Permutation Entropy and Signal Energy Increase the Accuracy of Neuropathic Change Detection in Needle EMG.

Background and Objective. Needle electromyography can be used to detect the number of changes and morphological changes in motor unit potentials of patients with axonal neuropathy. General mathematical methods of pattern recognition and signal analysis were applied to recognize neuropathic changes. This study validates the possibility of extending and refining turns-amplitude analysis using permutation entropy and signal energy. Methods. In this study, we examined needle electromyography in 40 neuropathic individuals and 40 controls. The number of turns, amplitude between turns, signal energy, and "permutation entropy" were used as features for support vector machine classification. Results. The obtained results proved the superior classification performance of the combinations of all of the above-mentioned features compared to the combinations of fewer features. The lowest accuracy from the tested combinations of features had peak-ratio analysis. Conclusion. Using the combination of permutation entropy with signal energy, number of turns and mean amplitude in SVM classification can be used to refine the diagnosis of polyneuropathies examined by needle electromyography.

Prediction of coronary vessel involvement on the basis of atherosclerosis risk factor analysis.

The prediction of coronary vessel involvement by means of noninvasive tests is one of the fundamental objectives of preventive cardiology. This review describes the current possibilities of coronary vessel involvement prediction by means of ultrasonographic examination of carotid arteries, analysis of polymorphisms in the genes encoding enzymes responsible for production of nitric oxide and carbon monoxide and assessment of levels of certain proinflammatory cytokines. In the presented work these noninvasive markers are correlated with the extent of coronary vessel involvement as assessed by coronary angiography, intravascular ultrasound and virtual histology (Fig. 5, Ref. 40).

[Late complication of surgical repair of aortic coarctation: ruptured pseudoaneurysm of the aorta treated by thoracic endovascular aortic repair]. / Complication tardive d'un traitement chirurgical par interposition prothétique d'une coartation aortique: rupture d'un faux anévrisme anastomotique traitée par implantation endoluminale d'endoprothèse couverte.

Aortic coarctation is a frequent congenital defect requiring early surgical treatment. Late complications of these surgical procedures can be fatal as in the case of a ruptured anastomotic pseudoaneurysm. We present a case of a 49-year-old man presenting with hemorrhagic shock due to this complication who was successfully treated by endovascular techniques with implantation of two stent grafts. This case illustrates the fact that endovascular aortic repair is feasible, certainly less invasive and very efficient for this type of complication when used in an experienced center.

[Outcomes of combined surgical and endovascular treatment of the venous thoracic outlet syndrome during 2000-2007 in the IInd Surgical Clinic of the VFN (General Faculty Hospital) and 1. LF UK (First Medical Faculty, Charles University) in Prague]. / Výsledky kombinované chirurgické a endovaskulární lécby zilního thoracic outlet syndromu v letech 2000-2007 na II. chirurgické klinice VFN a 1. LF UK v Praze.

OBJECTIVES: Between 2000-2007 we performed 31 surgical procedures for thoracic outlet syndrome, two patients underwent bilateral procedure. METHODS AND RESULTS: 26 patients had venous TOS, 4 neurovascular and 1 arterial TOS. Rib resection and scalenotomy were performed at 23 patients, rib resection, scalenotomy and deliberation at 9 patients, in one case re-operation. CONCLUSION: 76% patients were without difficulties after combined endovascular and surgical procedures.

Use of 3D geometry modeling of osteochondrosis-like iatrogenic lesions as a template for press-and-fit scaffold seeded with mesenchymal stem cells.

Computed tomography (CT) is an effective diagnostic modality for three-dimensional imaging of bone structures, including the geometry of their defects. The aim of the study was to create and optimize 3D geometrical and real plastic models of the distal femoral component of the knee with joint surface defects. Input data included CT images of stifle joints in twenty miniature pigs with iatrogenic osteochondrosis-like lesions in medial femoral condyle of the left knee. The animals were examined eight and sixteen weeks after surgery. Philips MX 8000 MX and View workstation were used for scanning parallel plane cross section slices and Cartesian discrete volume creation. On the average, 100 slices were performed in each stifle joint. Slice matrices size was 512 x 512 with slice thickness of 1 mm. Pixel (voxel) size in the slice plane was 0.5 mm (with average accuracy of +/-0.5 mm and typical volume size 512 x 512 x 100 voxels). Three-dimensional processing of CT data and 3D geometrical modelling, using interactive computer graphic system MediTools formerly developed here, consisted of tissue segmentation (raster based method combination and 5 % of manual correction), vectorization by the marching-cubes method, smoothing and decimation. Stifle- joint CT images of three individuals of different body size (small, medium and large) were selected to make the real plastic models of their distal femurs from plaster composite using rapid prototyping technology of Zcorporation. Accuracy of the modeling was +/- 0.5 mm. The real plastic models of distal femurs can be used as a template for developing custom made press and fit scaffold implants seeded with mesenchymal stem cells that might be subsequently implanted into iatrogenic joint surface defects for articular cartilage-repair enhancement.

Patient rights protection in the Czech Republic: challenges of a transition from Communism to a modern legal system.

The post-Communist countries in Central Europe, including the Czech Republic, underwent a rapid transformation of their legal systems, within which the concept of patient rights passed through revolutionary changes. This process however often left significant gaps in patient rights protection. There are practical difficulties for patients in defending their rights before the courts, such as problems with obtaining evidence and independent expert opinions, long delays and high costs of court proceedings, strict burden of proof rules and low compensation levels. Modern patient rights often collide with the systems of health care provision that are still unprepared for patient autonomy and responsibility. The experience gained in the transition process might be applicable also to other countries that undergo changes from traditional to modern system of patient rights protection.