Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference
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Conf Proc IEEE Eng Med Biol Soc · Jan 2010
Electroconvulsive therapy in the presence of deep brain stimulation implants: electric field effects.
The safety of electroconvulsive therapy (ECT) in patients who have deep brain stimulation (DBS) implants represents a significant clinical issue. A major safety concern is the presence of burr holes and electrode anchoring devices in the skull, which may alter the induced electric field distribution in the brain. We simulated the electric field using finite-element method in a five-shell spherical head model. ⋯ We compared electric field strength and focality among the DBS implantation techniques and ECT electrode configurations. The simulation results show an increase in the electric field strength in the brain due to conduction through the burr holes, especially when the burr holes are not fitted with nonconductive caps. For typical burr hole placement for subthalamic nucleus DBS, the effect on the electric field strength and focality is strongest for BF ECT, which runs contrary to the belief that more anterior ECT electrode placements are safer in patients with DBS implants.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2010
Development of modified intraoperative examination monitor for awake surgery (IEMAS) system for awake craniotomy during brain tumor resection.
Gliomas represent the most frequent type of primary intracranial tumors, which originate from the brain tissue itself, have infiltrative growth, unclear borders, and usually affect functionally-important cerebral structures. From March 2000 till March 2010, 839 neurosurgical procedures directed on resection of such neoplasms were performed in the intelligent operating theater of Tokyo Women's Medical University with the use of intraoperative MRI, real-time updated neuronavigation system, and Hi-vision operative microscope. To facilitate maximal possible tumor resection with minimal risk of neurological morbidity a special device, called Intraoperative Examination Monitor for Awake Surgery (IEMAS) was developed by us. ⋯ The clinical testing of t- - his system was initiated on February 1, 2010, but quickly revealed crossed line effect between transmitters and receivers. To overcome this obstacle and to isolate transmitters, one channel was changed from wireless connection into wired, which resulted in significant improvement of the clearness of both transmitted images and sounds, and provides an opportunity for effective clinical use of the device. In perspective we wish to make IEMAS system fully wireless, using several types of frequency range transmitters.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2010
Anaesthesia synchronization software: target controlled infusion system evaluation.
Target Controlled Infusion (TCI) systems are based in drug Pharmacokinetic (Pk) and Pharmacodynamic (Pd) models implemented in an algorithm to drive an infusion device. Several studies had compare manual titration of anesthesia and TCI system use; some studies evaluate the performance of the control algorithms for TCI systems, and a considerable number of studies assess the performance of Pk/Pd models implemented into TCI systems. ⋯ The goal of the current study was to assess the performance of the TCI system, Anaesthesia Synchronization Software (ASYS), on clinical set up to evaluate communication consistence (computer - infusion device) and controller performance in real time. These measures provided quantitative and qualitative evidences of software robustness and accuracy to be used at clinical environment.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2010
Merging PK/PD information in a minimally parameterized model of the neuromuscular blockade.
A recursive system identification algorithm that merges PK/PD information in a minimally parameterized Wiener model for the NMB level is presented. The results show that the coupling between one parameter from the linear block and one from the static nonlinearity is advantageous, when evaluated on a database of 60 real collected NMB cases.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2010
Effect of ECG quality measures on piecewise-linear trend detection for telehealth decision support systems.
Fledgling clinical decision support systems (DSSs) are being designed on the false assumption that consistent, good-quality signals are created in the unsupervised telehealth environment, but it has in fact been shown that signal quality is often very poor. Hence, it is important to investigate the detrimental impact of failing to recognize erroneous clinical parameter values. ⋯ The application of the same artifact detection also results in a significant improvement in trend fitting, when compared to a fitting of the reference HR values, by reducing the mean RMSE value of the error in the trend fit from 2.14 BPM to 0.78 BPM and standard error from 0.49 BPM to 0.10 BPM. As trend detection will be a component of future telehealth decision support systems, signal quality measures for unsupervised measurements are of paramount importance.