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[What does asymptomatic stenosis mean? Topics in clinical terminology and documentation].

A generally accepted classification and documentation for cerebrovascular insufficiency are needed to eliminate controversies and misinterpretation in clinical studies on the spontaneous course of the disease and the outcome of patients receiving surgical or conservative treatment. The author proposes a clinical classification (stages I to IV) based on the affected vascular territory (A, B, C). The following findings should be included: 1. the number of diseased extracranial arteries (I to IV vessel disease), 2. the presence of ischemic brain lesions (CT, SPECT, RMI), 3. concomitant diseases or risk factors (hypertension, coronary heart disease etc.). Such morphological and functional staging makes possible the selection of comparable groups of patients for investigation.

Brain Ischemia

The definition and operational criteria for treatment outcome of major depressive disorder. A review of the current research literature.

A review of research articles published in nine journals over a 2-year period was conducted to determine how critical changes in the clinical course of depressive disorder are defined in the research literature. These change points, labeled by terms such as response, recovery, and relapse, are critical for evaluation and communication of study results. The review focused on studies of unipolar depression that used a criterion-based diagnostic system and involved some form of therapeutic maneuver. The review showed significant inconsistency in the labeling and definition of change points and indicated the need for more precise conceptual definitions and operational criteria to enhance comparison, generalization, and application of results from clinical studies of depression.

Depressive Disorder

Understanding and eliminating errors in perinatal research.

Research studies published in the scientific literature have had a rapid impact on medical practice, especially in clinical obstetrics. Recently, incentives to control medical costs without sacrificing the quality of care have placed increased importance on studies that truly demonstrate clinical effectiveness. In addition, there are ethical concerns that improperly designed or conducted studies adversely affect medical practice and place patients at unnecessary risk. This article summarizes potential sources of error and encourages the valid interpretation of the results and conclusions of experimental studies by making four suggestions: (1) the errors and limitations that may be present in the methodology should be described and explanations given how the errors might have affected the results and why the limitations are acceptable; (2) the methods selected should allow an answer to the question proposed; (3) the investigator should verify that the appropriate statistical test is used; and (4) when unexpected or hard to explain results are found, verification before publication should be undertaken.

Models, Theoretical

Statistical analysis of channel current from a membrane patch. II. A stochastic theory of a multi-channel system in the steady-state.

A general stochastic theory is presented for analysis of current records of a patch containing an arbitrary number (N) of independent homologous channels in the steady-state. We give the "basic theorem" that at the instant of any open (or shut) transition of a channel, the other N-1 channels are located in each state with a probability equal to those in the steady-state, if enough transitions are observed. Using the "basic theorem", we derived: (a) the time-dependent open and shut frequencies after a definite type of transition, and (b) the probability density functions (pdf) of the duration of any period between two successive transitions. Briefly, the main results obtained were: (1) The time-dependent open (or shut) transition frequency after every shut (or open) transition at t = 0 in an N-channel patch, fJSh,Op(t)(N) (or fJOp,Sh(t)(N)), is the same as that of a one-channel patch except for the value of the constant. (2) In the all-shut (or all-open) period of a patch, the average duration of the period is 1/N, and the slowest exponential decay constant contained in the pdf is N times those of a single channel patch, respectively. (3) An example calculation for small N showed that the stochastic properties of a single channel can be obtained even when N is uncertain, if the channel open probability is small and exponential decay constants are separated. (4) When the channels are in equilibrium, the pdf of duration of every type of period in the patch is described by a sum of exponential terms with positive coefficients. This also holds for fJSh,Op(t)(N) and fJOp,Sh(t)(N).

Ion Channels