Adv Exp Med Biol
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There are two essential reasons for the slow progress in the acceptance of clinical similarity search-based decision support systems (DSSs); the especial complexity of biomedical data making it difficult to define a meaningful and effective distance function and the lack of transparency and explanation ability in many existing DSSs. In this chapter, we address these two problems by introducing a novel technique for visualizing patient similarity with neighborhood graphs and by considering two techniques for learning discriminative distance functions. We present an experimental study and discuss our implementation of similarity visualization within a clinical DSS.
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Indocyanine green (ICG) emits near-infrared fluorescence when it is excited by near-infrared light. The near infrared fluorescence of ICG was applied to the imaging of cerebral vessels during neurosurgical operations such as clipping of aneurysms. In this study, ICG angiography was applied to extracranial-intracranial (EC-IC) bypass surgery to evaluate the hemodynamic changes induced by bypass in moyamoya disease (MD) and non-moyamoya ischemic diseases (non-MD). ⋯ Interestingly, the anastomosed STA supplied blood flow to a larger cortical area in MD than non-MD. The bypass supplied greater extent of blood flow to the ischemic brain in MD than in non-MD. This difference might be caused by the fact that the perfusion pressure was lower in MD than in non-MD.
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The cerebral tissue oxygenation index (TOI) and fractional tissue oxygen extraction (FTOE) reflect the cerebral oxygenation. We studied the effect of glycaemia on the TOI and FTOE, as measured by near-infrared-spectroscopy (NIRS). ⋯ We found a significant negative correlation (r = -0.077; p = 0.0344) between glycaemia and TOI, also after correction for MABP, SaO(2) and tPCO(2) (r = -0.118; p = 0.002) and a significant positive correlation between glycaemia and FTOE (r = 0.147; p < 0.000) which remained significant after correction for MABP and tPCO(2) (r = 0.116; p = 0.001). Our results indicate that in neonates during the first days of life glycaemia - even within the normal ranges and after correction for MABP, SaO(2) and tPCO(2) - influences the cerebral oxygenation.
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Sensory gating is the brain's ability to adjust its sensitivity to incoming stimuli, i.e., to diminish its response to irrelevant or repetitive stimuli (gating out) and to increase it when a novel stimulus is presented (gating in). Most of the existing studies have investigated the gating out mechanism, giving little attention to the gating in function. Although both the P50 and N100 components of the auditory ERPs (event related potentials) show amplitude reductions to stimuli repetition, it is not clear if both components are part of a common gating system or if their sensory modulation is uncorrelated. ⋯ Thus, the results showed that both P50 and N100 are sensory modulated, showing that amplitude decreased to stimuli repetition (gating out) and increased when the two stimuli of a pair differed in intensity (gating in). A correlational analysis of the sensory gating indices (S2/S1 ratio and S1-S2 difference) obtained for P50 and N100 suggested that the sensory gating function of both components may be of a different nature. The reliability of the ratio and the difference indices of sensory gating is also discussed.