Approximately one percent of the world's population exhibits symptoms of epilepsy, a serious disorder of the central nervous system that predisposes those affected to experiencing recurrent seizures. The risk of injury associated with epileptic seizures might be mitigated by the use of a device that can reliably detect or predict the onset of seizure episodes and then warn caregivers of the event. In a hospital this device could also be used to initiate time-sensitive clinical procedures necessary for characterizing epileptic syndromes. This thesis discusses the design of a real-time, patient-specific method that can be used to detect the onset of epileptic seizures in non-invasive EEG, and then initiate time-sensitive clinical procedures like ictal SPECT.We adopt a patient-specific approach because of the clinically observed consistency of seizure and non-seizure EEG characteristics within patients, and their great heterogeneity across patients. We also treat patient-specific seizure onset detection as a binary classification problem. Our observation is a multi-channel EEG signal; its features include amplitude, fundamental frequency, morphology, and spatial localization on the scalp; and it is classified as an instance of non-seizure or seizure EEG based on the learned features of training examples from a single patient. We use a multi-level wavelet decomposition to extract features that capture the amplitude, fundamental frequency, and morphology of EEG waveforms. These features are then classified using a support vector machine or maximum-likelihood classifier trained on a patient's seizure and non-seizure EEG; non-seizure EEG includes normal and artifact contaminated EEG from various states of consciousness. The outcome of the classification is examined in the context of automatically extracted spatial and temporal constraints before the onset of seizure activity is declared.During validation tests our method exhibited an average latency of 8.0± 3.2 seconds while correctly identifying 131 of 139 seizure events from thirty-six, de-identified test subjects; and only 11 false-detections over 49 hours of randomly selected nonseizure EEG from these subjects. The validation tests also highlight the high learning rate of the detector; a property that allows it to exhibit excellent performance even when trained on as few as two seizure events from the test subject. 3 We also demonstrate through a comparative study that our patient-specific detector outperforms a nonpatient-specific, or generic detector in terms of a lower average detection latency; a lower total number of false-detections; and a higher total number of true-detections. Our study also underscores the likely event of a generic detector performing very poorly when the seizure EEG of a subject in its training set matches the non-seizure EEG of the test subject.
High concordance for VUR in identical twin siblings supports a genetic basis for the transmission of this disease. Results obtained from fraternal twin siblings provides convincing evidence that this trait is transmitted in an autosomal dominant fashion.
There is considerable interest in developing an 18 F-labeled PET myocardial perfusion agent. Rhodamine dyes share several properties with 99m Tc-MIBI, the most commonly used single-photon myocardial perfusion agent, suggesting that an 18 F-labeled rhodamine dye might prove useful for this application. In addition to being lipophilic cations, like 99m Tc-MIBI, rhodamine dyes are known to accumulate in the myocardium and are substrates for Pgp, the protein implicated in MDR1 multidrug resistance. As the first step in determining whether 18 F-labeled rhodamines might be useful as myocardial perfusion agents for PET, our objective was to develop synthetic methods for preparing the 18 F-labeled compounds so that they could be evaluated in vivo. Rhodamine B was chosen as the prototype compound for development of the synthesis because the ethyl substituents on the amine moieties of rhodamine B protect them from side reactions, thus eliminating the need to include (and subsequently remove) protecting groups. The 2′-[ 18 F]fluoroethyl ester of rhodamine B was synthesized by heating rhodamine B lactone with [ 18 F]fluoroethyltosylate in acetonitrile at 165°C for 30 min.using [ 18 F]fluoroethyl tosylate, which was prepared by the reaction of ethyleneglycol ditosylate with Kryptofix 2.2.2, K 2 CO 3 , and [ 18 F]NaF in acetonitrile for 10 min. at 90°C. The product was purified by semi-preparative HPLC to produce the 2′-[ 18 F]-fluoroethylester in >97% radiochemical purity with a specific activity of 1.3 GBq/μmol, an isolated decay corrected yield of 35%, and a total synthesis time of 90 min.
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