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Errors of computer electrocardiography

ANGIOLOGY 1997年第12期48卷 1045-1050页

作者： RuDusky, BM NE CARDIOVASC CLIN & RES INST WILKES BARREPA

A review of 6938 computer-generated electrocardiogram interpretations was undertaken by a single cardiologist. The computer-assisted program correctly interpreted 51.6% of the tracings. One or more corrections were necessary in 48.4%. The greatest number of incorrect interpretations involved repolarization (T wave) abnormalities, followed by ST segment changes. It is mandatory that computer-generated ECG interpretations be reviewed by an experienced electrocardiographer. Reliance on nonreviewed ECG interpretations may result in incorrect diagnoses that could lead to inappropriate management decisions.

关键词： Diagnostic Errors Electrocardiography/instrumentation Electrocardiography/standards Electrocardiography/statistics & numerical data Equipment Failure Analysis/statistics & numerical data Humans Prospective Studies signal processing, computer-assisted/instrumentation

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FAST MULTISITE OPTICAL-RECORDING OF MONOSYNAPTIC AND POLYSYNAPTIC ACTIVITY IN THE HAMSTER SUPRACHIASMATIC NUCLEUS EVOKED BY RETINOHYPOTHALAMIC TRACT STIMULATION

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NEUROIMAGE 1994年第4期1卷 247-263页

作者： SENSEMAN, DM REA, MA ARMSTRONG LAB BRAIN RES INSTBROOKS AFBTX 78235

Responses of the hamster suprachiasmatic nucleus (SCN) to retinohypothalamic tract (RHT) stimulation were studied in horizontal hypothalamic slices using fast multisite optical recording techniques. A 124-element photodiode detector array provided high-speed monitoring (0.5 ms/frame) of evoked neural activity in the SCN, while a larger 464-element photodiode array yielded improved spatial imaging with some loss in temporal resolution (1.6 ms/frame). Brief electrical stimulation of the optic nerves evoked a propagated compound action potential that was recorded optically as a single transient deplorization in many slice regions, including the SCN. Only within the SCN, however, was this optic tract signal followed by additional voltage-dependent optical responses which exhibited a fast and a slow depolarizing component. The initial upstroke of the fast component was Ca2+-insensitive and is presumed to reflect activity in presynaptic RHT afferents. The remainder of the fast depolarization and the slow depolarization were Ca2+-sensitive. These responses were labeled the early population excitatory postsynaptic potential (Early P.E.P.S.P.) and the Late P.E.P.S.P. respectively. The Late P.E.P.S.P. was not enhanced by K+ channel blockade, suggesting that glial depolarization is not the primary source of this component. Drugs known to suppress RHT-evoked SCN field potentials also suppressed the Early and Late P.E.P.S.P.'s recorded optically in the SCN. Unexpectedly, the Early P.E.P.S.P. was also reduced by the GABA(A) antagonist, bicuculline. Surface plots of normalized peak amplitudes showed that both SCN components had similar spatial distributions within the SCN, although the Early P.E.P.S.P. tended to be slightly more prominent within the medial SCN in some preparations. It is suggested that the Early P.E.P.S.P. represents firing of monosynaptically activated SCN neurons, while the Late P.E.P.S.P. reflects polysynaptic activity within the intrinsic SCN neuronal network

关键词： Animals Automatic Data processing Brain Mapping/instrumentation Brain Mapping/instrumentation Circadian Rhythm/physiology computer Systems Cricetinae Electric Stimulation/instrumentation Electroencephalography/instrumentation Hypothalamus/physiology Light Light Male Mesocricetus Nerve Net/physiology Retina/physiology signal processing, computer-assisted/instrumentation Suprachiasmatic Nucleus/physiology Synapses/physiology Synaptic Transmission/physiology Visual Pathways/physiology

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THE INTEGRITY OF VISUAL-PROPRIOCEPTIVE MAPPING IN CEREBRAL-PALSY

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NEUROPSYCHOLOGIA 1991年第11期29卷 1095-1106页

作者： WANN, JP EDINBURGH CTR RES CHILD DEV EDINBURGHSCOTLAND

Existing data on the ability of normal children to make intra-modal and cross-modal judgements about limb position are reviewed. A pattern of results emerges which suggests that although young children have difficulty with proprioceptive judgements. their performance is significantly enhanced if the task involves matching vision against proprioception. Some preliminary findings with cerebral palsied children suggest that this advantage may sometimes be lost. It is suggested. however, that the tasks used in previous studies do not allow the precise appraisal of this ability. This study examined intra- and cross-modal judgements in eight normal adults and eight severely cerebral palsied adolescents. In addition to the usual measures of spatial accuracy, joint angle measurements were recorded which allow some appraisal of the information strategy used for respective tasks. The results suggest that the cerebral palsied students had specific problems with mapping between vision and proprioception. This is discussed from a perspective of whether such mapping requires adaptive behaviour within a stable explorative environment, which is disrupted in cases of severe cerebral palsy.

关键词： Adolescent Biofeedback, Psychology/instrumentation Cerebral Palsy/psychology Cerebral Palsy/rehabilitation Child Humans Kinesthesis Neurologic Examination/instrumentation Paraplegia/psychology Paraplegia/rehabilitation Proprioception Psychomotor Performance Quadriplegia/psychology Quadriplegia/rehabilitation signal processing, computer-assisted/instrumentation Visual Perception

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SCREENING FOR SUBCLINICAL SLEEP-DISORDERED BREATHING

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SLEEP 1990年第4期13卷 344-353页

作者： SCHARF, SM GARSHICK, E BROWN, R TISHLER, PV TOSTESON, T MCCARLEY, R VET ADM MED CTR W ROXBURY DIV PULM MED SERV BOSTON MA 02132 USA VET ADM MED CTR W ROXBURY DIV PULM PSYCHIAT SERV BOSTON MA 02132 USA BRIGHAM & WOMENS HOSP CHANNING LAB BOSTON MA 02115 USA HARVARD UNIV SCH MED BOSTON MA 02115 USA

We evaluated self-administered questionnaires and short sleep studies in screening for sleep-disordered breathing (SDB) in 40 hypertensive men ages 36-66 unselected for symptoms. Each subject completed a questionnaire including questions on sleep-related symptoms and underwent overnight polysomnography in which we evaluated the apnea-hypopnea index (AHI) and the percentage of time during which arterial O2 saturation was < 90% (T90). The first 90 min of overnight study was evaluated separately, and 10 subjects with an AHI .gtoreq. 10 also underwent late afternoon nap study. By overnight polysomnography, 48% of the cohort had an AHI .gtoreq. 10, and 35% had a T90 .gtoreq. 10%. Using linear regression, we found no features of the symptom questionnaire that strongly predicted AHI. Only self-reported snoring and baseline arterial Po2 significantly predicted T90. The AHI and T90 were not significantly correlated. Considering an AHI .gtoreq. 10 in the overnight study as "abnormal" and an AHI .gtoreq. 10 on the short study as a "positive" test, the specificity of the AHI in the first 90 min was 100% (21/21), and the sensitivity was 42% (8/19). The sensitivity of the nap study was 60% (6/10). We conclude that in a cohort unselected for symptoms, the ability of self-administered questionnaires to predict SDB was low;short studies were only moderately sensitive for detecting an AHI .gtoreq. 10, and the AHI was not a major determinant of nocturnal desaturation.

关键词： Adult Aged Cohort Studies Humans Hypertension/complications Male Mass Screening Microcomputers Middle Aged Monitoring, Physiologic/instrumentation Risk Factors signal processing, computer-assisted/instrumentation Sleep Apnea Syndromes/diagnosis Sleep Apnea Syndromes/prevention & control

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VOLUNTARY FACIAL ACTION GENERATES EMOTION-SPECIFIC AUTONOMIC NERVOUS-SYSTEM ACTIVITY

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PSYCHOPHYSIOLOGY 1990年第4期27卷 363-384页

作者： LEVENSON, RW EKMAN, P FRIESEN, WV UNIV CALIF SAN FRANCISCO DEPT PSYCHIAT SAN FRANCISCO CA 94143 USA

Four experiments were conducted to determine whether voluntarily produced emotional facial configurations are associated with differentiated patterns of autonomic activity, and if so, how this might be mediated. Subjects received muscle-by-muscle instructions and coaching to produce facial configurations for anger, disgust, fear, happiness, sadness, and surprise while heart rate, skin conductance, finger temperature, and somatic activity were monitored. Results indicated that voluntary facial activity produced significant levels of subjective experience of the associated emotion, and that autonomic distinctions among emotions: (a) were found both between negative and positive emotions and among negative emotions, (b) were consistent between group and individual subjects'' data, (c) were found in both male and female subjects, (d) were found in both specialized (actors, scientists) and nonspecialized populations, (e) were stronger when the voluntary facial configurations most closely resembled actual emotional expressions, and (f) were stronger when experience of the associated emotion was reported. The capacity of voluntary facial activity to generate emotion-specific autonomic activity: (a) did not require subjects to see facial expressions (either in a mirror or on an experimenter''s face), and (b) could not be explained by differences in the difficulty of making the expressions or by differences in concomitant somatic activity.

关键词： Adult Arousal/physiology Autonomic Nervous System/physiology Emotions/physiology Facial Expression Facial Muscles/innervation Female Humans Male Microcomputers Monitoring, Physiologic/instrumentation signal processing, computer-assisted/instrumentation

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AN APPROACH TO ARTIFACT IDENTIFICATION - APPLICATION TO HEART PERIOD DATA

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PSYCHOPHYSIOLOGY 1990年第5期27卷 586-598页

作者： BERNTSON, GG QUIGLEY, KS JANG, JF BOYSEN, ST YERKES REG PRIMATE RES CTR LAWRENCEVILLE GA USA

A rational strategy for the automated detection of artifacts in the heart period data is outlined and evaluated. The specific implementation of this approach for heart period data is based on the distribution characteristics of successive heart period differences. Because beat-to-beat differences generated by artifacts are large, relative to normal heart period variability, extreme differences between successive heart periods serve to identify potential artifacts. Critical to this approach are: 1) the derivation of the artifact criterion from the distribution of beat differences of the individual subject and 2) the use of percentile-based distribution indexes, which are less sensitive to corruption by the presence of artifactual values than are least-square estimates. The artifact algorithms were able to effectively identify artifactual beats embedded in heart period records, flagging each of the 1494 stimulated and actual artifacts in data sets derived from both humans and chimpanzees. At the same time, the artifact algorithms yielded a false alarm rate of less than 0.3%. Although the present implementation was restricted to heart period data, the outlined approach to artifact detection may also be applicable to other biological signals.

关键词： Algorithms Arousal/physiology Attention/physiology Electrocardiography/instrumentation Heart Rate/physiology Humans Microcomputers Psychophysiology signal processing, computer-assisted/instrumentation

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THE ACTIVITY OF THE CRICOTHYROID MUSCLE AND THE INTRINSIC FUNDAMENTAL-FREQUENCY IN DANISH VOWELS

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PHONETICA 1990年第3-4期47卷 141-154页

作者： DYHR, N UNIV COPENHAGEN DEPT GEN & APPL LINGUIST NJALSGADE 80 DK-2300 COPENHAGEN DENMARK

The relationship between the electromyographic (EMG) activity from the pars obliqua of the cricothyroid (CT) muscle (recorded with bipolar hooked-wire electrodes) and the intrinsic fundamental frequency (IF0) in high and low vowels in Danish was investigated. The test material, which consisted of 306 randomized natural words inbedded in carrier sentences, was recorded by 4 native speakers of Danish. Vowel pairs were compared The results, which are based on visual inspection of average EMG and fundamental frequency (F0) curves, show a positive correlation between the CT activity and IF0, more specifically that the CT activity rise related to the high vowels starts earlier and in most cases more steeply than the CT activity related to the low vowels. However, a drop in F0 at the beginning of the low vowels cannot be accounted for by CT activity. This F0 drop is believed to be the result of either tongue retraction during the articulation or influence from the preceding consonant. The following conclusion is drawn: The CT muscle is a major factor in controlling IF0 in stressed high and low vowels in Danish.

关键词： Adult Electromyography/instrumentation Female Humans Language Laryngeal Muscles/physiology Male Pharyngeal Muscles/physiology Phonetics signal processing, computer-assisted/instrumentation Sound Spectrography/instrumentation Speech/physiology Tongue/physiology

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POLYSOMNOGRAPHIC ASSESSMENT OF DIMS - EMPIRICAL-EVALUATION OF ITS DIAGNOSTIC-VALUE

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SLEEP 1989年第4期12卷 315-322页

作者： EDINGER, JD HOELSCHER, TJ WEBB, MD MARSH, GR RADTKE, RA ERWIN, CW DUKE UNIV MED CTR CTR SLEEP DISORDERS DURHAM NC 27710 USA

This investigation examined the diagnostic value of polysomnography (PSG) for evaluating disorders of initiating and maintaining sleep (DIMS). The sample consisted of 100 outpatients who presented to the Duke Sleep Disorders Center with a complaint of chronic insomnia. All patients were given comprehensive medical, psychiatric, behavioral, and ambulatory PSG evaluations. Sleep disorder diagnoses were assigned using the criteria of the Association of Sleep Disorders Centers. Overall, PSG yielded important diagnostic information in 65% of the sample: 34% were given a primary sleep disorder diagnosis that was heavily dependent on PSG data [periodic movements of sleep (PMS) = 25%, apnea = 3%, and subjective insomnia = 6%];15% were given a secondary diagnosis of one of these disorders;and PSG ruled out suspected PMS in 9% and sleep apnea in 7% of the sample. Patients >40 years of age had a significantly higher rate of positive PSG findings than younger patients. Using only the clinical exam, two experienced sleep clinicians were able to predict only 14 of 25 PMS cases and one of three cases of sleep apnea. Based on these data, we suggest using PSG routinely with older insomniacs and with younger patients who fail initial treament.

关键词： Adult Aged Aged, 80 and over Alcoholism/complications Alcoholism/complications Arousal Electroencephalography/instrumentation Female Humans Male Mental Disorders/complications Middle Aged Monitoring, Physiologic/instrumentation signal processing, computer-assisted/instrumentation Sleep Apnea Syndromes/diagnosis Sleep Initiation and Maintenance Disorders/diagnosis Substance-Related Disorders/complications Substance-Related Disorders/complications

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COMPARISON BETWEEN THE RESULTS OF AN AUTOMATIC AND A VISUAL SCORING OF SLEEP EEG RECORDINGS

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SLEEP 1989年第4期12卷 354-362页

作者： FERRI, R FERRI, P COLOGNOLA, RM PETRELLA, MA MUSUMECI, SA BERGONZI, P UNIV CAGLIARI CATTEDRA NEUROPATOL & PSICOPATOL I-09100 CAGLIARI ITALY

In this paper, results from the visual scoring of nocturnal polygraphic recordings, carried out by nine different groups of readers from different Italian sleep laboratories, are analyzed;inter- and intragroup variability is shown and statistically discussed. Data are then compared with the results of an automatic scoring of the same recordings, carried out by the Medilog Sleep Stager. The validity of this automatic method of scoring is discussed. Finally, an epoch by epoch analysis is described, with the aim of achieving a more detailed evaluation of the intergroup variability.

关键词： Adolescent Adult Cerebral Cortex/physiology Electroencephalography/instrumentation Evoked Potentials Female Humans Male signal processing, computer-assisted/instrumentation Sleep Stages/physiology Sleep, REM/physiology Software Wakefulness/physiology

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SLEEP AND WAKEFULNESS IN NORMAL PREADOLESCENT CHILDREN

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SLEEP 1989年第4期12卷 299-308页

作者： PALM, L PERSSON, E ELMQVIST, D BLENNOW, G UNIV LUND HOSP DEPT CLIN NEUROPHYSIOL S-22185 LUND SWEDEN

Eighteen healthy children, 9 boys and 9 girls, between 8 and 12 years of age were examined with polygraphic sleep records, multiple sleep latency tests (MSLTs), and measurements of reaction times. Sleep was recorded at home on Oxford Medilog 9 channel cassette tape recorders (Oxford Medical Systems, Abingdon, U.K.) and sleep staging was performed from the screen of the display unit. Two consecutive nights were recorded. MSLT was done in the laboratory. The subjects were given 30 min to fall asleep on four occasions during the day after the last recorded night of sleep. Reaction times were measured repeatedly between each MSLT trial. More slow wave sleep was found in this study compared to others. Also, the first night effect was slight. It is proposed that this is due to the fact that the recordings were performed at home. The initial sleep cycle was incomplete in almost all subjects. A sleep stage with traits of both rapid eye movement (REM) and nonREM could be seen in this cycle, probably representing an abortive REM period. MSLT confirmed the low daytime sleepiness in healthy preadolescent children. A sleep latency of 10 min or less on two or more sleep trials, or a daily mean sleep latency of less than 20 min, is rarely seen in this age group. The reaction times were within normal limits for the age of the subjects. Nighttime sleep values, daytime sleep latencies, and reaction times were not correlated in these normal-sleeping children.

关键词： Arousal/physiology Cerebral Cortex/physiology Child Child Development Electroencephalography/instrumentation Humans Monitoring, Physiologic/instrumentation Reaction Time/physiology Reference Values signal processing, computer-assisted/instrumentation Sleep Stages/physiology Sleep, REM/physiology Wakefulness/physiology

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