Computer-supported collaborative work (CSCW) in biomedical signalvisualization and processing

A collaborative extension to a platform dedicated to signal visualization and processing is presented. The platform now allows geographically distant users to work together, in real time, on the same data (electroencephalographic signals). The extension is based on a client-server collaborative architecture using remote procedure call programming. Through this first implementation, general issues of computer-supported collaborative work are presented     

The organization of piriform cortex and the lateral olfactory tract following the loss of mitral cells in PCD mice

Homozygous Purkinje Cell Degeneration (PCD) mice exhibit a selective loss of olfactory bulb mitral cells (MCs) after 4 months of age. This selective degeneration leaves a subpopulation of denervated granule cells which establish new reciprocal dendro-dendritic synapses with unaffected tufted cells (TCs) (14). This suggests a capacity for plasticity in TCs and raises the question of whether a comparable degree of reorganization occurs in their axonal terminals in piriform cortex (PC) following the loss of MCs. Homozygous (experimental) and heterozygous (control) PCD mice were routinely perfused and processed for electron microscopy. A quantitative electron microscopic analysis was performed on radially oriented micrograph montages spanning from the pia into layer II of PC. After MC loss in the experimental animals there was a decrease in density of larger myelinated axons in the lateral olfactory tract (LOT). Myelinated axons in the LOT had a mean cross-sectional diameter of 1.26 +/- 0.04, and 0.81 +/- 0.025 microm in the control and experimental mice, respectively. In superficial layer I of PC, control mice had presynaptic axonal terminals from mitral and tufted cells with characteristic electron lucent (light) profiles establishing asymmetric synapses with pyramidal cell dendrites. In contrast, the experimental mice showed a decrease in electron lucent terminals and a robust increase in electron dense (dark) presynaptic associational terminals. Although the overall synaptic density did not differ between the control and experimental mice (16.40 +/- 0.94 and 18.10 +/- 0.96 synapses/100 microm2, respectively), an overall decrease in the thickness of Layer 1 suggests that the total number of synapses decreases following MC loss. In addition to the apparent increase of associational terminals, the diameter of terminal enlargements increased as well as the number of multiple synaptic contact per terminals in the experimental animal, suggesting further compensatory mechanisms for the loss of MC presynaptic terminals.     

Spatial analysis of intracerebral electroencephalographic signals in the time and frequency domain: identification of epileptogenic networks in partial epilepsy

Electroencephalography (EEG) occupies an important place for studying human brain activity in general, and epileptic processes in particular, with appropriate time resolution. Scalp EEG or intracerebral EEG signals recorded in patients with drug-resistant partial epilepsy convey important information about epileptogenic networks that must be localized and understood prior to subsequent therapeutic procedures. However, this information, often subtle, is 'hidden' in the signals. It is precisely the role of signal processing to extract this information and to put it into a 'coherent and interpretable picture' that can participate in the therapeutic strategy. Nowadays, the panel of available methods is very wide depending on the objectives such as, for instance, the detection of transient epileptiform events, the detection and/or prediction of seizures, the recognition and/or the classification of EEG patterns, the localization of epileptic neuronal sources, the characterization of neural synchrony, the determination of functional connectivity, among others. The intent of this paper is to focus on a specific category of methods providing relevant information about epileptogenic networks from the analysis of spatial properties of EEG signals in the time and frequency domain. These methods apply to either interictal or ictal recordings and share the common objective of localizing the subsets of brain structures involved in both types of paroxysmal activity. Most of these methods were developed by our group and are routinely used during pre-surgical evaluation. Examples are detailed. Results, as well as limitations of the methods, are also discussed.     

Familial epilepsy with unilateral and bilateral malformations of cortical development

BACKGROUND AND OBJECTIVE: A variety of biologic or synthetic materials have been used in brow suspension ptosis surgery. We describe extrusion and granuloma formation in 5 cases of congenital ptosis operated with Mersilene mesh sling. PATIENTS AND METHODS: Case reports with review of literature. RESULTS: Two cases of extrusion and 3 cases of granuloma formation were encountered in 79 eye lids of 52 (6.3%) patients performed for the treatment of congenital ptosis. Mersilene mesh fibers in the cut surface and a foreign body reaction were found by microscopic evaluation of tissue harvested at the time of surgical removal of the sling. CONCLUSION: Despite the operative precautions, the probability of extrusion and granuloma formation should be in mind in cases of congenital ptosis operated with Mersilene mesh sling, a synthetic material.     

Lymphoscintigraphy and radioguided biopsy of the sentinel axillary node in breast cancer

Lymphoscintigraphy associated with radioguided biopsy of the sentinel node (SN) is well established in clinical practice for melanoma. In breast cancer, the SN concept is similarly valid, and lymphoscintigraphy is a useful method for localizing the axillary SN. The aim of this study was to optimize the lymphoscintigraphy technique in association with a gamma ray detecting probe (GDP) for identifying and removing the SN in breast cancer patients. METHODS: Two-hundred fifty patients with operable breast tumor underwent lymphoscintigraphy before surgery. Three different size ranges of 99mTc-labeled colloid particles (<50, <80 and 200-1000 nm) were used, with either subdermal (above tumor) or peritumoral injection. Early and late scintigraphic images were obtained in anterior and oblique projections, and the skin projection of the detected SN was marked. Sentinel nodes were identified and removed with the aid of the GDP during breast surgery; they were tagged separately. Complete axillary dissection followed. In 40 patients, a blue dye was also administered in addition to subdermal radiolabeled colloid to compare blue dye mapping with lymphoscintigraphy localization. RESULTS: Lymphoscintigraphy successfully revealed lymphatic drainage in 245 of 250 patients (98%). The axillary SN was identified in 240 patients (96%). SN biopsy correctly predicted axillary node status in 234 of 240 patients (97.5%). Lymphoscintigraphy and GDP detected the SN most easily and consistently when 200-1000 nm colloid was administered subdermally in an injection volume of 0.4 ml. Blue dye mapping was successful in 30 of 40 patients (75%). In 26 of these patients, the dye and lymphoscintigraphy identified the same node; in 4 cases different nodes were identified. None of these four patients had axillary disease. CONCLUSION: Lymphoscintigraphy is a simple procedure that is well tolerated by patients. Sentinel node identification is more reliable when large-size radiolabeled colloids are injected in a relatively small injection volume (0.4 ml). Use of a GDP greatly facilitates precise pinpointing and rapid removal of the SN.     

Mining reproducible activation patterns in epileptic intracerebral EEG signals: application to interictal activity

The study of interictal transient events may substantially complement the analysis of seizures in the presurgical evaluation of intractable epilepsy. A comprehensive methodology of quantifying reproducibility of activation patterns in intracerebral electroencephalography signals is presented. It may be applied to various forms of transient epileptic events under the assumption that a time of occurrence may be assigned to them. In this paper, the method is used on two different forms of interictal events (interictal spikes or sharpwaves and transient bursts of fast activity). The methodology is based on signal processing and data mining algorithms and proceeds in three steps: (1) detection of transient paroxysmal events (monochannel event); (2) identification of quasisynchronous transient paroxysmal events (multichannel events); and (3) automatic extraction of similar activation patterns. Results show that the methodology allows reproducible sequential activation sets to be identified from signals recorded in four patients. Potential advantages of the method are discussed with respect to other approaches.