15 Fakultätsübergreifend / Sonstige Einrichtung
Permanent URI for this collectionhttps://elib.uni-stuttgart.de/handle/11682/16
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Item Open Access Die Ermittlung von Steuerprofilen zur Insulinabgabe mit programmierbaren Insulininfusionssystemen(1981) Schulz, Gerhard; Beyer, Jürgen; Nagel, Joachim H.; Strack, Thomas; Krause, Ulrich; Hassinger, Wieland; Cordes, UweDer Insulinverbrauch und die Form der Insulinabgabeprofile bei intravenöser Insulintherapie mit nicht rückgekoppelten Infusionsgeräten wurde bisher nur rein empirisch ermittelt. Dabei war die Form der Insulinabgabeprofile nicht zuletzt auch von den technischen Möglichkeiten des Dosiergerätes abhängig. Unser Ziel war es, Grundsätze für die Blutzuckerführung mit Open-Loop-Systemen zu entwickeln. Die Insulinprofile sollten dem Blutzuckeranstieg und Abfall nach den Mahlzeiten möglichst gut angepaßt sein und individuell programmiert werden können, so daß der Patient zu den Mahlzeiten das entsprechende Programm abrufen kann.Item Open Access Signal fidelity requirements for deriving impedance cardiographic measures of cardiac function over a broad heart rate range(1993) Hurwitz, Barry E.; Shyu, Liang-Yu; Lu, Chih-Cheng; Reddy, Sridhar P.; Schneiderman, Neil; Nagel, Joachim H.Our findings indicate that the impedance cardiogram spectrum extends from DC to 50 Hz. Any amplifier with an upper band limit less than 50 Hz can be expected to produce attenuation and distortion of the impedance cardiogram. This signal attenuation may be systematically enhanced under conditions of high heart rate when a greater proportion of signal energy will be in the upper frequency range of the impedance cardiogram spectrum. Therefore, the present study was designed to assess the influence of amplifier bandwidth on dZ/dtmax, stroke volume, and systolic time intervals (LVET, PEP, QZ, QX). Simultaneously measured ΔZ and dZ/dt signals from two impedance cardiographs, with corner frequencies of 120 and 60 Hz for the ΔZ and 50 and 15 Hz for dZ/dt channels, were contrasted over a broad range of heart rate (70–150 bpm). In addition to the analog dZ/dt signals obtained from the instruments, the ΔZ signals were digitally converted to dZ/dt by off-line digital differentiation with a 50 Hz corner frequency. The results demonstrated that the measurements with the 15 Hz corner frequency, when compared with the 50 Hz corner frequency measurements, systematically attenuated the dZ/dtmax amplitude and stroke volume measurements as heart rate increased. The attenuation of dZ/dtmax and stroke volume ranged from about 13% to 26% as heart rate increased from 70 to 150 bpm. When the upper bandlimit was 50 Hz, the dZ/dt signal had greater resolution of waveform events and produced less prolonged systolic time intervals. The 15 Hz amplifier differentially influenced the B point, Z-peak and X minimum, having no apparent effect on the temporal location of the B point, but delaying the Z-peak about 21.7 ms and the X minimum about 7.4 ms. These findings indicate that impedance cardiographs with insufficient upper bandlimits will differentially influence ICG-derived measurements as heart rate varies.Item Open Access Quantification of aortic stenosis based on the morphology of Doppler ultrasound signals using image processing techniques(1994) Zahn, Thomas P.; Nagel, Joachim H.; Agatston, Arthur S.A method was developed to evaluate the morphologic structure of continuous wave Doppler ultrasound signals in order to quantify aortic valve stenosis in the human heart. The systolic peaks of the Doppler signal were assigned digital images and the stability of shape information was tested for patients with low stroke volume and aortal fibrillation. The results indicate that the shape of the signal peaks remains stable despite variations in amplitude and duration. The shape information was then used to quantify the severity of aortic stenosis by optimally matching Doppler peak images to selected templates representing typical diagnostic patterns. The developed software is capable of automatic extraction of shape information from Doppler ultrasound signals in order to support the clinical decision about valve functioning and replacement.Item Open Access Digital signal processing of the fetal heart sound(1982) Kartmann, Peter; Schlotter, Claus M.; Zhou, Li Gao; Nagel, Joachim H.; Schaldach, Max-Item Open Access Development of individual insulin infusion profiles for open loop infusion systems(1984) Strack, Thomas; Krause, Ulrich; Schulz, Gerhard; Beyer, Jürgen; Beutelspacher, Friedrich; Nagel, Joachim H.The computer program for the open loop infusion device simulated the feed-back structure of a closed loop insulin secretion control by an algorithm based upon a theoretical postprandial blood sugar profile. Fifteen unstable juvenile onset insulin requiring diabetics could be well controlled after two to three days of an intravenous open loop insulin infusion program. The programs consisted of two constant basal rates and superimposed wavy step profile programs activated at the beginning of each meal.The preabsorptive bolus or cephalic phase was an additional tool both for improved postprandial blood sugar control and further reduction of insulin consumption.The programmable insulin infusion device proved as a valuable tool for the study of a sophisticated insulin infusion profile suitable as well for open loop as for closed loop insulin infusion systems.Item Open Access Patient motion compensation for renal scintigraphic studies by a fast correlation image registration method(1994) Georgiou, Michalis F.; Sfakianakis, George N.; Nagel, Joachim H.; Cideciyan, Artur V.A computer method has been developed to compensate for patient motion which is a serious problem in real scintigraphic studies. The developed computer method compensates for translational and rotational differences between images acquired while the patient was not moving and images acquired after the occurrence of motion.Item Open Access Diagnosis and modelling of Alzheimer's disease through neural network analyses of PET studies(1990) Kippenhan, Jonathan Shane; Nagel, Joachim H.The back-propagation neural network algorithm was applied to the analysis of regional patterns in cerebral function, as demonstrated in positron emission tomography (PET). A trained network was able to successfully distinguish PET scans of normal subjects from PET scans of Alzheimer's Disease patients. It is concluded that the combination of PET and neural networks is a useful diagnostic tool for Alzheimer's Disease. A new paradigm for back-propagation learning is discussed which emphasizes its similarity to template matching. It is demonstrated that, under certain circumstances, the back-propagation network can be used as an estimation tool, as well as a classification tool, i.e., a trained neural network can indicate the criteria by which its classifications are performed.Item Open Access Fast multi-modality image matching(1989) Apicella, Anthony; Kippenhan, Jonathan Shane; Nagel, Joachim H.Automated image matching has important applications, not only in the fields of machine vision and general pattern recognition, but also in modern diagnostic and therapeutic medical imaging. Image matching, including the recognition of objects within images as well as the combination of images that represent the same object or process using different descriptive parameters, is particularly important when complementary physiological and anatomical images, obtained with different imaging modalities, are to be combined. Correlation analysis offers a powerful technique for the computation of translational, rotational and scaling differences between the image data sets, and for the detection of objects or patterns within an image. Current correlation-based approaches do not efficiently deal with the coupling of the registration variables, and thus yield iterative and computationally-expensive algorithms. A new approach is presented which improves on previous solutions. In this new approach, the registration variables are de-coupled, resulting in a much less computationally expensive algorithm. The performance of the new technique is demonstrated in the matching of MRI and PET scans, and in an application of pattern recognition in linear accelerator images.Item Open Access Digital analysis of high resolution fundus images(1992) Nagel, Joachim H.; Cideciyan, Artur V.Fundus photography is a common procedure in ophthalmology providing high resolution images of the inside back portion of the eye to diagnose diseases of the retina and the optic nerve, and to record their progress over time. In many instances, objective, quantitative, reproducible and reliable interpretation of fundus images requires their computerized analysis. A comprehensive system for digital analysis of high resolution fundus images has to address virtuallly all engineering aspects of medical image processing: restoration, segmentation, pattern recognition, and registration. Based on the specific application of investigating the tapetal-like reflex, a retinal reflection uniquely present in carriers of X-linked retinitis pigmentosa (XLRP), novel approaches to the various stages of image processing are presented, and applications in other areas of medical diagnostics are outlined.Item Open Access Differential patterns of dynamic cardiovascular regulation as a function of task(1993) Hurwitz, Barry E.; Nelesen, Richard A.; Saab, Patrice G.; Nagel, Joachim H.; Spitzer, Susan B.; Gellman, Marc D.; McCabe, Philip M.; Phillips, Donna J.; Schneiderman, NeilIn cardiovascular reactivity studies, interpretations of the processes supporting the blood pressure response may become problematic when systolic blood pressure, diastolic blood pressure, and heart rate all increase in response to a behavioral challenge. Therefore, in addition to evaluating these cardiovascular responses, this study examined cardiac output, total peripheral resistance and systolic time intervals derived from impedance cardiogram, electrocardiogram and phonocardiogram recordings during a speech Stressor, a mirror tracing task, and a foot cold pressor test. All of the behavioral Stressors elicited increases in blood pressure and heart rate, with the largest changes occurring during the overt speech. Based on the examination of the response patterns of the underlying hemodynamic variables it would appear that, in both men and women, the blood pressure increase during the speech preparation period was supported by increased cardiac output; the speech itself resulted in a mixed pattern of increased cardiac output and total peripheral resistance; whereas, the mirror tracing and cold pressor tasks produced increased total peripheral resistance. Although men and women produced similar response patterns to the behavioral challenges, sex differences in the estimates of myocardial contractility were observed during rest. These results provide evidence that different behavioral stressors can produce a distinct yet integrated pattern of responses, whose differences may be revealed, when impedance cardiography is used, to derive sufficient response measures for assessing dynamic cardiovascular processes.