Passive functional mapping of receptive language areas using electrocorticographic signals.

OBJECTIVE: To validate the use of passive functional mapping using electrocorticographic (ECoG) broadband gamma signals for identifying receptive language cortex. METHODS: We mapped language function in 23 patients using ECoG and using electrical cortical stimulation (ECS) in a subset of 15 subjects. RESULTS: The qualitative comparison between cortical sites identified by ECoG and ECS show a high concordance. A quantitative comparison indicates a high level of sensitivity (95%) and a lower level of specificity (59%). Detailed analysis reveals that 82% of all cortical sites identified by ECoG were within one contact of a site identified by ECS. CONCLUSIONS: These results show that passive functional mapping reliably localizes receptive language areas, and that there is a substantial concordance between the ECoG- and ECS-based methods. They also point to a more refined understanding of the differences between ECoG- and ECS-based mappings. This refined understanding helps to clarify the instances in which the two methods disagree and can explain why neurosurgical practice has established the concept of a "safety margin." SIGNIFICANCE: Passive functional mapping using ECoG signals provides a fast, robust, and reliable method for identifying receptive language areas without many of the risks and limitations associated with ECS.

Intraoperative ultrasound is associated with clear lumpectomy margins for palpable infiltrating ductal breast cancer.

OBJECTIVE: To evaluate the efficacy of intraoperative ultrasound in obtaining adequate surgical margins in women undergoing lumpectomy for palpable breast cancer. SUMMARY BACKGROUND DATA: Adequacy of surgical margins is a subject of debate in the literature for women undergoing breast-conserving therapy. The emerging technology of intraoperative ultrasound-guided surgery lends itself well to a prospective study evaluating surgical accuracy and margin status after lumpectomy. METHODS: Two groups of women undergoing lumpectomy for palpable breast cancer were studied, one group using intraoperative ultrasound (n = 27) and the other without (n = 24). Pathologic specimens were evaluated for size, margins, and accuracy, and patients were questioned about satisfaction with cosmetic results. RESULTS: Surgical accuracy was improved with intraoperative ultrasound-guided surgery. Margin status was improved, patient satisfaction was equivalent, and cost was not affected using ultrasound technology. Intraoperative ultrasound appears especially efficacious for women whose preoperative mammogram shows dense parenchyma surrounding the lesion. CONCLUSIONS: The use of ultrasound-guided surgery optimizes the surgeon's ability to obtain satisfactory margins for breast-conserving techniques in patients with breast cancer. Patient satisfaction is excellent and a cost savings is most likely realized.

Taxonomy of singers used as subjects in scientific research.

Criteria for determining the classification of singers in research has posed numerous problems for both researchers and their readership. Previous attempts at creating usable categories have failed because of disagreement within the professions involved in such research. The object of this paper is to explore and suggest a system in which scientific research related to singing is based on a quantifiable singing standard. Use of the systematic categorization set out in this paper will help to alleviate the questions regarding performance abilities of singers used as subjects in scientific projects and lead to more credible results. Nine singer categories have been consolidated and based on proven performance achievement. These categories range from superstar (household name) to local community and amateur singers with comprehensive subcategories under each topic for each type of singer, that is, opera, pop, jazz, etc.