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PubMed2002

Movement quantification in epileptic seizures: a new approach to video-EEG analysis.

It is common that epileptic seizures induce uncoordinated movement in a patient's body. This movement is a relevant clinical factor in seizure identification. Nevertheless, quantification of this information has not been an object of much attention from the scientific community. In this paper, we present our effort in developing a new approach to the quantification of movement patterns in patients during epileptic seizures. We attach markers at landmark points of a patient's body and use a camera and a commercial video-electroencephalogram (EEG) system to synchronously register EEG and video during seizures. Then, we apply image-processing techniques to analyze the video frames and extract the trajectories of those points that represent the course of the quantified movement of different body parts. This information may help clinicians in seizure classification. We describe the framework of our system and a method of analyzing video in order to achieve the proposed goal. Our experimental results show that our method can reflect quantified motion patterns of epileptic seizures, which cannot be accessed by means of traditional visual inspection of video recordings. We were able, for the first time, to quantify the movement of different parts of a convulsive human body in the course of an epileptic seizure. This result represents an enhanced value to clinicians in studying seizures for reaching a diagnosis.

Algorithms↗
PubMed2001

Feasibility and clinical value of "intelligent" compression and digital storage of transthoracic echocardiograms in day-to-day practice.

BACKGROUND: The aim of this study was to assess the clinical concordance of expert cardiologists' interpretation of echocardiographic studies recorded on Super-VHS videotape or stored in magneto-optical disk, as well as the feasibility and clinical value of intelligent compression and digital storage of echocardiographic data as cine-loops and still-frames for interpretation of transthoracic echocardiographic images in clinical practice. METHODS: All clinical cardiologists experienced in echocardiography in our department (n = 10) reported on a standardized worksheet checklist the echocardiographic data of 7 consecutive patients (140 reports), and recorded them on videotape or magneto-optical disks to compare the interpretation of videotaped studies, acquired in the usual way, with clinically compressed studies stored to magneto-optical disks using a standard (Italian Society of Echocardiography) image acquisition protocol. RESULTS: The time interval between analog and digital study readings was 50 +/- 15 days. Except for tricuspid valve regurgitation grading (k = 0.28) and for left ventricular global hypokinesia (k = 0.32), the intraobserver agreement in the interpretation of the 3290 cardiovascular morphological and functional findings found on analog and digitally stored images was good (k value ranging from 0.66 to 1.00). The wall motion score index was 1.56 +/- 0.53 when interpreting analog studies, and 1.52 +/- 0.54 on digital studies (p = 0.35). Conversely, the interobserver variability of the wall motion score index (Gini index ranging from 0 to 0.80) was significantly lower when interpreting studies stored digitally than when analog ones were examined (0.48 +/- 0.021 and 0.52 +/- 0.023 respectively, p = 0.006). In comparison to videotape recordings, digital storage of echocardiographic studies significantly shortened the time to image access for study review (327 +/- 62 and 30 +/- 4 s, respectively, p < 0.0001) and the reading time (600 +/- 300 and 540 +/- 300 s respectively, p = 0.034), rendered study accessibility easier (difficult or good: 73 vs 43% of observers, fast or optimal: 27 vs 57% of observers respectively, p = 0.0011) and improved the recorded image quality perception (poor: 25 vs 10% of observers, sufficient or good: 75 vs 90% of observers respectively, p = 0.022), without loss of study completeness (insufficient: 18 vs 17% of observers, adequate or complete: 82 vs 83% of observers, respectively; p = NS). Finally, from September 1, 1999, digital storage has become routine practice for patients admitted to our Department. By December 31, 1999, 411 echo studies had been stored: 7 +/- 3 cine-loop/study, 32 +/- 18 frames/cine-loop, and 3 +/- 2 still-frames/study. The average amount of memory needed for storage was 18.6 +/- 11.9 MB/study. CONCLUSIONS: Clinical compression of echocardiographic studies seems to be an accurate summary of the complete examination recorded to videotape for the assessment of patients admitted in the coronary care unit. In addition, digitally stored studies allow a significant improvement in the interobserver reproducibility of wall motion score assessment.

Analog-Digital Conversion↗
PubMed1992

A survey of instructional technology in dental education.

Little is known about current use of hardware and non-hardware instructional technologies in dental education. To address this area, the investigators designed a questionnaire to assess support for the development of instructional technology and determine the extent to which different instructional technologies are used in North American dental schools. Responses were received from 59 of 65 dental schools (91 percent). Respondents at most schools judged the administration at their school to be supportive of the development of instructional technology, but in general, did not feel faculty were enthusiastic about or rewarded for developing innovative methods. The most common computer-based application involves testing and record keeping, which is used extensively in about half the dental schools. Individualized instruction and paper and pencil simulations are used in at least some courses at a majority of dental schools. Schools with available support services apply certain technologies to a significantly greater extent than schools without available support services.

Canada↗
PubMed2004

Exchanging digital video of laryngeal examinations.

Laryngeal examinations, especially stroboscopic examinations, are increasingly recorded using digital video formats on computer media, rather than using analog formats on videotape. It would be useful to share these examinations with other medical professionals in formats that would facilitate reliable and high-quality playback on a personal computer by the recipients. Unfortunately, a personal computer is not well designed for reliable presentation of artifact-free video. It is particularly important that laryngeal video play without artifacts of motion or color because these are often the characteristics of greatest clinical interest. With proper tools and procedures, and with reasonable compromises in image resolution and the duration of the examination, digital video of laryngeal examinations can be reliably exchanged. However, the tools, procedures, and formats for recording, converting to another digital format ("transcoding"), communicating, copying, and playing digital video with a personal computer are not familiar to most medical professionals. Some understanding of digital video and the tools available is required of those wanting to exchange digital video. Best results are achieved by recording to a digital format best suited for recording (such as MJPEG or DV),judiciously selecting a segment of the recording for sharing, and converting to a format suited to distribution (such as MPEG1 or MPEG2) using a medium suited to the situation (such as e-mail attachment, CD-ROM, a "clip" within a Microsoft PowerPoint presentation, or DVD-Video). If digital video is sent to a colleague, some guidance on playing files and using a PC media player is helpful.

Analog-Digital Conversion↗
PubMed1985

Coronary angiography and intracoronary thrombolytic therapy in the coronary care unit: an alternative approach.

The feasibility, safety and efficacy of performing left heart catheterization, coronary angiography, and intracoronary thrombolytic therapy in the coronary care unit setting were examined in 17 patients with acute ischemic syndromes presenting at a time when routine catheterization facilities were not available. In all cases, cardiac catheterization and coronary angiography were performed in the coronary care unit without difficulty using a portable image intensifier and a portable video recording system, and selective intracoronary streptokinase was safely administered in 13 patients with a total coronary occlusion, with successful thrombolysis in seven patients (54%). No adverse effects attributable to the performance of these procedures in the coronary care unit were observed. This approach might allow for a more prompt response and wider availability of intracoronary thrombolytic therapy for patients presenting with acute myocardial infarction.

Coronary Angiography↗
PubMed2004

What effect does isoflurane have upon ciliary beat pattern: an in vivo study.

The effect of anaesthetic gases given via laryngeal mask on nasal ciliary beat pattern and frequency has not been studied. Anaesthetic gases such as isoflurane, halothane and enflurane are known to reduce ciliary beat frequency, but it is unknown whether they also cause cilia to beat in a dyskinetic fashion. Brush biopsies of nasal mucosa were taken pre- and post-anaesthesia with isoflurane, given via a laryngeal mask, from patients undergoing nasal surgery. The samples were observed by light microscopy, and high-speed digital video recordings were made to determine ciliary beat frequency. Using slow-motion playback, the ciliary beat pattern was scored for dysmotility, and the proportion of immotile cilia in the sample was determined. We found that ciliary beat frequency decreased significantly (P < 0.01) after exposure to isoflurane (10.24 Hz compared to 9.20 Hz). However, isoflurane did not alter the ciliary beat pattern or the proportion of immotile cilia.

Adolescent↗
PubMed2006

Teaching therapeutic communication VIA camera cues and clues: the video inter-active (VIA) method.

For nursing and other health care students to be effective, remain in their training, and subsequently join the health care workforce, they need to have good therapeutic communication skills. This article presents an innovative strategy to improve therapeutic communication skills for nursing and health sciences students. The Video Inter-Active (VIA) computer-based, challenge-response-record-evaluate method used in this pilot study engaged students in realistic responses to scenarios commonly encountered in health care settings and provided them with opportunities to see themselves and critique their responses. Findings from this pilot study indicate that the VIA method is an effective and efficient way for students to develop and practice therapeutic communication skills. In a relatively short period (5 weeks), their learning from this method far

Adult↗
PubMed2004

Digital video.

The process of digital capture, editing, and archiving video has become an important aspect of documenting arthroscopic surgery. Recording the arthroscopic findings before and after surgery is an essential part of the patient's medical record. The hardware and software has become more reasonable to purchase, but the learning curve to master the software is steep. Digital video is captured at the time of arthroscopy to a hard disk, and written to a CD at the end of the operative procedure. The process of obtaining video of open procedures is more complex. Outside video of the procedure is recorded on digital tape with a digital video camera. The camera must be plugged into a computer to capture the video on the hard disk. Adobe Premiere software is used to edit the video and render the finished video to the hard drive. This finished video is burned onto a CD. We outline the choice of computer hardware and software for the manipulation of digital video. The techniques of backup and archiving the completed projects and files also are outlined. The uses of digital video for education and the formats that can be used in PowerPoint presentations are discussed.

Humans↗
PubMed1993

[X-ray VTR analysis for the inflowing movement of the contrast medium in the esophagocardiac region: the inflowing movement of contrast medium on healthy people].

The application of S-VHS video system has made it possible to easily detect the functional disease. Among several position, left posterior prone position where gravitational force could be ignored, and spontaneous, physiological movement could be registered in the recording of the esophagocardiac movement. Through the observation and the classification of the movement at this position, we evaluated the contribution of this method to the assessment, and the study of the functional diseases such as achalasia, hiatus hernia, and the study of the organic diseases such as carcinoma. In our present study on normal 60 cases, the time from the inflowing first phase to the inflowing interrupted phase in the last period becomes longer as the age of the subjects gets older. The continuous contractive period was divided into three types, shorter type, medium type and longer type. The shorter type seems to correspond to the type closer to hernia. The longer type is regarded as the type closer to achalasia.

Cardia↗
PubMed2004

Propagation of tonic posturing in supplementary motor area (SMA) seizures.

We analyzed ictal motor symptoms in 10 patients diagnosed to have supplementary motor area (SMA) seizures based on ictal encephalographic (EEG) findings and ictal clinical semiology. Inclusion criteria were (1) EEG seizure pattern in the vertex for the scalp recording or in the area over and/or adjacent to SMA for epicortical recording and (2) ictal motor semiology characterized, as previously reported, by sudden and a brief tonic posturing of extremities and trunk mainly occurring during sleep without loss of consciousness. In 50% (5/10) of the patients, tonic posturing began in one part of the body and moved to other part(s) in 5-10s. Unlike Jacksonian march seen in seizures involving the primary sensorimotor area (S1-M1), it spread in no accordance with the somatotopy in S1-M1. The sequential propagation of tonic posturing may represent the somatotopic organization within the SMA proper.

Adolescent↗
PubMed2003

Tackling children's road safety through edutainment: an evaluation of effectiveness.

The burgeoning market in electronic media has encouraged a trend toward 'edutainment', where entertaining, media-based materials are used to facilitate educational outcomes. In this study, we evaluated the effectiveness of a video that has recently been released by a popular children's entertainment group to help tackle Britain's poor record on children's road safety. We wished to determine whether the video had an impact on either children's knowledge or parents' awareness of pedestrian skills, when used in a standard home-based fashion. A total of 120 families participated, all of whom had children 5 years of age. Half the families received videos at the beginning of the study, while the other half served as a control group against which to measure change in the treatment group. Data were gathered at baseline and again 1 month later, using a series of tailored questionnaire items. A robust pattern of null findings indicated that the video, when used in this casual fashion, had no educational impact on either parents or children. Crucially, however, parents strongly believed that it had. The discussion explores the implications of such a mismatch and highlights similarities with outcomes of other health education interventions.

Accidents, Traffic↗
PubMed2002

Feasibility of using a video-based motion analysis system for measuring thumb kinematics.

While several different methods have been used to measure hand kinematics, fluoroscopy is generally considered to be the most accurate. Recently, video-based motion analysis has been developed for the measurement of joint kinematics. This method is versatile, easy to use, and can measure motions dynamically. Surface markers are most commonly used in the video-based motion systems. However, whether the surface markers placed on the thumb accurately represent the true kinematics of the underlying bony segment is questionable. In this study, the feasibility of surface markers to represent thumb kinematics was investigated by fluoroscopy. Both the positions of surface markers and bony landmarks were simultaneous recorded and then digitized. The Ra(2) values comparing the angular changes of the thumb interphalangeal, metacarpal and carpometacarpal joints derived using the surface markers or bony landmarks were 0.9986, 0.9730 and 0.9186 in the flexion/extension plane respectively, 0.8837, 0.9697 and 0.8775 in the abduction/adduction plane; and 0.9884, 0.9643 and 0.9431 in the opposition plane. The ranges, mean and standard deviation of the absolute differences between calculated angles of different marker sets were also compared. These data revealed that the similarities of the two different marker techniques throughout the motion cycle were high. The differences between the two methods were also within clinically allowable range of +/-5 degrees. It is concluded that the application of the video-based motion analysis system with surface markers to thumb kinematics is warranted.

Adult↗
PubMed2001

The application of three-dimensional internal structure microscopy in the observation of mare ovary.

The ovary of the mare has a unique structure which differs totally from that of other mammals. However, because of its relatively large size, conventional histological techniques were unsuitable for the observation of the internal structure of the whole ovary. Three-dimensional internal structure microscopy (3D-ISM) consists of a cryotome-CCD camera-laser disc recorder-PC-based control system coupled with a graphic workstation. The internal structure of the ovary is observed by processing over more than 1,000 stored images of serially sliced surfaces of each frozen equine ovary. The 3D reconstruction was done using the full-coloured, volume-rendering method. The relationship between the localization of medulla, cortex and ovulation fossa was clarified. The ovulation fossa is localized in the centre of the ovary and is surrounded by a broad ovarian cortex. A trace of ovulation was observed only at the ovulation fossa. Medulla are localized in narrow peripheral areas. The phenomenon of the competition to occupy the cortical area ahead of the ovulation fossa by developing secondary follicles was visualized. Spatial localization of various sized follicles was identified from 3D-reconstructed images. In this study, it has been clarified that application or this novel computerized technique can clarify the anatomical arrangements of the equine ovary and the complex mechanism of equine follicular development.

Animals↗
PubMed1998

The effect of B-mode ultrasonic image standardisation on the echodensity of symptomatic and asymptomatic carotid bifurcation plaques.

BACKGROUND: To develop a method that allows B-mode ultrasonic images of carotid plaques to be standardised so that measurements of plaque echodensity become comparable and clinically useful. METHODS: Design. Cross sectional study. Setting. Teaching hospital, England. PATIENTS: a random consecutive series of 23 patients in part I, 19 in part II and 77 in part III. Measures. Part I: twenty-three images of carotid bifurcation plaques from 2 duplex scanners were digitised. Images were standardised by 4 observers so that the grey scale median (GSM) would be 0-5 for blood and 185-195 for adventitia. Part II: the effect of three different recording media: video, magneto-optical disk (MOD) and thermal paper on the echodensity of 19 plaques' images was determined. Part III: the echodensity of 91 carotid bifurcation plaques with greater than 50% stenosis was correlated to the presence or absence of ipsilateral hemispherical symptoms. RESULTS: Part I: the coefficient of variation (CV) among 4 observers was 0.7%, 0% and 4.7% after image standardisation for the adventitia, blood and plaques respectively. Part II: a near perfect agreement was obtained between the GSM of plaques from images on video and MOD (r = 0.97) after standardisation. Part III: after standardisation, the GSM of symptomatic plaques was lower (21 +/- 14.8) than in asymptomatic plaques (38 +/- 26) p = 0.002. Plaque echolucency was more likely to be associated with symptoms (relative risk 4.1 90% CI 1.8-9.4). CONCLUSIONS: Images from different scanners by different ultrasonographers and through different peripherals can be standardised so that measurements of plaque echodensity may become comparable. The method is recommended for use in future natural history studies on carotid plaques where stroke is the end-point.

Carotid Artery Thrombosis↗
PubMed1988

A new rhythm library for testing automatic external defibrillators: performance of three devices.

A library of arrhythmias obtained from patients with cardiac arrest was developed. Such a data base will permit both in vitro testing of the rhythm analysis system of automatic external defibrillators before clinical field trials are conducted and comparison of devices. Defibrillators equipped with voice/electrocardiographic tape recorders and used in the prehospital defibrillation programs in Iowa and King County, Washington provided the rhythm source. From these recordings, segments of ventricular fibrillation with minimal artifact and a duration of greater than or equal to 6 s were selected. Segments of ventricular fibrillation (n = 102) were categorized by average peak amplitude as fine (1 to less than 3 mm), medium (3 to less than 7 mm), coarse (7 to less than 12 mm) and extra coarse (greater than or equal to 12 mm), and transcribed onto high fidelity videocassette tapes. Nonventricular fibrillation cardiac arrest rhythms (n = 144), which included wide complex idioventricular rhythms, ventricular and supraventricular tachycardias, asystole and artifact, were also transcribed. Automatic external defibrillators developed by three manufacturers reached a treat (shock) decision on 88 to 93% of the ventricular fibrillation rhythms and on 5 to 10% of the nonventricular fibrillation rhythms. The latter decisions were defined as false positive, though for many rapid nonventricular fibrillation rhythms, countershock may be the appropriate treatment response. There were no statistically significant differences among the three devices in the shock/no shock decisions. A variety of ventricular fibrillation arrhythmias and terminology to express the preclinical performance of automatic external defibrillators are defined. Three commercially available automatic external defibrillators appear to successfully identify ventricular fibrillation and nonventricular fibrillation rhythms.(ABSTRACT TRUNCATED AT 250 WORDS)

Arrhythmias, Cardiac↗
PubMed1992

AI/Learn/Rheumatology. A computer-assisted educational system for teaching about rheumatic diseases.

Education of health professionals about the rheumatic diseases is in need of improvement. The computer is an instrument that can be used efficiently to educate large numbers of users. With specific educational principles in mind, we developed AI/Learn/Rheumatology, a computer-assisted interactive videodisc system for teaching the rheumatic diseases. While interacting with the user, it conveys knowledge using visual and problem-solving techniques. The system is efficient, enjoyable to use, and useful for small groups and independent study. It is applicable for teaching medical and allied health professional students, postgraduate trainees, and primary care physicians.

Computer-Assisted Instruction↗
PubMed1984

Light microscopic observations on the release of vesicles by isolated chromaffin cells.

Cultured bovine adrenal medullary chromaffin cells were stimulated with the secretogogues Ba2+ or carbamyl choline plus Ca2+. With video-enhanced contrast, differential interference contrast microscopy, small vesicles were found to appear on the cell surface during stimulation. The structures were of lower refractive index than the cytoplasm, and their appearance required several tenths of a second. The vesicles are thought to correspond to omega figures seen with electron microscopy due to exocytosis. Many of the structures disappeared within a few seconds, but some appeared to coalesce into larger structures. The large structures may lead to the vacuoles that have been demonstrated to be present following stimulation. The nature of the cellular elements responsible for the vesicle which appeared on the surface was not found with either differential interference or interference reflection microscopy. The simplest explanation is that the refractive index of the elements is similar to that of the cell, and therefore the elements cannot be seen.

Adrenal Medulla↗