The authors address the use of multimodality imaging as an aid to the planning and guidance of neurosurgical procedures, and discuss the integration of anatomical (CT and MRI), vascular (DSA), and functional (PET) data for presentation to the surgeon during surgery. The authors' workstation is an enhancement of a commercially available system, and in addition to the guidance offered via a hand-held probe, it incorporates the use of multimodality imaging and adds enhanced realism to the surgeon through the use of a stereoscopic three-dimensional (3-D) image display. The probe may be visualized stereoscopically in single or multimodality images. The integration of multimodality data in this manner provides the surgeon with a complete overview of brain structures on which he is performing surgery, or through which he is passing probes or cannulas, enabling him to avoid critical vessels and/or structures of functional significance.
An expert system for the automated detection of spikes and sharp waves in the EEG has been developed. The system consists of two distinct stages. The first is a feature extractor, written in the conventional procedural language Fortran, which uses parts of previously published spike-detection algorithms to produce a list of all spike-like occurrences in the EEG. The second stage, written in the production system language OPS5, reads the list and uses rules incorporating knowledge elicited from an electroencephalographer (EEGer) to confirm or exclude each of the possible spikes. Information such as the time of occurrence, polarity and channel relationship are used in this process. A summary of the detected epileptiform events is produced which is available to the EEGer in interpreting the EEG. The performance of the expert system is compared with an EEGer using a 320s segment from an EEG containing epileptiform activity. The system detected 19 events and missed seven (false negative) which the EEGer considered epileptiform. There were no false positive detections.
We measured tracheal flow, tracheal pressure, and alveolar capsule pressure in four anesthetized paralyzed tracheostomized open-chest dogs. Lung impedance between 0.12 and 4.88 Hz was measured with a forced volume oscillation technique before and after the intravenous administration of methacholine (MCh). Before MCh administration, lung impedance was well described by a model featuring a single airway leading to an alveolar region surrounded by tissue with a continuous distribution of viscoelastic time constants as used by Hantos et al. (J. Appl. Physiol. 68: 849-860, 1990). After MCh, however, this model gave a poor fit to the impedances. The impedances were well accounted for, however, when the model was enhanced to include an extra time constant term, which we suspect is required to account for the uneven ventilation distribution produced by MCh. Airway impedance before MCh administration was well described by a simple resistance-inertance model, but a model incorporating serial inhomogeneity of ventilation was again required after MCh. Our results support those of previous studies indicating that the impedance of the normal dog lung is well described by a homogeneously ventilated viscoelastic tissue model. In contrast, our results after MCh administration show strong evidence of marked regional ventilation inhomogeneity in addition to the rheological properties of the tissues.
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