EP0633746A1 - Dispositif pour diagnostique des troubles circulatoires - Google Patents

Dispositif pour diagnostique des troubles circulatoires

Info

Publication number
EP0633746A1
EP0633746A1 EP93904284A EP93904284A EP0633746A1 EP 0633746 A1 EP0633746 A1 EP 0633746A1 EP 93904284 A EP93904284 A EP 93904284A EP 93904284 A EP93904284 A EP 93904284A EP 0633746 A1 EP0633746 A1 EP 0633746A1
Authority
EP
European Patent Office
Prior art keywords
examination
patient
verbal
computer
signal receiver
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP93904284A
Other languages
German (de)
English (en)
Inventor
Mihály BODO
István NAGY
János PEREDI
György THUROCZY
László OZSVALD
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
BODO Mihaly
Original Assignee
BODO Mihaly
Richter Gedeon Vegyeszeti Gyar RT
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by BODO Mihaly, Richter Gedeon Vegyeszeti Gyar RT filed Critical BODO Mihaly
Publication of EP0633746A1 publication Critical patent/EP0633746A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4884—Other medical applications inducing physiological or psychological stress, e.g. applications for stress testing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0002—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/0205—Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition

Definitions

  • the invention relates to a method for diagnosing circulatory irregularities, which enables an early detection of vascular diseases and a sorting out of the cerebrovascular affectedness and danger.
  • the invention also relates to the device used to implement the method.
  • various electro-diagnostic examinations are carried out one after the other in order to open up the circulatory irregularities - on the basis of the complaints of the patients.
  • Such examinations are e.g. the EKG (electrocardiography) and the EEG (electroencephalography) examinations, as well as the pulse wave measurement.
  • the doctor determines the diagnosis or gives the information representing the diagnostic value.
  • the greatest disadvantage of the current examination methods is that the individual examinations are carried out separately from one another in terms of space and time, generally not by the same physicians (the internists, cardiologists, angiologists, etc. work separately) and one after the other - i.e. not simultaneously - recorded information does not provide sufficiently accurate information about the condition of the person examined.
  • the information registered at different points in time in no way enables the acquisition of finer, more nuanced information from the relationships between the individual parameters, as well as the implementation of more decisive preventive and complex measures based on the same.
  • Another disadvantage of the current examination methods is, of course, that the patient has to go to the various diagnostic departments for the information required for differential diagnosis, which in many cases can only be obtained in laborious and cumbersome ways.
  • Another disadvantage of the current diagnostic examination methods is that they are not suitable for being able to determine the hardening of the arteries in a very early phase.
  • the object of the invention is to provide such a method for diagnosing the irregularities
  • REPLACEMENT LEAF in other words to determine the degree of human arteriosclerosis, which within a short time enables the complex and maximally detailed knowledge of the circulatory system of the examined person in a simple manner and thereby the possibility not only to select the optimal method or Offers methods of treatment or therapy, but also for a preventive intervention that occurs so early, for which the currently known examination and diagnostic methods do not offer any possibility.
  • the object of the invention is also to provide the contemporary device that can be used to implement the method.
  • the invention is based on the following findings:
  • ER SA TZBLATT an informational questionnaire (the questioning of the examined person) and the examination using instruments and the information resulting from these two sources provide the basis for the establishment of a diagnosis that surpasses any previous accuracy and level of detail, which also enables early preventive interventions offers.
  • the object was achieved in the sense of the invention with the aid of a method in the course of which arterial blood flow parameters are measured and registered and the diagnosis is made on the basis of the results obtained, the method being characteristic that a / the Patients are asked questions about their neurological condition and the answers are registered; b / in the patient
  • ERS A TZBLATT and the objective data of human arteriosclerosis are collected and measured numerically, on the one hand by recording such neurological symptoms that may indicate a disorder of the cerebral circulation, on the other hand by information that also highlights the dangerous factors (stress, smoking, high blood pressure, sugar- and heart disease, alcohol consumption).
  • the measurement and data processing of the physiological parameters take place in parallel or essentially in parallel within a short period of time, in the course of which, in addition to conventional data processing, an essential aspect is the detection of the information and relationships between the individual parameters and the flow thereof Diagnostic conclusions are (e.g.
  • EKG + pulse wave pulse delay
  • simultaneous measurement extending practically over the whole body (head, hand, foot), at least in three modalities, which are the EEG, the rheogram and the Rhe ⁇ e ⁇ zephalogram parallel to the EKG.
  • the method enables the simultaneous examination of such data and physiological parameters, which are not common in current medical practice and which realizes data management according to a new concept using the GRAL language, which is written down according to the principle of intermodal information management and with the help of the Time series analysis
  • the system builds within the mentioned co-existence emphasized on the measurement of the pathophysiological appearance, which is referred to as the weakening of the vessel wall - "wind boiler" function and which shows the decrease in the elasticity of the vessel walls with age or means vein calcification.
  • the method is suitable for numerical measurement of the deterioration (disease) occurring in the state of the circulatory system in the brain and the extremities, for its detection and exact tracking in the earliest phase, for differential diagnostics, for tracking the Medicinal effects, for intensive patient monitoring, for displaying or displaying and archiving the registered physiological parameters in the form of curves.
  • it is suitable for solving the decision-making (diagnostic) tasks and converting them into an expert system.
  • the verbal and device-based examination are carried out immediately one after the other. According to another feature of the method, first the majority of the verbal examination, then the device-based examination and then the remaining part of the verbal examination
  • the risk factors of arteriosclerosis in particular smoking, regular alcohol consumption, diabetes, heart disease and high blood pressure are determined in the course of the verbal examination.
  • the device used to implement the method is equipped with a computer and it is characteristic of the device that the computer is connected by means of a data transmission channel to a patient adaptation unit, the relay converter channels, data collection, which are used to register and forward the human physiological parameters ⁇ lerritt, power supply device, the computer, however, contains a patient-related adaptation card.
  • the data are stored in the dBASE database management system and the analog signal processing is carried out using the GRAL program.
  • the operation is expediently carried out with the aid of a patient adaptation unit connected in front of an IBM-compatible AT computer, which accordingly corresponds to the analog measurement (the physiological
  • FIG. 1 shows the schematic structure of an advantageous exemplary embodiment of the device which can be used to implement the method
  • Fig-i 2 the block diagram of the investigation
  • 3 shows the basic diagram of the measurement and data processing of the physiological functions
  • 4 shows the result of a frequency analysis carried out on the right and left half of the head of a patient (EEG examination)
  • 5 shows the result of the pulse wave measurement carried out on the right and on the left half of the head of the same patient to whom FIG. 4 relates.
  • the computer 2 (which can be, for example, an IBM-AT computer) of the device shown in FIG. 1 is connected by means of the data transmission channel 6 to the patient adaptation unit, designated as a whole by reference number 1.
  • the latter has the signal receiver converter channels 3a-3c, the data collector unit 4, the power supply unit 5 and the adaptation card 5a.
  • the signal receiver converter channels 3a-3c are used to record, amplify and forward the physiological signals of the patient.
  • the data collector unit 4 stores and forwards the measurement results and the information obtained by questioning (verbal examination).
  • the network connection device 5 which is connected to the signal receiver converter channels 3a-3c is advantageously a type of construction which corresponds to the regulations of IEC-601.
  • the data transmission channel 6 is a galvanically separated two-way data transmission channel for high-rate transmission.
  • Block 7 contains the identification questions and answers directed to the person of the patient (names, dates of birth, gender, weight, height, time of examination, etc.).
  • Block 8 contains the questions and answers relating to general diseases and risk factors (smoking, regular alcohol consumption,
  • Block 10 includes the questions and answers associated with neurology (cerebral vascular spasm), e.g. can be summarized in a questionnaire according to the following table:
  • Temporary impairment of vision Temporary disturbance or loss of vision in one eye ... X in both eyes ... X
  • Block 11 records the physiological examinations.
  • EEG electroencephalogram
  • An electrical examination of the heart (ECG, i.e. electrocardiogram) is carried out and the pulse is recorded on the one hand on the head (REG, i.e. rheo-electroencephalogram) and on the other hand on the extremities (rheographic or impulse pulse).
  • ECG electroencephalogram
  • REG head
  • rheo-electroencephalogram extremities
  • REPLACEMENT LEAF captures the evaluation of the results of the verbal examinations and the examinations carried out with the aid of devices, possibly supplemented by the results of other examinations from block 16 (not listed in the questionnaire); other such examinations are primarily aimed at determining the cholesterol level, the blood sugar level and also include ophthalmic examinations (fundus examination).
  • Block 14 represents the finding itself, i.e. the directional diagnosis, which can be compiled as part of the questionnaire according to the following table:
  • Block 15 represents the execution of a blood flow examination (Doppler control), whereby block 17 corresponds to the other examinations which may become necessary due to the finding (block 14).
  • Block 18 is the EEG block (electroencephalogram examination and device);
  • the arrow _a1 corresponds to the information obtained from the right side of the head, the arrow a2 corresponds to the information obtained from the left side thereof.
  • Block 19 represents the REG examination (rheo-encephalogram), the arrows _a 1, Z mean the same as in the case of block 18.
  • Block 20 relates to the instrument-based examination (measurement) of the pulse;
  • the arrows _k_1 and j ⁇ 2 mean the pulse signals of the right and left hand, whereas the arrows JI and 12 illustrate the pulse signals taken from the right and left leg.
  • Block 21 is the block of the EKG II derivation, the arrow j n the data transmission channel.
  • Block 23 corresponds to a computational activity, the fast Fourier analysis known per se, whereas block 22 represents a computational averaging operation, in each case separately; the middle formation operation takes about 40 seconds.
  • Block 22a is required for the operations illustrated by blocks 22 and 23 for computational reasons and illustrates the generation of the starting pulse coming from the EKG signal (the comparison signal is the "R" wave of the EKG).
  • Block 24 provides the pulse peak search, whereas block 25 the spectrum peak search associated with EEG; these are computational minimum-maximum search operations.
  • block 25 corresponds to the part of the questionnaire where the calculated values of the device-based examination (blocks 24 and 25) are entered in the questionnaire (see Table 4 later).
  • the values entering this block 25 are generally asymmetry values calculated by means of the computer; the values obtained from the right-hand body parts are regarded as the basis, and the values calculated from the left-hand side are related to these.
  • FIG. 4 the end result shown with a graphic illustration is the processes described in connection with the blocks 18, 23 and 25 in FIG. 3, ie in the specific case the illustration of the EEG spectrum examination of the two brain spheres.
  • the result of the instrument-based measurement of the left-hand hemisphere can be seen at the bottom, and that of the right-hand hemisphere at the top, which represents approximately the average of 40 measured values.
  • FIG. 4 proves that in the given concrete case there is no difference between the right-hand and left-hand hemispheres of the patient with regard to the electrical activity. It should be noted here that according to the viewpoint accepted worldwide in this respect, an approximately 30 ⁇ EEG amplitude difference is practically not pathological, but permissible. In the case according to FIG. 4, the percentage difference between the two hemispheres is negligible, since it is not a “natural” curve, but rather one that can be understood as a magnification that is several hundred times made by means of a computer.
  • FIG. 5 shows the end result shown with a graphical illustration of the processes described in connection with blocks 19, 22 and 24 according to FIG. 3; the pulse waves coming from the right and left brain hemisphere of the same patient (REG examination) are shown, as in FIG. 4. In this case too, the one from the bottom is shown
  • REPLACEMENT LEAF the pulse wave emanating from the right brain hemisphere (the average of about 40 measurements) is shown on the top left. 5 clearly shows that there is already a substantial difference between the two different pulse waves, since the distance e (which illustrates a period of time) shown in the pulse wave of the right-hand brain hemisphere already has a length that corresponds to a indicates pathological change.
  • the limit value accepted in international terms is 180 msec and this is substantially exceeded by the value corresponding to the distance.
  • the majority of the verbal examination is completed.
  • the electrodes required for the EEG and REG examinations were then fastened to the seated patient and then placed recumbently on the examination bed. Then the electrodes required for the ECG and pulse examination were placed on the right and left side
  • REPLACEMENT LEAF attached to the body (above the wrist and ankle).
  • the electrodes are connected to signal receiver converter channels, which form part of the patient adaptation unit (FIG. 1) connected to the computer mentioned, the inputs of which form.
  • the computer With the Prog ⁇ rammlauf the computer starts processing the measurement and ⁇ 'of the analog physiological signals, especially the EEG, REG and the ECG signals (Fig. 3). The following data were obtained as a result of this operation:
  • REPLACEMENT LEAF The graphical representation of the data of the first row (EEG frequency spectrum) was also carried out (FIG.).
  • the REG value (pulse wave * on the head) is also graphically visible in the second row. However, its presentation is absolutely not necessary, at most in the case when it is already noticeable at this stage of the examination that further circulatory examinations will also take place.
  • the greatest advantage of the invention is that it enables the detection of arteriosclerosis and the anomalies in the circulatory system that preceded it (not yet pathologically qualifiable) (decrease in the anode function of the vessel wall) at the earliest possible stage.
  • a deviation from the normal state can be shown at the time when no real calcifications have yet formed in the vessel wall, but whose elasticity has already been reduced, so that the invention is an ideal means of prevention.
  • the Doppler method which is currently considered the most up-to-date, can only be used to determine the consequences of the flow disorders that are already causing it
  • REPLACEMENT LEAF measure calcified vessel walls The method contains no invasive element, is gentle on the patient, pain-free and can be carried out within 30 minutes and is largely economical.
  • the patient receives the examination protocol containing the results and, if necessary, can use this for further examinations.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Physiology (AREA)
  • Physics & Mathematics (AREA)
  • Surgery (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Molecular Biology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Cardiology (AREA)
  • Developmental Disabilities (AREA)
  • Hospice & Palliative Care (AREA)
  • Child & Adolescent Psychology (AREA)
  • Social Psychology (AREA)
  • Psychology (AREA)
  • Psychiatry (AREA)
  • Computer Networks & Wireless Communication (AREA)
  • Pulmonology (AREA)
  • Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)

Abstract

Pendant le déroulement du procédé, des paramètres concernant le débit sanguin artériel sont mesurés et enregistrés. Les résultats obtenus permettent d'établir les diagnostics. Le procédé se caractérise en ce que: a) on pose au patient un certain nombre de questions se rapportant à son état neurologique et qu'on enregistre ses réponses; b) on mesure sur le patient et on enregistre, à l'aide d'appareils, l'activité cérébrale électrique, les pulsations rhéographiques au niveau de la tête et des membres, l'activité cardiaque électrique; c) les données recueillies à l'issue des examens effectuées sous forme de questions orales ainsi qu'à l'aide d'appareils sont exploitées pour permettre ensuite d'établir le diagnostic. Le dispositif permettant de mettre le procédé en oeuvre est équipé d'un ordinateur (2) et sa principale caractéristique est que cet ordinateur (2) est relié à l'aide d'un canal de transmission des données (6) à un circuit d'interface côté patient (1) qui contient des canaux de conversion (3a-3c) servant à enregistrer et à transmettre les paramètres physiologiques de l'homme, une unité de collecte des données (4) et un bloc d'alimentation secteur (5), alors que l'ordinateur comprend une carte d'adaptation (5a) spécifique du patient.
EP93904284A 1992-03-31 1993-02-08 Dispositif pour diagnostique des troubles circulatoires Withdrawn EP0633746A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
HU921079 1992-03-31
HU9201079A HUT64459A (en) 1992-03-31 1992-03-31 Process and apparatus for the diagnostics of cardiovascular
PCT/HU1993/000006 WO1993019665A1 (fr) 1992-03-31 1993-02-08 Dispositif pour diagnostique des troubles circulatoires

Publications (1)

Publication Number Publication Date
EP0633746A1 true EP0633746A1 (fr) 1995-01-18

Family

ID=10981651

Family Applications (1)

Application Number Title Priority Date Filing Date
EP93904284A Withdrawn EP0633746A1 (fr) 1992-03-31 1993-02-08 Dispositif pour diagnostique des troubles circulatoires

Country Status (6)

Country Link
US (1) US5584297A (fr)
EP (1) EP0633746A1 (fr)
AU (1) AU3573493A (fr)
CA (1) CA2133314A1 (fr)
HU (1) HUT64459A (fr)
WO (1) WO1993019665A1 (fr)

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US5788640A (en) * 1995-10-26 1998-08-04 Peters; Robert Mitchell System and method for performing fuzzy cluster classification of stress tests
US5771897A (en) * 1996-04-08 1998-06-30 Zufrin; Alexander Method of and apparatus for quantitative evaluation of current changes in a functional state of human organism
US6081743A (en) * 1996-10-02 2000-06-27 Carter; John Leland Method and apparatus for treating an individual using electroencephalographic and cerebral blood flow feedback
US6050950A (en) 1996-12-18 2000-04-18 Aurora Holdings, Llc Passive/non-invasive systemic and pulmonary blood pressure measurement
US6002952A (en) 1997-04-14 1999-12-14 Masimo Corporation Signal processing apparatus and method
US6021404A (en) 1997-08-18 2000-02-01 Moukheibir; Nabil W. Universal computer assisted diagnosis
US6080106A (en) * 1997-10-28 2000-06-27 Alere Incorporated Patient interface system with a scale
US6366804B1 (en) 1999-12-29 2002-04-02 Ge Medical Systems Information Technologies, Inc. Method of and apparatus for Identifying a portion of a waveform representing a physiological event
KR20030066325A (ko) * 2000-05-13 2003-08-09 오메가웨이브 엘엘씨 인간의 현재 기능적 상태와 적응성 반응의 비관혈적 측정장치 및 방법
WO2002087410A2 (fr) 2001-04-27 2002-11-07 Yacov Naisberg Diagnostic et traitement de troubles mentaux et recherche effectuee sur ces troubles
US8211031B2 (en) * 2002-01-15 2012-07-03 Orsan Medical Technologies Ltd. Non-invasive intracranial monitor
US20060116557A1 (en) * 2004-11-30 2006-06-01 Alere Medical Incorporated Methods and systems for evaluating patient data
CN1803085B (zh) * 2005-01-14 2011-11-09 费兆馥 一种人体亚健康状态的检测装置
TWI400062B (zh) * 2007-11-08 2013-07-01 私立中原大學 Medical devices that record physiological signals
US9307918B2 (en) 2011-02-09 2016-04-12 Orsan Medical Technologies Ltd. Devices and methods for monitoring cerebral hemodynamic conditions

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Also Published As

Publication number Publication date
WO1993019665A1 (fr) 1993-10-14
HUT64459A (en) 1994-01-28
HU9201079D0 (en) 1992-07-28
AU3573493A (en) 1993-11-08
US5584297A (en) 1996-12-17
CA2133314A1 (fr) 1993-10-01

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