to be unreliable. CONCLUSIONS: When applied to intraoral images, color-coded image processing of digital images had limited value in the estimation of periradicular lesional dimensions.

Analysis of Variance↗