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PubMed1980

The dorsal lumbar muscles of the cat.

Observations made in the present study of the dorsal lumbar muscles of the cat are at variance with descriptions in the available literature. The morphology of these muscles is described in detail, and a revised interpretation of this morphology is made. There are 5 muscles -- multifidus, intertransversarii mediales, lumbococcygeus, iliocostalis lumborum and longissimus lumborum. They are arranged in 5 parallel polysegmental columns and are covered by the dorsal layer of thoracolumbar fascia and the erector spinae aponeurosis. The multifidus consists of fibres connecting mamillary and spinous processes. From each mamillary process 4 sets of fasciculi arise. Each set has constant specific attachments. The intertransversarii mediales are fibres connecting accessory and mamillary process. 3 principal fasciculi arise from each accessory process and insert into particular mamillary processes at more caudal levels. The iliocostalis and longissimus arise from the ilium and from opposite surfaces of an intermuscular septum. The lumbococcygeus arises in the lumbar region from the accessory processes but inserts in the tail. Reasons for the revised nomenclature and interpretation are discussed. A specific definition of the longissimus lumborum and iliocostalis lumborum is made on the basis of their observed morphology and nerve supply. It is argued that the lumbococcygeus should be considered as the lumbar portion of sacrocaudalis dorsalis lateralis rather than part of a common muscle mass.

Animals↗

PubMed1981

[Principles and definitions in epidemiology (author's transl)].

When medical research became concerned with the aetiology of chronic diseases, it also became necessary to adapt the principles enounced by Koch for the study of acute infectious diseases and this was expressed most satisfactorily by Evans. These changes entailed the profusion of new definitions of epidemiology which were recently reviewed by Evans and led him to propose a new one--the 24th. One important characteristic of epidemiology, however, does not appear clearly in these various definitions, namely that it is a branch of medicine. In short, it could be defined as the medical science of human groups. The authors show how the work of the epidemiologist parallels that of the medical practitioner facing a patient. The observation of the distribution of the disease within the population, referred to as descriptive epidemiology corresponds to the clinical examination and the enumeration of symptoms in the individual. The clinical interpretation of the symptoms and reasoning leading to a diagnosis is paralleled by the work of the "analytical" epidemiologist trying to discover the aetiological factors of the disease. The clinician finally takes action and administers treatment, while the findings of the epidemiologist find their application in Public Health preventive action. The authors conclude by proposing a modified version of Evans' definition of epidemiology; it reads: "Epidemiology is the quantitative study of physiological, prepathological and pathological conditions and processes in human populations, in relation to natural or man-made environmental factors which account for or favour their inception, development or disappearance. Its purpose is to prevent health disorders, to reduce their incidence or to lessen their ill effects. Epidemiology uses the resources of all medical sciences, plus all those--including statistics--imposed by its specific subject. It is the medical science of human groups. It completes and expands traditional medicine dealing with individuals".

Epidemiologic Methods↗

PubMed1995

Clinical and psychological classification of non-specific low-back pain. A new study in primary care practice.

This study aimed to explore the clinical and psychological features of non-specific low-back pain (LBP), and to evaluate a classification of patients based on the relationship between psychological disturbances and LBP clinical presentation. An unselected population of consecutive patients (n = 262) complaining of low-back pain to primary care physicians of the Epidemiology Team of the French Rheumatology Society, in October and November 1991, was studied. Measures included a standardized clinical evaluation of the back and a psychological assessment using the General Health Questionnaire. Ninety nine patients (38%) were classified as having a psychological disorder. The following symptoms: psychological precipitating event, permanent pain at night, diffuse spinal pain, pain increased by changing climate, pain increased by psychological factors, dysesthesias in the back, non-anatomical tenderness, were found to be closely associated with the existence of psychological disorder. Correspondence and cluster analyses provided support for the four-group classification of low-back pain previously devised. This classification may be interpreted through the relationships between psychological disturbances and the back clinical features. Although the study was mainly descriptive and used a cross sectional design, its results underline the importance of psychological influence on low-back pain presentation, and suggest the interest of a psychiatric assessment in low-back pain patients. Psychological disorders appear to be frequent in these patients and specific management of these disorders may prove useful.

Adolescent↗

PubMed1995

How to design smile styles for cosmetic dentistry.

Even though many patients may simply let you choose a smile style for them, once you select it, show it to them for their approval. As Jennifer de St. Georges says, "Inform before you perform. No surprises!" On the other hand, when patients offer verbal descriptions of how they want their smiles to look, there is a lot of room for subjective interpretation. By using photographs and models, much of the confusion can be eliminated. After all, our goal is to make the patient smile.

Color↗

PubMed1994

Identification of substructures in CT-images.

Identification of substructures is one of the important issues in automated and computer assisted systems used for interpretation of radiographic images because of vague definition of organ shape. In this paper an Autoregressive model has been proposed for shape description of substructures(organs) obtained in the form of outer boundaries from the abdominal CT-images. The results of matching show the effectiveness of the proposed model in identifying substructures from the images.

Humans↗

PubMed1996

Patients' narratives concerning good and bad caring.

Narratives from patients (n = 80) and patients' relatives (n = 12) were collected to illuminate experiences of good and bad caring episodes and to obtain descriptions of good caring. Narratives describing good caring included such task aspects as swift and correct assessment and access to information. Aspects less frequently mentioned were, for example, being given time, receiving pain relief and good food. Relationship aspects mentioned; having an interest shown in the care, being taken seriously and being cared about. There are parallels regarding relationship aspects between the narratives concerning good and bad caring episodes; for example what was praised in the good caring narratives was criticized in those describing bad caring. Such parallels were being/not being trusted, being/not being believed and being/not being respected. The narrations concerning bad caring were more specific and more vivid than those about good caring. The authors' interpretation was that the bad episodes were unexpected and very painful and therefore remained imprinted in the patients' memories. The descriptions of good caring included relationship aspects in only 34 cases, task aspects in only five cases and a combination of both in 50 cases. The ultimate purpose of the study was to obtain a basis for the development of a policy for good caring founded on patients' experiences. It is desirable that further studies be undertaken within various clinical specialties which would also take into consideration medical, social and cultural perspectives.

Adolescent↗

PubMed2001

Quantifying the characteristics of unambiguous chest radiography reports in the context of pneumonia.

RATIONALE AND OBJECTIVES: The purpose of this study was to statistically identify some characteristics of unambiguous (ie, clear) chest radiography reports in the context of acute bacterial pneumonia. MATERIALS AND METHODS: Seven physicians individually read 292 chest radiography reports to determine if they contained radiologic evidence of pneumonia. Unambiguous reports were defined as those that physicians unanimously classified as supporting or not supporting the diagnosis of pneumonia. Ambiguous reports were assigned degrees of ambiguity on the basis of how much disagreement they caused among the physicians. Characteristics of unambiguous reports as described in the literature were manually quantified and assigned to every report. To identify characteristics that statistically distinguished unambiguous from ambiguous reports, the authors performed an ordinal logistic regression analysis for which the dependent variable was the number of dissenting votes the report received and the independent variables were the quantified characteristics of the report. RESULTS: Six independent variables were statistically significantly associated with unambiguous reports (P < .05). Three were positively associated: an interpretation of whether findings supported the diagnosis of pneumonia in reports with pneumonia-related observations, short sentences, and redundancy of pneumonia-related observations. Three were negatively associated: high use of uncertainty modifiers for pneumonia-related observations, use of only descriptive terms to describe pneumonia-related observations, and insufficient amount of pneumonia-related information. CONCLUSION: The most influential characteristic of an unambiguous chest radiography report was an interpretation of whether the radiograph supported the diagnosis of pneumonia when findings could be indicative.

Diagnosis, Differential↗

PubMed1996

Interpretation of flow encoding and quantification in MRI: time domain versus frequency domain.

The traditional approach to flow effects in MRI is based on the gradient moment expansion. Recently, we have presented an alternative description by using linear response theory: the distortions of the velocity waveform induced by the gradient waveforms were analyzed in the frequency domain on the basis of the transfer function. In the present paper, we perform an analysis of flow encoding and quantification in the time domain, on the basis of the impulse response. The analysis shows that flow encoding should be interpreted as a weighted averaging process. Instantaneous flow encoding is determined by the centroid of the impulse response, but care should be taken regarding the physical meaning of the instant of encoding. The relationship of this approach to the frequency domain and gradient moment expansion approaches is clarified. By way of example, some interesting applications are investigated: asymmetrical phase encoding gradients to minimize misregistration and oscillating read-out gradients for flow quantification. A variety of new applications are expected to derive from the combination of both the time and frequency domains.

Magnetic Resonance Imaging↗

PubMed2003

Optically induced dynamics in nematic liquid crystals: the role of twist deformation and asymmetry.

We present a theoretical study of optically induced dynamics in a homeotropic nematic liquid crystal excited at normal incidence. By retaining the first symmetric and antisymmetric reorientation modes, the dynamical equations are reduced to a four-dimensional problem. The main advantage of this minimal approach is to emphasize the role of twisted mode and asymmetry of the light-induced molecular reorientation in a manner suitable for a clear physical interpretation. Theoretical results are compared with experiments in the particular case of circularly polarized light beams to show the physical origin of mode competition and of the breakdown of chiral and longitudinal symmetry. The model successfully describes previous experimental studies such as time-dependent three-dimensional molecular dynamics, light-induced stabilized helical reorientation, and in-plane precession regime in achiral nematics. While a recent experiment has revealed a new spatiotemporal transition, the model succeeds to describe all the features of such a bifurcation pointing out anew the importance of asymmetry. Finally, the first quantitative description of the appearance of a giant mirrorless optical bistability when twisted reorientation modes are excited is demonstrated. A qualitative physical interpretation is suggested for all these phenomena.

Journal Article↗

PubMedDate not supplied

Correlation of emergency department radiographs: results of a quality assurance review in an urban community hospital setting.

BACKGROUND: The study objective was to compare the accuracy of radiograph interpretation by emergency and family physicians with radiologists' overreadings. METHODS: We undertook a historical chart review of patients seen consecutively during a 1-year period at an inner-city emergency department of a medium-volume community hospital. The participants were a racially mixed group of 22,141 patients for whom 12,083 radiographs had been ordered. We compared interpretations by emergency and family physicians with those of radiologists who performed overreadings within 24 hours. This intervention was performed retrospectively. Measurements consisted of descriptive statistics, such as percentages and chi-square analysis. RESULTS: The main result was an overall discrepancy rate (ODR) of 1.1 percent. This figure is significantly different (P < 0.0001) from the lowest reported overall discrepancy rate to date (2.8 percent). CONCLUSIONS: Consistently low overall discrepancy rates have specific implications for the medical practice and reimbursement of primary care physicians for radiograph interpretation.

Clinical Competence↗

PubMed2003

Circumferential change scores in phallometric assessment: normative data.

Phallometric testing is a procedure that has enjoyed considerable popularity as an objective component in the assessment of sexual offenders. The value of this procedure may be most notably compromised in the realm of interpretation, and problems in interpretation are particularly acute for those participants where full arousal is not obtained during testing. The calculation of Percent Full Erection (PFE) scores has of necessity involved a speculative component in such cases. Eliminating this speculation through empirical investigation was the purpose of the current research. Circumferential change scores (from flaccidity to full erection) were obtained for 724 respondents at nine North American correctional facilities, allowing for the calculation of descriptive statistics and a determination of the distribution characteristics of these scores. The results provide an empirical basis for calculating PFE scores and interpreting phallometric data in those cases where full arousal is not obtained, and specific confidence levels associated with interpretation are offered. It is suggested that only through a more rigorous application of the principles of science will the procedure of phallometric assessment fulfill its true potential.

Adolescent↗

PubMed2006

Zen and the art of nomenclature maintenance: a revised approach to respiratory symbols and terminology.

In this paper we point out that there are different entities involved in the mathematical descriptions, or models, of the respiratory system: variables and parameters. These, in turn, can be divided into different types. Variables can be primary variables, difference variables, or change variables. Difference variables express the difference between primary variables measured simultaneously at 2 locations. Change variables are primary variables measured relative to fixed reference values. Parameters that appear in input-output models that are valid over a wide range of inputs can be interpreted as properties. There are 3 levels of properties, depending on the detail included in the model. If the model specifically includes the geometry of the system and the substances of which the system is composed, then the parameters in the model are material properties. If the model includes the general structures that compose the system, the parameters are structural properties. And if the model describes the behavior of the system as a whole with no detail included pertaining to internal makeup, then the parameters can be considered system properties. Parameters that appear in mathematical descriptions of input and/or output wave shapes can be interpreted as waveform characteristics. General waveform characteristics are attributes of arbitrary inputs and/or outputs. However, in those special cases in which a system is subjected to a well-defined, specialized input and the output waveform is described mathematically (even if only at a single point), the parameter(s) in such descriptions can be considered system response characteristic(s). We suggest that the symbols and names given to these various entities should follow well-defined guidelines that distinguish among the entity types. These guidelines should include symbol and name conventions and also sign conventions and expected unit ranges on appropriate measurement scales. One such set of conventions would be as follows. Italicize all variables. Use upper-case for primary (absolute) variables. Use the delta symbol (Delta) to denote difference variables (difference between 2 locations). Use lower-case letters for change variables (change relative to a reference, or operating, point) and for abbreviations (eg, "pl" for "pleural"). Use upper-case characters to represent the initial letters of words (eg, "AO" for "airway opening"). Make bold nonitalicized groups of letters used for properties (upper-case, lower-case, multi-height). Do not bold or italicize groups of letters used for characteristics (upper-case, lower-case, multi-height). Compound symbols are those that include subscripts and/or superscripts. Subscripts following a symbol indicate location, direction, or index (time); if more than one subscript, separate them by commas. Superscripts following a symbol indicate a component, or it can indicate a power if the symbol is enclosed in parentheses. Letters on the same line as initial letter but in smaller type are part of the generic symbol. Arguments are enclosed in parentheses; parentheses are also used to isolate compound symbols from powers or additional subscripts. Adapt currently standard symbols to retain their identity but conform to the above conventions. The sign of an entity is always dictated by and its interpretation is based on the model in which the entity is used. Units used are consistent with measurement resolution and accuracy. Copious examples of the applications of this set of suggested conventions are given in the text and in 4 tables. Our hope is that the presentation of these suggestions will start a dialogue in the field and will influence journal and book publishers to adopt a consistent set of conventions for the names and symbols used for respiratory-system-related terms.

Communication↗

PubMed2003

Structural, chemical topological, electrotopological and electronic structure hypotheses.

The first important hypothesis in the prediction of properties of synthesized molecules is the structural hypothesis. In the study of drug-receptor interactions, the case where the three-dimensional structure of the receptor is known allows the application of molecular simulation and energy calculations to estimate the binding affinity for a proposed series of compounds. The chemical topological hypothesis permits the description of molecular structures without using concepts such as force or energy. These notions would not be as dominant as supposed since they should be able to be deduced from topology. Although topological descriptors are able to describe specific physicochemical properties, there is no any mechanistic interpretation for topological descriptors, but they can be considered as essential magnitudes, able to describe molecular structure as an alternative and independent approach, since they allow an algebraic description of the structure itself. The hypothesis is based on the ability of topological descriptors for the prediction of virtually any kind of structure-related macroscopic property, and to design directly new compounds showing predetermined properties. It is possible to design new lead drugs ignoring the explicit mechanism of action, but only by topological similarity with other active compounds. This is a basic difference with all the conventional methods based on the use of physical variables, which need to know the specific drug-receptor interaction. The electrotopological hypothesis may be considered a synthesis of both previous hypotheses. Finally, the electronic structure hypothesis is formulated.

Electrons↗

PubMed2001

[Significance of medical statistics in insurance medicine].

Knowledge of medical statistics is of great benefit to every insurance medical officer as they facilitate communication with actuaries, allow officers to make their own calculations and are the basis for correctly interpreting medical journals. Only about 20% of original work in medicine today is published without statistics or only with descriptive statistics--and this trend is falling. The reader of medical publications should be in a position to make a critical analysis of the methodology and content, since one cannot always rely on the conclusions drawn by the authors: statistical errors appear very frequently in medical publications. Due to the specific methodological features involved, the assessment of meta-analyses demands special attention. The number of published meta-analyses has risen 40-fold over the last ten years. Important examples for the practical use of statistical methods in insurance medicine include estimating extramortality from published survival analyses and evaluating diagnostic test results. The purpose of this article is to highlight statistical problems and issues of relevance to insurance medicine and to establish the bases for understanding them.

Actuarial Analysis↗

PubMed2000

IBIS data library: clinical description of the Finnish database. Improved Monitoring for Brain Dysfunction during Intensive Care and Surgery.

Improved monitoring of brain function in intensive care and surgery is a project aiming to develop methods of biosignal processing and interpretation, in order to characterise critical events during anaesthesia and cardiac surgery, effect of anaesthesia regimen, neurophysiological findings of different sedation levels, arousal from post-anaesthesia sedation, post-cardiopulmonary bypass brain dysfunction and early brain dysfunction in patients with multiple organ failure. A data library was collected in the three participating hospitals. This is a description of the data library from the University Hospital of Kuopio, Finland, which includes data from 40 patients after cardiac surgery and from seven patients with multiple organ dysfunction. This project demonstrates that active neuromonitoring can be performed in the intensive care unit without interference with the normal treatment and care. The presented database may serve other scientific workers as a reference for a typical spectrum of perioperative data with respect to severity of disease, length of cardiopulmonary bypass, postoperative levels of sedation and length of hospital stay in cardiac surgery patients, and for types of diseases and outcome in patients with multiple organ dysfunction.

Adult↗

PubMed1987

Kinetic description of proteolysis. Part 4. Hydrolysis kinetics of partial protein hydrolysates.

This report presents experimental data on kinetics of casein hydrolysate hydrolysis. The experiments were interpreted in the framework of a theory reported, which is guided by an experimentally measurable value--a total molar concentration of all peptides and amino acids (total amino nitrogen). The total amino nitrogen N was determined by photometry of N-trinitrophenyl (N-TNP) derivatives obtained by means of trinitrobenzenesulfonic acid (TNBS). Unlike the procedures reported previously, we stopped the proteolysis reaction by boiling, and performed the trinitrophenylation in a 20% V. aqueous solution of MeCN.

Amines↗

PubMed2006

Description of the cardiac movement using hexagonal image structures.

The most notable characteristic of the heart is its movement. Detection of dynamic information describing cardiac movement such as amplitude, speed and acceleration facilitates interpretation of normal and abnormal function. In recent years, the Omni-directional M-mode Echocardiography System (OMES) has been developed as a process that builds moving information from a sequence of echocardiography image frames. OMES detects cardiac movement through construction and analysis of Position-Time Grey Waveform (PTGW) images on some feature points of the boundaries of the ventricles. Image edge detection plays an important role in determining the feature boundary points and their moving directions as the basis for extraction of PTGW images--Spiral Architecture (SA) has proved efficient for image edge detection. SA is a hexagonal image structure in which an image is represented as a collection of hexagonal pixels. There are two operations called spiral addition and spiral multiplication defined on SA. They correspond to image translation and rotation, respectively. In this paper, we perform ventricle boundary detection based on SA using various defined chain codes. The gradient direction of each boundary point is determined at the same time. PTGW images at each boundary point are obtained through a series of spiral additions according to the directions of boundary points. Unlike the OMES system, our new approach is no longer affected by the translation movement of the heart. As its result, three curves representing the amplitude, speed and acceleration of cardiac movement can be easily drawn from the PTGW images obtained. Our approach is more efficient and accurate than OMES, and our results contain a more robust and complete description of cardiac motion.

Algorithms↗

PubMed1989

Structure-function studies of the T4 endonuclease V repair enzyme.

Published data on the structure and mechanism of endonuclease V from bacteriophage T4 are reviewed with the objective of developing a working mechanistic model of this enzyme. Endonuclease V is an interesting and important candidate to be the first DNA-repair enzyme to have its structure determined by crystallography, and a more detailed model of the reaction process is needed to mechanistically interpret such a structure. Such a model should be sufficiently detailed to support future investigations of structure/function relationships between the enzyme and the DNA damage repair pathway it initiates, as probed by site-directed mutagenesis techniques and other methods. The early literature is presented in an historical perspective, followed by a description of prior models and biochemical investigations. The biochemical phenotypes of mutants in the enzyme structural gene are discussed. The results of computer analyses aimed at structural interpretations of the protein sequence are given, together with a brief discussion of the strengths and weaknesses of such experiments.

DNA Damage↗