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Introducción. La disfagia se define como la dificultad para movilizar la comida desde la boca hasta el estómago. La prueba diagnóstica para esta condición es la videofluoroscopia, la cual no es totalmente inocua pues utiliza radiación ionizante. La electromiografía de superficie registra la actividad eléctrica de los músculos de manera no invasiva, por lo que puede considerarse como una alternativa para evaluar la deglución y estudiar la disfagia. Objetivo. Evaluar la relación entre los tiempos relativos de activación de los músculos implicados en la fase oral y faríngea de la deglución, con los movimientos registrados durante la videofluoroscopia. Materiales y métodos. Se analizaron las señales de la electromiografía de superficie de 10 pacientes neurológicos con síntomas de disfagia, captadas en forma simultánea con la videofluoroscopia. Se suministraron 5 ml de yogur y 10 ml de agua, y 3 g de galleta. Se estudiaron bilateralmente los grupos musculares maseteros, suprahioideos e infrahioideos. Se analizó el paso del bolo por la línea mandibular, las valleculas y el músculo cricofaríngeo, correlacionándolo con el tiempo inicial y el final de la activación de cada uno de los grupos musculares. Resultados. El tiempo promedio de la fase faríngea fue de 0,89 ± 0,12 s. En la mayoría de los casos, hubo activación muscular antes del paso por la línea mandibular y las valleculas. La terminación de la actividad muscular parece corresponder al momento en que se completa el paso del bolo alimenticio por el músculo cricofaríngeo. Conclusión. Se determinaron los tiempos de actividad muscular, la duración de la fase faríngea y la secuencia de la activación de los grupos musculares involucrados en la deglución, mediante electromiografía de superficie, validada con la videofluoroscopia.
Introduction: Dysphagia is defined as the difficulty in transporting food and liquids from the mouth to the stomach. The gold standard to diagnose this condition is the videofluoroscopic swallowing study. However, it exposes patients to ionizing radiation. Surface electromyography is a non-radioactive alternative for dysphagia evaluation that records muscle electrical activity during swallowing. Objective: To evaluate the relationship between the relative activation times of the muscles involved in the oral and pharyngeal phases of swallowing and the kinematic events detected in the videofluoroscopy. Materials and methods: Electromiographic signals from ten patients with neurological involvement who presented symptoms of dysphagia were analyzed simultaneously with videofluoroscopy. Patients were given 5 ml of yogurt, 10 ml of water, and 3 g of crackers. Masseter, suprahyoid, and infrahyoid muscle groups were studied bilaterally. The bolus transit through the mandibular line, vallecula, and the cricopharyngeus muscle was analyzed in relation to the onset and offset times of each muscle group activation. Results: The average time of the pharyngeal phase was 0.89 ± 0.12 s. Muscle activation was mostly observed prior to the bolus transit through the mandibular line and vallecula. The end of the muscle activity suggested that the passage of the bolus through the cricopharyngeus muscle was almost complete. Conclusion: The muscle activity times, duration of the pharyngeal phase, and sequence of the muscle groups involved in swallowing were determined using sEMG validated with the videofluoroscopic swallowing study.
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Deglutition Disorders , Neurologic Manifestations , Parkinson Disease , Signal Processing, Computer-Assisted , Electromyography , Multiple SclerosisABSTRACT
Epilepsy is a serious chronic neurological disorder that can be detected by analysing the brain signals generated by brain neurons, with electroencephalography (EEG) becoming a key tool in the diagnosis of epilepsy. The application of specific methods for processing and analysing EEG signals is important in exploring the working mechanisms of the brain and in the diagnosis of neurological disorders of the brain. The article describes the application of EEG signals in epilepsy treatment through feature extraction, feature classification and other related analysis methods. The article presents an overview of recent research advances through the use of principal component analysis, independent component analysis, wavelet transform, linear discriminant analysis, support vector machine, artificial neural network and decision tree. It provides some reference for the detection and classification of seizures and future research directions.
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Objetivo: Este artigo apresenta o sistema de monitoramento de soro hospitalar OpenSerum. Trata-se de uma solução open source que faz uso de tecnologias de comunicação móvel para o acompanhamento em tempo real do serviço de infusão intravenosa de soro hospitalar. Método: Na primeira etapa, montou-se um circuito elétrico baseado em sensores infravermelhos para a monitoração da queda das gotas. Na segunda etapa, codificou-se um sistema servidor capaz de manter dados de configuração e enviar mensagens de texto informativas de status para dispositivos móveis cadastrados. Resultados: O sistema de monitoramento permitiu detectar, por meio de mudanças na faixa de valores analógicos do receptor infravermelho, se o soro estava em atividade ou não. Conclusão: O sistema desenvolvido cumpriu com seus objetivos de monitoração, destacando a capacidade de interação com dispositivos móveis quando necessário para informar o status de atividade do soro monitorado.
Objectives: This paper presents the OpenSerum system for serum monitoring. It is an open source solution that uses mobile communication technologies for real-time monitoring of intravenous serum infusion service. Method: First, an electrical circuit was assembled based on infrared sensors in order to detect the fall of drops. Next, a server system was programed in order to maintain circuit configuration data and send textual messages with status information for mobile devices. Results: The monitoring system allows the detection, through changes in the range of analog infrared receiver values, whether the serum was active or not. Conclusion: The developed system reached its monitoring goals, highlighting the ability to interact with mobile devices when necessary to inform the serum activity status.
Objetivo: Ese artículo presenta el sistema de monitoreo de suero OpenSerum, una solución open source que hace uso de tecnologías de comunicación móviles para la monitorización en tiempo real de la infusión intravenosa de suero. Método: En la primera etapa, se creó un circuito eléctrico basado en sensores de infrarrojos para el seguimiento de la caída de las gotas. En la segunda, un sistema de servidor fue programado con el fin de mantener los datos de configuración de circuitos y enviar mensajes de texto con información de estado para dispositivos móviles. Resultados: El sistema de monitoreo permitió detectar por medio de cambios en la escala de valores analógicos del receptor infrarrojo, si el suero era o no en actividad. Conclusión: El sistema desarrollado cumplió con sus objetivos de monitoreo, poniendo de relieve la capacidad de interacción con dispositivos móviles cuando necesario para informar el status de actividad del suero.
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Infusion Pumps , Medical Informatics , Signal Processing, Computer-Assisted , Drug Monitoring , Biomedical TechnologyABSTRACT
OBJECTIVES: The clinical effects of the simultaneous application of nonlinear frequency compression and dichotic hearing on people with hearing impairments have not been evaluated previously. In this study, the clinical effects of the simultaneous application of these two techniques on the recognition of consonant-vowel-consonant (CVC) words with fricatives were evaluated using normal-hearing subjects and a hearing loss simulator operated in the severe hearing loss setting. METHODS: A total of 21 normal-hearing volunteers whose native language was English were recruited for this study, and two different hearing loss simulators, which were configured for severe hearing loss in the high-frequency range, were utilized. The subjects heard 82 English CVC words, and the word recognition score and response time were measured. RESULTS: The experimental results demonstrated that the simultaneous application of these two techniques showed almost even performance compared to the sole application of nonlinear frequency compression in a severe hearing loss setting. CONCLUSION: Though it is generally accepted that dichotic hearing can decrease the spectral masking thresholds of an hearing-impaired person, simultaneous application of the nonlinear frequency compression and dichotic hearing techniques did not significantly improve the recognition of words with fricatives compared to the sole application of nonlinear frequency compression in a severe hearing loss setting.
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Humans , Dichotic Listening Tests , Hearing Loss , Hearing , Masks , Reaction Time , Signal Processing, Computer-Assisted , VolunteersABSTRACT
JUSTIFICATIVA E OBJETIVO: A obesidade é um dos maiores e principais fatores de risco para doenças cardiovasculares. A gordura epicárdica é encontrada em torno das artérias coronárias e do miocárdio. O objetivo deste trabalho foi apresentar um protótipo de software capaz de quantificar a gordura em imagens de tomografia computadorizada. Foram encontrados estudos sobre o assunto, porém todos necessitam da interação do usuário. Os resultados foram avaliados positivamente por um cardiologista, que, hoje, delimita manualmente essa membrana. A gordura localizada em torno do coração contribui diretamente para a obstrução das artérias. MÉTODOS: Estudo retrospectivo, no qual os pacientes receberam aproximadamente 20mg de metoprolol endovenoso, para controle da frequência cardíaca (faixa de 70bpm), e 5mg de dinitrato de isossorbida sublingual, para dilatação e melhor visualização das artérias coronárias. As mesmas imagens foram submetidas a três operadores, sendo um deles cardiologista, para que detectassem, de forma manual, a gordura nas imagens. O comparativo entre o sistema manual e automático foi realizado usando o RUMA, para identificar a validade do experimento automático. RESULTADO: O protótipo obteve um percentual médio de 91% de acerto das imagens analisadas. Esse percentual correspondeu à área de gordura encontrada de maneira automática em comparação àquela encontrada por intermédio do processo manual. CONCLUSÃO: As reais possibilidades de automatização de processos maçantes na área médica reforçam os resultados positivos obtidos por este trabalho. O sistema deve garantir ao cardiologista ou operador um tempo mais longo, a ser utilizado em trabalhos que exijam análise e delineamento do problema...
BACKGROUND AND OBJECTIVE: Obesity is one of the highest and major risk factors among those for cardiovascular diseases. The epicardial fat remains around the coronary arteries and myocardium. The objective of this work was to develope a prototype to quantify the epicardial fat in tomography images. We have found studies that address the topic, but in all of them the user interaction is necessary. The results were evaluated by a cardiologist with extensive experience. The fat localized around the heart directly contributes to bad prognosis. The aim of this study was to develop a prototype for the automatic detection of epicardial fat in computed tomography images. METHODS: Retrospective study, in which patients received around 20mg of intravenous metoprolol, for heart rate control (70bpm), and 5mg sublingual isosorbide dinitrate, to dilation and better visualization of the coronary arteries. These images were processed by one cardiologist and by two lay operators, to detect the fat manually. The RUMA method was used to validate the automatic process. RESULTS: The prototype achieved an average percentage of 91% correct images analyzed. This percentage corresponded to the area of fat found in an automatic way compared to that found by manual process. CONCLUSION: The real possibilities of automation of tiresome processes in the medical reinforce the positive results obtained in this work. This system must ensure a greater portion of time, that can be used in analysis that require a more critical thinking...
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Adipose Tissue , Computer Graphics , Medical Informatics , Pericardium/physiology , Signal Processing, Computer-Assisted , Tomography, X-Ray Computed , Risk FactorsABSTRACT
Objective To explore a kind of biomedical signal pattern (BSP) with a new method called as state representation methodology (SRM ) .Methods Based on the heart sound signals ,ECG signals ,breathing ,as the important research problem for BSP description ,with some comparisons on several traditional methods ,in which support vector machines (SVM ) and response sur-face methodology (RSM ) etc .,using frequency slice wavelet transform (FSWT ) method to extract the BSP signal dynamic damping characteristics ,thus ,this paper proposes a new idea of SRM analysis .In the case of heart sound signal analysis ,the general steps of SRM evaluation method is given .Results In 40 cases of normal heart sounds SRM model is set up ,with 80 cases of abnormal heart sounds are compared ,the obvious differences of the SRM state distributions of the two groups are found .Conclusion The combi-nation of SRM with FSWT can provide a novel approach for BSP analysis ,and provide powerful development tool for the analysis of BSP .
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Objective To evaluate diffusion weighted imaging (DWI) sequence and apparent diffusion coefficient (ADC) in dif-ferentiation of various solid focal liver lesions (SFLL )commonly encountered .Methods 142 cases with 158 SFLLs underwent breath-hold diffusion weighted imaging (DWI)(b = 500 s/mm2 ) using a 1 .5 Tesla MR scanner .The cases included 7 cases of imma-tured abscesses ,12 cases of FNHs ,74 cases of hepatic cell cancer ,26 cases of cholangiocarcinomaes and 39 cases of metastasises . The signal intensity on DWI ,ADC value and the difference for each type of SFLLs were measured and analyzed .Results 24 cases of SFLLs were manifested as high signal intensity ,132 cases of SFLLs manifested as slightly high signal intensity and only 2 cases of SFLLs manifested as iso-signal intensity on DWI sequence .The mean ADC value ( × 10 - 3 mm2 /s)for immatured abscesses , FNHs ,HCCs ,cholangiocarcinomaes ,metastasises were (1 .48 ± 0 .23) ,(1 .75 ± 0 .26) ,(1 .23 ± 0 .43) ,(1 .47 ± 0 .35) ,(1 .36 ± 0 .33) ,respectively .The difference in ADC values between FNH patients and other SFLLs patients showed statistically significant (P 0 .05) .Conclusion The signal intensity on DWI and ADC values may be helpful for diagnosing solid focal liver lesions .
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Objective: To study the effect of gait analysis based on digital video and digital image processing in rehabilitation training in patients with stroke. Methods: Twenty patients with unilateral hemiplegia after stroke were selected. Gait analysis by digital video and digital image processing were used to evaluate the parameter changes of the temporal-spatial parameters of bilateral limbs (stride circles, stride length, stride frequency, stride speed, stand phase time) and the joint (hip, knee, ankle joints) angles before and after (3 months) the rehabilitation training. Results: Circled digit oneThe stride length and speed in 20 patients were 0.51 ± 0.12 m and 0.26 ± 0.17 m/s before the rehabilitation training; they were 0.66 ± 0.23 m and 0.33 ± 0.21 m/s after the training (P < 0.05 all). There were no significant differences among the stride circles, stride frequency, and stand phase time before and after the training. Circled digit twoThe flexion angle of the affected ankle joint reduced significantly when first touched ground after the rehabilitation training as compared to that before the training; the maximum extension angle of the standing phase of ankle and hip joints was increased; the flexion angle of knee joint increased at toe-off, so did the extension angle of ankle joint; the maximum flexion angles of knee and hip joints at stride phase was increased; the range of hip joint angle change in sagittal plan was increased, and that of the ankle joint angle was decreased. Before and after the rehabilitation training on the unaffected sides, there were no significant changes in other joint angle parameters, except the increased maximum flexion angle of the knee joint in stride phase (P < 0.05). Conclusion: The gait analysis base on digital video and digital image processing contributes to qualitatively evaluate the gait characteristics and the efficacy of rehabilitation treatment in patients with stroke.
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ObjectiveTo investigate the value of combined digital mammography and Color Doppler Mammasonography in the diagnosis of the breast carcinoma with ROC analysis.MethodsFifty female patients with breast carcinoma and fifty female patients with breast benign lesions confirmed by means of surgery and histopathological examinations were studied.All patients were examined by Digital Mammagraphy and Color Doppler Mammasonography.Images of all patients were sorted and divided into three groups,Digital radiographs of all patients was the first group,and the second group was Color Doppler photographs,and the third was included the above two photographs.Each group was evaluated respectively by three radiologists independently.The diagnostic result of breast carcinoma or benign lesions were investigated with a five point confidence-rating scale:(1)definitely positive;(2)probably positive;(3)indeterminate;(4)probably negative,and(5)definitely negative.ROC analysis was made with SPSS 11.0 software.The differences of the area under the curve for each group was made by Z test.ResultsThe average number of breast carcinoma diagnosed by three radiologists with digital mammography,Color Doppler Mammasonogaraphy and both of them was 42,38,and 48,respectively;and the average number of breast benign lesions was 40,43,and 47,respectively.The sensitivity and specificity for digital mammography was 84%(42/50),80%(40/50),and they were 76%(38/50),86%(43/50)for Color Doppler;and 96%(48/50),94%(47/50)for two modes combination.ROC analysis indicated that the average area under the curve was 0.852 for Digital Mammagraphy,0.825 for Color Doppler,and 0.952 for both combined.For digital mammography combined with Color Doppler Mammasono-garaphy on diagnosis breast carcinoma,the area under the curve(Az)was significally larger than that for digital mammography(Z1=2.183,P＜0.01),and also larger than that for Color Doppler Mammasono-garaphy(Z2=2.581,P＜0.01), respectively.Conclusions Among three medical imaging modes on diagnosing breast carcinoma,the diagnostic value of digital mammography combined with Color Doppler Mammasono-garaphy was the highest. It was helpful on detecting and diagnosing breast carcinoma early.
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Objective To investigate the clinical application value of the modified radiography by digital ra- diography of the tempro-mandibular joint in the tempro-mandibular joint radiography.Methods A digital radiogra- phy machine(Siemens Aristos MX)was used to the tempro-mandibular joint disorders of 68 patients with the meth- ods of the modified radiography of the tempro-mandibular joint,and the results were compared with those of 45 cases acquired with conventional radiography.Results The modified radiography by digital radiography provided high res- olution,precise location and excellent images,and the total structures of tempro-mandibular joint was clearly dis- played,with a success rate of 99%(67/68),while the results acquired by conventional radiography were not clear, only with a success rate of 60%(18/45).There is significant statistical differences between the modified radiography by digital radiography and conventional radiography(x~2 = 35.08,P
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Objective: To study characteristics of children's EEG complexity at different ages and in different physiological states.Methods: The continuous 24 hour EEG recordings were obtained from 16 electrodes in 45 essential healthy children between the ages of 0 to 15 years. EEG complexity was analyzed by non linear measure in 7 states: awake with eyes opened, awake with eyes closed, NREM (nonrapid eye movements) sleep including stages ⅠandⅡ (light sleep), ⅢandⅣ(deep sleep) and REM (rapid eye movements) sleep. Meanwhile, the correlation was analyzed between complexity and ages.Results: (1)The global EEG complexity in state of being awake with eyes opened was greater than that with eyes closed;that in wakefulness state was greater than in sleep state. The EEG complexity gradually decreased with the increase of deep sleep in NREM sleep state.The complexity in REM sleep state was greater than that in deep sleep state, but lower than in wakefulness state. (2) The global EEG complexity was positively related to ages in state of being awake with eyes opened, state of being awake with eyes closed, light sleep, and not related to ages in deep-sleep state and REM sleep state.(3)In every brain area EEG complexity was positively related to ages in state of being awake with eyes closed .In paracentral region EEG complexity was positively related to ages in states of being awake with eyes opened and light sleep.Conclusion: The EEG complexity was used to study the brain dynamical characteristics in different physiology states and the relationship between encephalic electric activity and brain development. It can be used as an objective index to evaluate the function and development of brain.
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Objective To evaluate the optimization of perfusing artery and contrast agent dose, and to determine the effect of precontrast injection of papaverine into the perfusing artery or not on the degree of contrast enhancement of the hepatic parenchyma during MRAP in dog models. Methods Sixteen dogs were included in this study and distributed to three study groups (perfusing artery, dose of Gd-DTPA and use of papaverine or not). Animals were anesthetized with Thiopental Sodium. After placement of a 5F end hole angiography catheter with no metal parts into the perfusing artery, the dogs were transferred immediately to the MR imaging unit. Unenhanced GRE MR and MRAP images were performed with a 2.0 T superconducting magnet. Signal intensity of liver parenchyma was measured with 6 different regions of interest. Relative value (%) of liver parenchymal enhancement was measured and compared. Time-enhancement curves were created and compared. Results MRAP images with good quality were obtained in all 16 dogs. The peak relative value of liver parenchymal enhancement and the time to the peak enhancement was similar in the superior mesenteric artery (SMA) group and in the splenic artery (SA) group. The peak relative value of liver parenchymal enhancement was the lowest in the 0.025 mmol/kg group among all groups. There was no statistical difference in the time to relative peak liver enhancement across the four groups. The time to relative peak liver enhancement in the group with papaverine injection was statistically earlier than that in the group without papaverine injection. Conclusion MRAP is a new and feasible imaging technique to detect hepatic masses before operation. When a 20 ml mixed solution of Gd-DTPA(0.050 -0.100 mmol/kg)was injected into perfusing artery at the rate of 1 ml/s, MRAP image of best liver parenchymal enhancement in dogs could be obtained at 21-28 s after the start of injection of Gd-DTPA. We can place catheters in SMA or SA and there was no statistical difference on MRAP images and time-enhancement curves. The dose of 0.050-0.100 mmol/kg Gd-DTPA was sufficient for MRAP. Application of papaverine precontrast advanced the time to peak liver enhancement, but the peak value of liver enhancement was not affected.
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Objective To explore the management model and realizing of PACS image data flow. Methods Based on the implementing environment and management model of PACS image data flow after full digital reengineering for radiology department in Shanghai First Hospital was completed, analysis on image data flow types, procedure, and achieving pattern were conducted. Results Two kinds of image data flow management were set up for the PACS of Shanghai First Hospital, which included image archiving procedure and image forward procedure. The former was implemented with central management model while the latter was achieved with a program that functionally acted as workflow management running on the central server. Conclusion The image data flow management pattern, as a key factor for PACS, has to be designed and implemented functionally and effectively depending on the performance environment, the tasks and requirements specified to particular user.